| Background and objective:Mycoplasma pneumoniae(MP)is a common pathogen of respiratory infections,The incidence in China is 26%,And there is a growing trend.The clinical manifestations of mycoplasma infection are pharyngitis,bronchitis,pneumonia,but the clinical symptoms are atypical,especially in elderly patients.The basic diseases of the elderly,especially the basic diseases of the lung,make the clinical diagnosis more difficult and easy to miss.Studies have shown that mycoplasma pneumoniae infection is associated with bronchitis,asthma,chronic obstructive pulmonary disease,pulmonary fibrosis and other diseases,Can cause the acute aggravation of lung disease,thereby aggravate the old person disease pain,medical burden.Therefore,it is very important to study the epidemiology of mycoplasma pneumoniae infection.To provide support for early prevention,early diagnosis and early treatment.Methods:1.Data collection: double double blind entry method.2.Isolation and culture of mycoplasma: clinical samples were inoculated in rapid medium,after culture,the color of reagent bottle is bright yellow.3.Analysis of M.pneumoniae subtypes:The elderly patients who were hospitalized with respiratory tract infection in nanjing cuhk hospital were studied.The throat swaps of patients and epidemiological investigation were conducted On the basis of informed consent.After 16 Sr RNA gene amplified by Nest-PCR to detect M.pneumoniae clinical strains,we used MLVA analysis to compare characteristics of M.pneumoniae.4.Statistical analysis: Using excel to establish database and SPSS 19.0 or SAS 9.3 software to analyze the data.Qualitative data were described with rate or proportion and analyzed with Chisquare test or Fisher’s exact test.Quantitative data were described with means and standard orthe median and interquartile and analyzed with Wilcoxon test or Kruskal-Wallis H test.Results:1.Mycoplasma pneumoniae infection in the elderly: 326 cases of elderly respiratory tract infection,187 cases of males(MP(+)33 cases),139 cases of females(MP(+)29 cases),mean age 71.4 + 11.3years old,MP infection rate about 19.02%.The MP infection rate of older men was 17.65% andthat of older women was 20.86%.MP can be prevalent throughout the year,with the highestincidence in October,November and December.2.Clinical features of mycoplasma pneumoniae infection in old age: The majority ofpatients present with cough,cough and sputum,and half of them have a history ofhypertension,cardiovascular diseases,chest tightness and asthma,digestive tractsymptoms,peripheral symptoms and lung murmur.(1)basic existence lung diseasesgroups: MP infection group compared with the MP infection,the symptoms of diabetes,bosom is frowsty asthma is statistical significance(P < 0.05),the others such as allergies,hypertension,cardiovascular disease,smoking,drinking,fever,cough,sputum,such aslung’s no statistical significance.(2)there is no basic lung diseases groups: MP infectiongroup compared with the MP infection,the symptoms of diabetes,bosom is frowstyasthma is statistical significance(P < 0.05),the others such as allergies,hypertension,cardiovascular disease,smoking,drinking,fever,cough,sputum,such as lung’s nostatistical significance.3.Laboratory indicators of mycoplasma pneumoniae infection in old age:On the whiteblood cell count,neutrophils ratio,proportion of lymphocyte,neutrophilcount/lymphocyte count,troponin,c-reactive protein,erythrocyte sedimentation rate andother indicators statistical analysis,it was found that there was no statistically significantcorrelation between MP infection group and non-mp infection group.4.Detection method of mycoplasma pneumoniae:The detection rate of MP was 19.02%,andthe PCR method was 22.09%.PCR detection sensitivity 96.78%;Specificity 95.46%;Thepositive predictive value was 83.33%;Negative predictive value 99.21%;False positiverate 4.55%;False negative rate 3.23%.5.The MLVA classification of mycoplasma pneumoniae: 60 cases of successful typing,26cases of M3-5-6-2,26 cases of M3-6-6-2,6 cases of m4-5-7-2,and 2 cases ofm3-6-7-2.Statistical analysis of MP infection patients with m3-5-6-2 and mm-6-6-2,therewas no significant difference in age,gender,clinical manifestations,inflammatory markers and myocardial injury.Conclusions: 1.The annual incidence of MP in this region is high in autumn and winter,and diabetes is ahigh risk factor for MP infection.During 2016,the main types of MP were m3-6-2 andm3-6-2 genotypes.2.Most of the elderly patients with MP infection in our hospital show cough,cough andsputum,half of them have chest tightness,asthma and general discomfort.Comparedwith other bacterial infections,MP infection is more prominent in the elderly withsymptoms of upper sensation and chest tightness and asthma.3.For elderly MP infection,PCR method has high sensitivity and specificity,which issuperior to rapid culture method.It is suggested that this detection method can be selectedas an early diagnosis of MP infection. |
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