Abstract
Objective This study aimed to assess the consistency of Mycoplasma pneumoniae (MP)-DNA load in the respiratory tracts, its correlation with Mycoplasma pneumoniae pneumonia (MPP) manifestations, and its predictive value for refractory Mycoplasma pneumoniae pneumonia (RMPP).
Methods A retrospective study was performed on a cohort of MPP cases, including 215 patients
with positive nasopharyngeal aspirate (NPA) MP-DNA and 59 with positive bronchoalveolar
lavage fluid (BALF) MP-DNA. Patients were categorized into two groups based on MP-DNA
load: low load (≤106/mL) and high load (>106/mL). The consistency of MP-DNA load in NPA and BALF was determined by Spearman's
correlation coefficient. Clinical, laboratory, and radiological data were compared,
and the predictive value of NPA MP-DNA for RMPP was evaluated using the receiver operating
characteristic curve.
Results A strong correlation was observed between NPA and BALF MP-DNA. High-load groups in
both had longer fever durations and more pronounced increases in C-reactive protein,
lactate dehydrogenase, and ferritin (p < 0.05). Routine-dose glucocorticoids were more required for patients exhibiting
high MP-DNA loads, regardless of the source of the sample. The area under the curve
for predicting RMPP using NPA MP-DNA load was 0.861, with 92.9% sensitivity and 67.9%
specificity at a cutoff of 9.5 × 105/mL.
Conclusion The NPA MP-DNA load reflects the severity of pulmonary inflammatory response. Increased
MP-DNA load in both the upper and lower airways is associated with longer fever and
increased inflammation, indicating a need for glucocorticoid therapy. NPA MP-DNA can
predict RMPP with high sensitivity.
Keywords
Mycoplasma pneumoniae
- pneumonia - deoxyribonucleic acid
