Neumonía atípica en pacientes pediátricos, resistencia al tratamiento
DOI:
https://doi.org/10.56048/MQR20225.7.4.2023.1878-1897Palabras clave:
Mycoplasma pneumoniae, mecanismo de resistencia, mutación, deleciónResumen
Introducción: La neumonía atípica en pacientes pediátricos representa un desafío clínico significativo, caracterizado por su presentación clínica insidiosa y patrones de resistencia al tratamiento convencional. Esta condición es causada típicamente por patógenos que no se identifican en las pruebas rutinarias para neumonía, incluyendo Mycoplasma pneumoniae, Chlamydophila pneumoniae y Legionella spp.
Objetivo: La presente investigación tuvo como finalidad revisar la literatura científica actual referente a la neumonía atípica en pacientes pediátricos, con énfasis en la resistencia al tratamiento.
Metodología: Se efectuó un estudio bibliográfico minucioso en repositorios de datos como PubMed, Scopus y Google Scholar, utilizando palabras clave como “neumonía atípica pediátrica”, “resistencia antibiótica” y “tratamiento”. El conjunto final seleccionado abarcó 45 publicaciones que cumplieron los requisitos de inclusión predefinidos.
Resultados: La investigación destacó un patrón emergente de resistencia a macrólidos en M. pneumoniae, con tasas que varían geográficamente. La presentación clínica de casos resistentes no difiere significativamente de la neumonía típica, aunque se observa una duración prolongada de síntomas.
Conclusiones: subrayan la necesidad de protocolos diagnósticos más eficientes que identifiquen rápidamente patógenos y su resistencia. Es crucial adaptar los tratamientos a la resistencia local y reforzar la prevención mediante vacunación y control de infecciones. La investigación para desarrollar nuevas terapias antimicrobianas y alternativas de tratamiento para estos pacientes es fundamental. La prevención y una estrategia de tratamiento informada y actualizada se vuelven esenciales para combatir esta condición creciente en la población infantil.
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Ahn, J. G., Cho, H.-K., Li, D., Choi, M., Lee, J., Eun, B.-W., ... & Lee, J. (2021). Efficacy of tetracyclines and fluoroquinolones for the treatment of macrolide-refractory Mycoplasma pneumoniae pneumonia in children: A systematic review and meta-analysis. BMC Infectious Diseases, 21(1). https://doi.org/10.1186/s12879-021-06508-7
Bermudez, A., Hoberman, A., & Diaz, A. (2020). Neumonía en niños: epidemiología, diagnóstico y tratamiento. Enfermedades Infecciosas y Microbiología Clínica, 38(6), 282–288.
Chen, Y.-C., Hsu, W.-Y., & Chang, T.-H. (2020). Macrolide-resistant Mycoplasma pneumoniae infections in pediatric community-acquired pneumonia. Emerging Infectious Diseases, 26(7). https://wwwnc.cdc.gov/eid/article/26/7/20-0017_article
Elkolaly, R. M., & Shams Eldeen, M. A. (2019). Easy and rapid diagnosis of Mycoplasma pneumonia: is it possible? Egyptian Journal of Bronchology, 13(3), 394–402. https://doi.org/10.4103/ejb.ejb_46_18
Goldman, R. D., McGregor, S., Marneni, S. R., Katsuta, T., Griffiths, M. A., Hall, J. E., ... & Gelernter, R. (2020). Willingness to vaccinate children against influenza after the coronavirus disease 2019 pandemic. The Journal of Pediatrics, 228, 87-93.e2. https://doi.org/10.1016/j.jpeds.2020.07.054
