儿童重症肺炎支原体肺炎临床特征及耐药基因突变研究

Research of clinical characteristics and drug resistence gene mutation of Severe Mycoplasma Pneumoniae Pneumonia in children

目的:了解儿童重症肺炎支原体肺炎(SMPP)的临床特征以及肺炎支原体对大环内酯类药物的耐药基因突变情况。方法:将103例肺炎支原体肺炎患儿分为SMPP组与非SMPP组,采用实时荧光定量PCR的方法检测患儿咽拭子标本肺炎支原体对大环内酯类药物常见耐药基因突变位点(A2063G和A2064G)的点突变,并对2组临床特征进行比较。结果:SMPP组与非SMPP组相比,年龄较大(7.68±2.52y VS4.53±2.48y,P=0.000),发热时间长(9.51±2.17d VS 5.69±2.03d,P=0.000),住院天数长(8.58±1.81d VS 6.09±1.05d,P=0.000),C反应蛋白高(20.67±15.29mg/L VS 14.52±12.23mg/L,P=0.019),并发症更多见;SMPP组耐药基因阳性率为70.97%,高于非SMPP组(P<0.05)。结论:SMPP病情重,并发症多,肺炎支原体对大环内酯类药物耐药基因突变是SMPP的危险因素。

[Objective]To study the clinical feature of children SMPP and drug resistence mutation gene related to macrolide antibiotics. [Method]103 cases of MPP were divided into two groups(SMPP and Non-SMPP) and the clinical features were observed. Mycoplasma pneumoniae were extracted from throat swab and the drug resistence mutation genes related to macrolide antibiotics were detected by Quantitative Real-time PCR. [Result]The older age(7. 68 ±2. 52 y vs 4. 53 ±2. 48 y,P =0. 000),longer duration of fever(9. 51 ±2. 17 d VS 5. 69 ±2. 03 d,P =0. 000) and length of stay(8. 58 ±1. 81 d vs 6. 09 ±1.05 d,P =0. 000),higher level of C-reactive protein(20. 67 ±15. 29 mg/L vs 14. 52 ±12. 23 mg/L,P =0. 019) were observed in SMPP group than in Non-SMPP group. More complications occurred in SMPP group than in Non-SMPP group. There was difference of incidence of drug resistence mutation gene between SMPP group(70. 97%) and Non-SMPP group(37.50%)(P <0. 05). [Conclusion]There were seriously ill and more complications in children with SMPP. It was a risk factor to children SMPP who existeddrugresistence mutation gene related to macrolide antibiotics of mycoplasma pneumoniae.