PMC10351524_01
Timeline of the clinical course of the case and identification of A2063G mutation.
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C, pulse rate of 99 bpm, respiratory rate of 26 breaths per min, blood pressure of 102/65mmHg and blood oxygen saturation of 97%. Chest X ray and CT showed consolidation and multiple ground-glass density opacity in right lower lobe, and right pleural effusion, which were the signs of pneumonia (Figure 1). The patient suffered from persistent hyperpyrexia, chill, cough, sputum, shortness of breath, and headache (Figure 1). Further auxiliary examinations showed an elevation of CRP (76mg/L), deterioration of respiratory function and the range of pneumonia in Chest X-ray was expanded (Figure 1). Her clinical conditions improved, as shown in Figure 1, including temperature, respiratory symptoms, oxygenation situation and chest imaging.
The A2063G gene mutation in the result of mNGS.
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In the following AMR analysis, macrolide-resistance 23S ribosomal RNA gene was confirmed with read depth of 64 X for the A2063G mutation, which can decrease the affinity of macrolide with M. pneumoniae ribosome resulting in macrolide resistance (Figure 2).