Guo, D.-X., Hu, W.-J., Wei, R., Wang, H., Xu, B.-P., Zhou, W., et al. (2019). Epidemiology and mechanism of drug resistance of Mycoplasma pneumoniae in Beijing, China: A multi-center study. Bosnian Journal of Basic Medical Sciences, 19(3). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716100/
Han, H. Y., Park, K. C., Yang, E.-A., & Lee, K.-Y. (2021). Macrolide-resistant and macrolide-sensitive Mycoplasma pneumoniae pneumonia in children treated using early corticosteroids. Journal of Clinical Medicine, 10(6), 1309. https://doi.org/10.3390/jcm10061309
Hsiung, C., Ma, H.-Y., Lu, C.-Y., Yen, T.-Y., Chi, H., Liau, Y.-J., ... & Chiu, C.-H. (2022). Children with Mycoplasma pneumoniae infection in Taiwan: Changes in molecular characteristics and clinical outcomes. Journal of the Formosan Medical Association, 121(11), 2273–2280. https://doi.org/10.1016/j.jfma.2022.07.002
Hu, J., Ye, Y., Chen, X., Xiong, L., Xie, W., & Liu, P. (2022). Insight into the pathogenic mechanism of Mycoplasma pneumoniae. Current Microbiology, 80(1). https://pubmed.ncbi.nlm.nih.gov/36459213/
Jacobs, E., Ehrhardt, I., & Dumke, R. (2015). New insights in the outbreak pattern of Mycoplasma pneumoniae. International Journal of Medical Microbiology, 305(7), 705-708. https://pubmed.ncbi.nlm.nih.gov/26319941/
Jung, Y., Hee, E., Lee, E., Kim, C.-H., Lee, Y. J., Kim, H.-B., et al. (2022). Clinical characteristics of macrolide-refractory Mycoplasma pneumoniae pneumonia in Korean children: A multicenter retrospective study. Journal of Clinical Medicine, 11(2), 306. https://pubmed.ncbi.nlm.nih.gov/35054002/
Kawakami, N., Namkoong, H., Saito, F., Ishizaki, M., Yamazaki, M., & Mitamura, K. (2021). Epidemiology of macrolide-resistant Mycoplasma pneumoniae by age distribution in Japan. Journal of Infection and Chemotherapy, 27(1), 45–48. https://doi.org/10.1016/j.jiac.2020.08.006
Korppi, M. (2017). Non-specific host response markers in the differentiation between pneumococcal and viral pneumonia: what is the most accurate combination? Pediatric Infectious Disease Journal, 36(7), 693–696.
Kuo, C.-Y., Tsai, W.-C., Lee, H.-F., Ho, T.-S., Huang, L.-M., Shen, C.-F., et al. (2021). The epidemiology, clinical characteristics, and macrolide susceptibility of Mycoplasma pneumoniae pneumonia in children in Southern Taiwan, 2019–2020. Journal of Microbiology, Immunology, and Infection, 55(4). https://www.sciencedirect.com/science/article/pii/S1684118221001973
Lee, H., Choi, Y. Y., Sohn, Y. J., Kim, Y. K., Han, M. S., Yun, K. W., ... & Kim, K.-H. (2021). Clinical efficacy of doxycycline for treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children. Antibiotics, 10(2), 192. https://doi.org/10.3390/antibiotics10020192
Leng, M., Yang, J., & Zhou, J. (2023). The molecular characteristics, diagnosis, and treatment of macrolide-resistant Mycoplasma pneumoniae in children. Frontiers in Pediatrics, 11, 1115009. https://www.frontiersin.org/articles/10.3389/fped.2023.1115009/full
Liu, X., Shen, X., Chang, L., & Xu, W. (2019). Epidemiology and clinical presentation of children hospitalized with mycoplasma pneumonia in Beijing, China between 2010 and 2017. BMC Infectious Diseases, 19(1), 783.
