湖州地区儿童支原体感染横断面调查及耐药突变状况

Epidemiological characteristics of Mycoplasmainfection among children in Huzhou area

目的 调查湖州地区儿童肺炎支原体(Mycoplasma pneumoniae,MP)核酸阳性和耐大环内酯类药物基因突变情况,为临床合理防治MP感染提供依据。方法 回顾性收集湖州地区4家医院的9 631例儿童急性呼吸道感染咽拭子样本,采用real-time PCR技术进行MP核酸及耐药基因(23S rRNA)突变检测,并探讨其流行特征。结果 共检出MP阳性878例,阳性率为9.12%。在MP阳性样本中检出耐大环内酯类药物基因23S rRNA突变610例,耐药突变检出率为69.48%。男童MP阳性率(8.31%)低于女童(10.05%),差异有统计意义(χ^(2)=8.757,P=0.0301);不同性别儿童耐药突变率差异无统计意义(P>0.05)。儿童MP阳性率随年龄的增长呈上升趋势(χ^(2)趋势=289.46,P<0.001),耐药突变检出率在不同季节差异无统计学意义(χ^(2)=2.662,P>0.05)。结论 湖州地区MP感染多发于大年龄段儿童,女童高于男童。大环内酯类耐药突变率较高,需及时监测。

Objective To investigate the prevalence of Mycoplasma pneumoniae(MP)nucleic acid positivity and macrolide resistance-associated gene mutations in children with pneumonia in the Huzhou area,in order to provide evidence for the rational prevention and treatment of MP infections in clinical practice.Methods A retrospective collection of 9631 throat swab samples from children with acute respiratory tract infections in four hospitals in the Huzhou area was conducted.Real-time PCR technology was used to detect MP nucleic acid and macrolide resistance-associated gene mutations(23S rRNA).The epidemiological characteristics of MP were also explored.Results A total of 878 cases(9.12%)were detected with MP positive.Among the MP-positive samples,610 cases were found to have macrolide resistance-associated gene mutations in the 23S rRNA gene,with a detection rate of 69.48%.The positivity rate of MP in boys(8.31%)was lower than that in girls(10.05%),and the difference was statistically significant(χ^(2)=8.757,P=0.0301).However,there was no statistically significant difference in the rate of macrolide resistance-associated gene mutations between different genders of children(P>0.05).The positivity rate of MP in children showed an increasing trend with age(χ^(2) trend=289.46,P<0.001).There was no statistically significant difference in the detection rate of drug-resistant mutations among different seasons(χ^(2)=2.662,P>0.05).Conclusions MP infection is more common in older children in the Huzhou area,with a higher prevalence in girls compared to boys.Moreover,a relatively high rate of macrolide resistance-associated gene mutations was observed.These results highlight the need for timely monitoring of macrolide resistance in MP infections.