儿童社区获得性肺炎分离的肺炎支原体耐药性分析

Analysis on drug resistance of Mycoplasma pneumoniae isolated from children with community acquired pneumonia

目的探讨石岩地区儿童社区获得性肺炎标本中分离的肺炎支原体对抗菌药物的耐药性。方法采集2013年2月至2015年4月,石岩疑似社区获得性肺炎儿童病例的咽拭子和血清标本共426例;咽拭子进行肺炎支原体培养,血清标本使用ELISA检测肺炎支原体抗体(Mp-IgM);阳性者采用支原体专用培养基进行培养鉴定与药敏检测。结果 426例儿童患者中确认为肺炎支原体感染的69例;药敏试验结果显示:肺炎支原体对红霉素耐药率为76.8%(53/69),对阿奇霉素耐药率为65.2%(45/69),对左氧氟沙星耐药率为18.8%(13/69),对四环素耐药率为4.3%(3/69),对米诺环素耐药率为4.3%(3/69),对庆大霉素耐药率24.6%(17/69)。结论肺炎支原体是石岩地区儿童社区获得性肺炎的主要病原体之一,其对大环内酯类药物耐药性较为严重,治疗时可选择敏感药物作为治疗药物,但是务必考虑这几种药物对儿童的毒性和造成的不良反应,切忌盲目用药。

Objective To explore the resistance to antibacterial drugs in Mycoplasma pneumoniae（Mp）isolated from the children with community acquired pneumonia（CAP）in Shiyan area.Methods A total of 426 throat swabs and serum samples were collected from children patients with suspected CAP in Shiyan area from Feb.2013 to Apr.2015.The throat swabs were used to culture Mp.The serum Mp-IgM was detected by ELISA,the positive samples were confirmed by plate culture method,meanwhile,the drug sensitivity test was taken.Results Among 426 children cases,69 cases were confirmed as Mp infection;the drug susceptibility test results showed that the resistance rate of Mp was 76.8（53/69）to erythromycin,65.2%（45/69）to azithromycin,18.8%（13/69）to levofloxacin,4.3%（3/69）to tetracycline,4.3%（3/69）to minocycline and 24.6%（17/69）to gentamicin.ConclusionMp is one of the key pathogens of CAP in Shiyan area,which is severely resistant to macrolide.The treatment should choose sensitive drugs as the treatment drug,but it is important to consider the toxicity and adverse reactions of these several kinds of drugs to children.The blind medication should be avoided.