Mateo, J., Terance, A., & Goyal, R. (2022). Atypical bacterial pneumonia. Indian Academy of Pediatrics (IAP). https://es.scribd.com/document/622859048/10-STANDARD-TREATMENT-GUIDELINES-2022-Atypical-Bacterial-Pneumonia-en-es
McAuley, A. J., Kuiper, M. J., Durr, P. A., Bruce, M. P., Barr, J., Todd, S., ... & Vasan, S. S. (2020). Experimental and in silico evidence suggests vaccines are unlikely to be affected by D614G mutation in SARS-CoV-2 spike protein. npj Vaccines, 5(1), 96. https://www.nature.com/articles/s41541-020-00246-8
Miyashita, N. (2022). Atypical pneumonia: Pathophysiology, diagnosis, and treatment. Respiratory investigation, 60(1), 56-67. https://www.sciencedirect.com/science/article/abs/pii/S2212534521001775
Nakamura, Y., Oishi, T., Kaneko, K., Kenri, T., Tanaka, T., Wakabayashi, S., et al. (2021). Recent acute reduction in macrolide-resistant Mycoplasma pneumoniae infections among Japanese children. Journal of Infection and Chemotherapy, 27(2), 271–276. https://www.jiac-j.com/action/showPdf?pii=S1341-321X(20)30366-4
Oishi, T., & Ouchi, K. (2022). Recent trends in the epidemiology, diagnosis, and treatment of macrolide-resistant Mycoplasma pneumoniae. Journal of Clinical Medicine, 11(7), 1782. https://pubmed.ncbi.nlm.nih.gov/35407390/
Olson, D., Watkins, L. K. F., Demirjian, A., Lin, X., Robinson, C. C., Pretty, K., ... & Dominguez, S. R. (2015). Outbreak of Mycoplasma pneumoniae–associated Stevens-Johnson syndrome. Pediatrics, 136(2), e386-e394. https://publications.aap.org/pediatrics/article-abstract/136/2/e386/33743/Outbreak-of-Mycoplasma-pneumoniae-Associated
Pereyre, S., Goret, J., & Bébéar, C. (2016). Mycoplasma pneumoniae: current knowledge on macrolide resistance and treatment. Frontiers in microbiology, 7, 974. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4916212/
Pneumonia Etiology Research for Child Health (PERCH) Study Group. (2019). Aetiology of severe pneumonia in children in developing countries. Pediatric Infectious Disease Journal, 38(6), e131–e140.
Saraya, T. (2016). The history of Mycoplasma pneumoniae pneumonia. Frontiers in microbiology, 7, 364. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801885/
Shim, J. Y. (2020). Current perspectives on atypical pneumonia in children. Clinical and Experimental Pediatrics, 63(12), 469. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7738772/
Subspecialty Group of Respiratory Diseases, The Society of Pediatrics, Chinese Medical Association. (2018). The interpretation of “2017 Clinical Practice Guidelines for the Management of Community-Acquired Pneumonia in Infants and Children under 5 Years of Age”. Zhonghua Er Ke Za Zhi, 56(4), 263–269.
Tong, L., Huang, S., Zheng, C., Zhang, Y., & Chen, Z. (2022). Refractory Mycoplasma pneumoniae pneumonia in children: early recognition and management. Journal of Clinical Medicine, 11(10), 2824. https://www.mdpi.com/2077-0383/11/10/2824
Torres, A., Lee, N., Cilloniz, C., Vila, J., & Van der Eerden, M. (2018). Laboratory diagnosis of pneumonia in the molecular age. European Respiratory Journal, 52(6), 180116.
Waites, K. B., Ratliff, A., Crabb, D. M., Xiao, L., Qin, X., Selvarangan, R., ... & Atkinson, T. P. (2019). Macrolide-resistant Mycoplasma pneumoniae in the United States as determined from a national surveillance program. Journal of Clinical Microbiology, 57(11), e00968-19. https://doi.org/10.1128/JCM.00968-19
Wang, Y., Li, X., Ge, T., Xiao, Y., Liao, Y., Cui, Y., ... & Zhang, T. (2016). Probiotics for prevention and treatment of respiratory tract infections in children: A systematic review and meta-analysis of randomized controlled trials. Medicine, 95(31). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4979858/
Williams, D. J., Hall, M., Auger, K. A., et al. (2019). Timeliness of antibiotics for pediatric inpatients with community-acquired pneumonia. Hospital Pediatrics, 9(7), 530–537.
Zhang, W.-Z., Zhang, S.-J., Wang, Q.-Y., Li, Y.-D., Jing, H.-B., Hu, G.-Y., ... & Zhang, S. (2019). Outbreak of macrolide-resistant Mycoplasma pneumoniae in a primary school in Beijing, China in 2018. BMC Infectious Diseases, 19(1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6805422/
Zhou, Y., Wang, J., Chen, W., Shen, N., Tao, Y., Zhao, R., et al. (2020). Impact of viral coinfection and macrolide-resistant mycoplasma infection in children with refractory Mycoplasma pneumoniae pneumonia. BMC Infectious Diseases, 20(1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7447613/
Zhou, Y., Zhang, Y., Sheng, Y., Zhang, L., Shen, Z., & Chen, Z. (2014). More complications occur in macrolide-resistant than in macrolide-sensitive Mycoplasma pneumoniae pneumonia. Antimicrobial agents and chemotherapy, 58(2), 1034-1038. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3910883/
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