儿童肺炎支原体23S rRNA基因位点突变检测分析

Analysis of mutations detection in 23S rRNA gene locus of Mycoplasma pneumoniae among children

目的了解儿童肺炎支原体(MP)大环内酯类耐药基因(23SrRNA)位点突变,以及与临床资料的相关性。方法收集该院354份肺炎患儿的呼吸道标本,采用实时荧光定量PCR法检测MP及23SrRNA位点突变(A2063G或/和A2064G)情况,并将MP阳性患儿分成位点突变组和未突变组,比较两组之间的临床资料。结果 354份呼吸道标本中,166份检测为MP阳性(46.9%),且135份MP阳性标本中存在23SrRNA基因位点突变(阳性检出率81.3%),31份未检测到23SrRNA基因位点突变。分析突变组和非突变组的临床资料发现两组在年龄和性别方面比较差异无统计学意义(P>0.05),但突变组的重症肺炎和肺外并发症发生率高于未突变组(P<0.05),且平均住院时间和平均发热时间均较未突变组长(P<0.05)。结论 MP 23SrRNA基因位点突变的较高检出率提示MP对大环内酯类耐药率较高,这为临床MP的感染、治疗提供一定的参考依据。

Objective To understand the mutations of macrolide resistance gene locus（23SrRNA）of Mycoplasma pneumoniae（MP）and its correlation with clinical features.Methods A total of 354 respiratory tract samples were collected from children patients with pneumonia.MP and its mutations in 23 SrRNA gene locus were detected by real-time PCR.The children cases of MP positive were divided into the mutation group and non-mutation group.Then the clinical data were compared between the two groups.Results Among 354 respiratory tract samples,166cases（46.9%）were MP positive,moreover the mutation of 23 SrRNA gene locus existed in 135 MP positive samples with the positive detection rate of 81.3%,while no 23 SrRNA gene locus mutations were detected in 31 samples.Analyzing the clinical data of the mutation group and non-mutation group found that there was no statistical difference in the aspects of age and gender between the two groups.The occurrence rates of severe pneumonia and extrapulmonary complications in the mutation group were higher than those in the non-mutation group（P〈0.05）,moreover the average hospitalization time and fever duration in the mutation group were longer than those in the non-mutation group（P〈0.05）.Conclusion 23 SrRNA gene locus mutation has higher detection rate,prompting that MP shows high resistant rate to macrolides,which could provide a certain basis for treatment of MP infections.