儿童肺炎支原体耐药基因突变和特征分析

Resistance gene mutations and characteristics of Mycoplasma pneumoniae in children

目的了解湖州地区儿童肺炎支原体(Mycoplasma pneumoniae)的感染状况及其对大环内酯类药物耐药基因突变与特征。方法在湖州市第一人民医院儿科2021年1月—2022年7月共收集2623例0岁~14岁急性呼吸道感染患儿的咽拭子样本,采用real-time PCR法检测MP核酸阳性率及耐药基因(23S rRNA)的突变情况,并对住院患儿中有和无耐药突变的2组特征进行比较。结果2623例急性呼吸道感染患儿中,MP感染398例,感染率为15.17%;其中有288例检测到23S rRNA突变,耐药突变率为72.36%。女童MP阳性率高于男童(P<0.05);不同年龄组间MP感染率比较,差异有统计学意义(P<0.05),且MP感染率和耐药突变检出率均有随着年龄的增长而升高的趋势(P<0.05);不同季节中以夏季MP感染率最高(23.56%)。有耐药突变的患儿CRP更高,住院时间和治疗时间更长,应用大环内酯类药物后退热时间,呼吸道症状持续时间更长(P<0.05)。结论本地区MP感染可能与性别、年龄和季节等因素相关,MP对大环内酯类药物的耐药率较高,且有耐药突变的患者疗效较差。

Objective This paper aims to investigate the infection rate of Mycoplasma pneumoniae(MP)among children in Huzhou area,and also to investigate the characteristics and mutations of MP resistance genes to macrolides.Methods Throat swab samples were collected from 2623 children aged 0-14 years with acute respiratory tract infection in the Department of Pediatrics,Huzhou First People's Hospital from January 2021 to July 2022.Real-time PCR was used to detect the positive rate of MP nucleic acid and the mutation of drug resistance gene(23S rRNA).The characteristics of two groups of children with and without drug resistance mutations were compared.Results Among 2623 children with acute respiratory tract infection,MP infection was detected in 398 cases,the infection rate was 15.17%,and 23S rRNA mutation was detected in 288 cases,and the drug resistance mutation rate was 72.36%.The positive rate of MP in girls was higher than that in boys(P<0.05).There was statistical significance on the differences in MP infection rate among different age groups(P<0.05),and the infection rate of MP and the detection rate of drug resistance mutation increased with the increase of age(P<0.05).The infection rate of MP was the highest in summer(23.56%).The highest MP infection rate was found in summer(23.56%).Children with drug-resistant mutations had higher CRP,longer hospital stays and treatment,longer fever resolution after macrolides,and longer duration of respiratory symptoms(P<0.05).Conclusion MP infection in this area may be related to gender,age,season and other factors.The drug resistance rate of MP to macrolides is high,and the treatment efficacy of patients with drug resistance mutations is poor.