Questions and answers about Mycoplasma pneumoniae infection and Mycoplasma pneumonia

Mycoplasma pneumoniae infection, mycoplasma pneumonia, in fact, every year, in addition to the early peak of incidence, there is also a trend of younger age. The reasons for the high incidence this year, I personally believe are related to the following:

1. The incidence of various infectious diseases has increased, which may be related to the reduction of non-drug (such as mask) interventions.

2. The increased susceptibility of the population may be related to the decline in the immunity of the population after infection with the new crown.

3. There are many infectious diseases in autumn and winter, resulting in relatively insufficient public health services.

4. Due to the abuse of azithromycin in recent years, drug-resistant mycoplasma infection has indeed caused certain difficulties in clinical treatment.

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1. About prevention

Mycoplasma pneumoniae (MP) is the smallest known independent pathogenic microorganism, has no cell wall, and can be killed by 75% alcohol and chlorine-containing disinfectants (such as 84 disinfectant).

M. pneumoniae infects humans for about 1-3 weeks of incubation, and the incubation period is infectious until symptoms are relieved for several weeks.

Because it is mainly spread by droplets (cough, sneeze, nasal discharge), it is generally not very contagious in the absence of symptoms (incubation and convalescence).

All respiratory infections are prevented by the same – wash your hands frequently, ventilate more, wear masks when going to crowded places or caring for the sick.

After Mycoplasma pneumoniae infection, protective antibodies MP-IgG and MP-IgA are produced, but the protective effect is limited, and if the pathogen load is large, reinfection may also occur.

(Other questions and responses, Figures 1 and 2)

2. About symptoms

There are many pathogens that cause cough and fever as the main symptoms this season, in addition to Mycoplasma pneumoniae, there are also A stream, B stream, new crown, adenovirus, syncytial virus, etc., after infection, the early symptoms of the disease are similar, mild cases are also very similar to colds.

M. pneumoniae infection can be asymptomatic, mild cases can have no fever symptoms or fever symptoms are not obvious, and even cough is very mild.

Typical Mycoplasma pneumoniae infection in children and adults, the two symptoms are most prominent, one is persistent (1-3 weeks) moderate to high fever, and the other is irritating cough (dry cough, nocturnal cough is obvious). Infants and young children may present directly with dyspnea and wheezing.

Mycoplasma pneumonia refers to a disease in which infection with Mycoplasma pneumoniae, a pathogenic microorganism, affects the lungs of the lower respiratory tract.

The upper respiratory tract is mainly nasopharyngeal symptoms, nasal congestion, sneezing, sore throat, hoarseness, generally short fever, cough is not bad; The lower respiratory tract is mainly trachea, bronchi, pulmonary symptoms, cough, wheezing, chest tightness, dyspnea, generally fever lasts for a long time, cough is obviously serious.

(Other responses to questions, Figures 3 – 6)

3. About diagnosis

The same pathogen infection may have different symptoms, different pathogen infections may have similar symptoms, it is difficult to distinguish simply from the symptoms alone, and etiological testing is required.

Etiological testing, throat swab test (nucleic acid) MP-RNA can be done if possible, which is suitable for early diagnosis of infection. Or draw blood to test (antibody) MP-IgM, because MP-IgM infection can appear 4-5 days after the onset, can be detected about 7 days after the onset, so 5 days after the onset, 1 week within the MP-IgM test is negative, can not completely exclude MP infection, and because MP-IgM turns negative takes 12-16 weeks, so the detection of MP-IgM positive, can not directly confirm the recent MP infection - MP-IgM diagnosis is meaningful, depending on the titer change of the two tests before and after, If the first test is positive for MP-IgM1:160 (above) about 1 week after the onset of the disease, the MP-IgM titer increases significantly or decreases by more than 4 times 1-2 weeks after the second test.

If lower respiratory tract infection is suspected, diagnosis of mycoplasma pneumonia requires clinical aetiological ➕ testing ➕ and imaging findings.

(Other questions and responses, Figures 7 and 8)

4. About medication

M. pneumoniae infects the upper respiratory tract, as long as it does not progress to the lower respiratory tract, anti-Mycoplasma pneumoniae treatment is not recommended, and medication can be used for symptomatic care (fever and cough).

For mild cases of mycoplasma pneumonia, oral anti-Mycoplasma pneumoniae drugs are treated in addition to care for symptomatic care (fever and cough).

Severe mycoplasma pneumonia, symptomatic nursing medication ➕, anti-mycoplasma pneumoniae drug treatment, other (including hormone) comprehensive treatment ➕.

Unlike bacteria, Mycoplasma pneumoniae has no cell wall structure, so antibacterial drugs that act on the cell wall (familiar penicillin, cephalosporin antibiotics) are completely ineffective against Mycoplasma pneumoniae. Anti-mycoplasma pneumoniae drugs prefer macrolide antibacterial drugs (such as azithromycin), but due to the abuse of azithromycin in recent years, drug-resistant mycoplasma infection has occurred, which makes clinical treatment difficult.

(Other responses to questions, Figures 9 – Figures 16)

5. About vaccines

There is currently no vaccine for Mycoplasma pneumoniae. After the occurrence of infectious diseases, it is easy to be infected with other pathogens, especially infants and young children, so other vaccines should be actively vaccinated.

(Other questions and responses, Figures 17 and 18)