富阳区儿童肺炎支原体感染及耐药分析

Mycoplasma pneumoniae infection and drug resistance among children in Fuyang District

目的了解杭州市富阳区儿童肺炎支原体(MP)感染及MP耐大环内酯类药物情况。方法收集2015年5月—2017年7月富阳区妇幼保健院1 104例0~14岁急性呼吸道感染儿童的临床资料和呼吸道标本,采用实时荧光定量PCR法检测MP及耐药基因(23S r RNA)突变情况。结果 1 104例急性呼吸道感染儿童检出MP阳性175例,阳性率为15.85%。MP阳性标本中检出23S r RNA突变115例,耐药率为65.71%。不同季节MP阳性率及耐药率差异有统计学意义(P<0.05);夏季(7—9月)MP阳性率及耐药率均较高,分别为25.74%和82.69%;冬季(1—3月)较低,分别为11.72%和40.63%(均P<0.008)。男、女患儿MP阳性率分别为15.36%和16.49%,耐药率分别为66.67%和64.56%,差异均无统计意义(P>0.05)。随着年龄的增长,患儿MP阳性率呈上升趋势(P<0.05),但耐药率未见变化趋势(P>0.05)。结论儿童感染MP与气候和年龄有一定关系,MP对大环内酯类药物的耐药率较高。

Objective In order to investigate the Mycoplasma pneumonia（MP） infection and drug resistance in children in Fuyang,Hangzhou,and to provide a rational basis for the clinical diagnosis and treatment of MP in children. Methods A total of 1104 respiratory tract samples were collected from children patients with pneumonia. MP and its mutations in 23 S r RNA gene locus were detected by real-time PCR. Then analyze pertinence between the clinical data and experimental results were conducted. Results Among 1104 respiratory tract samples,175 cases（15.85%） were MP positive. Moreover,the mutation of23 S r RNA gene locus existed in 115 MP positive samples with the positive infection rate of 65.71%. The infection rate（25.74%） and mutation rate（82.69%） in summer（Jul.-Sep.） was higher than other seasons, and the infection rate（11.72%） and mutation rate（40.63%） was the lowest in winter（Jan.-Mar.）. The infection rates of male and female children were 66.67% and 64.56%,and the mutation rates of male and female children were 66.67% and 64.56%. Conclusion MP infection may be related with climate and age. 23 S r RNA gene locus mutation has a higher detection rate,prompting that MP shows high resistant rate to macrolides.