2019—2023年宁波市0~17岁住院患儿肺炎支原体感染及耐药基因突变流行特征分析

Epidemic characteristics of mycoplasma pneumoniae infection and drug-resistant gene mutations in hospitalized children aged 0-17 in Ningbo City from 2019 to 2023

分析2019—2023年宁波市0~17岁住院患儿的肺炎支原体(Mp)感染及耐药基因23S rRNA突变情况。采集2019—2023年在宁波大学附属妇女儿童医院因呼吸道感染住院的患儿咽拭子,对其进行实时荧光定量聚合酶链法检测,分析Mp感染及耐药基因(23S rRNA)突变情况。组间比较采用χ^(2)检验或Fisher确切概率法。结果显示,18 968例患儿的Mp总阳性率为30.37%(5 760/18 968),耐药基因总突变检出率为82.45%(4 749/5 760)。男性患儿Mp阳性率为29.26%,低于女性患儿31.67%(χ^(2)=12.948,P<0.001)。男性患儿Mp耐药基因突变检出率(82.52%)高于女性(82.37%,χ^(2)=0.021,P=0.885)。Mp阳性率随着年龄的增长而升高(χ^(2)=1 722.215,P<0.001),且Mp耐药基因突变检出率亦随着年龄的增长而升高(χ^(2)=13.152,P<0.001)。四季中,夏秋两季Mp总阳性率显著高于冬春两季(χ^(2)=1 085.149,P<0.001),其中2019年夏秋两季Mp阳性率高达38.26%和34.49%,而2020年夏秋两季Mp阳性率分别为2.55%、1.65%,为历年夏季和秋季阳性率最低,2023年夏秋两季Mp阳性率升至47.22%和51.06%。Mp耐药基因总突变检出率的四季差异无统计学意义。综上,宁波市Mp感染在夏秋季节高发,女性,7~17岁儿童更易感。宁波市Mp感染流行于2019年夏季,2020年COVID-19流行后,Mp阳性率快速下降,后处于低发状态,2023年限制性防控措施取消后,Mp感染又处于流行状态。Mp耐药基因(23S rRNA)突变检出率较高。

To analyze the infection and drug-resistant gene 23S rRNA mutations of mycoplasma pneumoniae(Mp)in hospitalized children aged 0-17 in Ningbo City from 2019 to 2023.Throat swabs were collected from hospitalized children with respiratory tract infections in Ningbo University Affiliated Women and Children′s Hospital from 2019 to 2023.They were subjected to real-time fluorescence quantitative polymerase chain reaction detection to analyze Mp infection and drug-resistant gene(23S rRNA)mutations.Intergroup comparisons were made by the Chi-square test or Fisher′s exact probability method.A total of 18968 hospitalized children were included,with a total positive rate of 30.37%(5760/18968).The total positive rate of drug-resistant gene mutations was 82.45%(4749/5760).The positive rate of Mp in male children was 29.26%,which was lower than that in female children(31.67%,χ^(2)=12.948,P<0.001).The positive rate of Mp drug-resistant gene mutations in male children was 82.52%,which was higher than that in female children(82.37%,χ^(2)=0.021,P=0.885).The positive rates of Mp increased with age(χ^(2)=1722.21,P<0.001).The positive rates of Mp drug-resistant gene mutations also increased with age(χ^(2)=13.152,P<0.001).In the four seasons,the total positive rate of Mp in summer and autumn was significantly higher than that in winter and spring(χ^(2)=1085.149,P<0.001).Among them,the Mp positive rates in the summer and autumn of 2019 were as high as 38.26%and 34.49%,while in the summer and autumn of 2020,the Mp positive rates were 2.55%and 1.65%,respectively,which were the lowest in previous years.In the summer and autumn of 2023,the Mp positive rates increased to 47.22%and 51.06%.There was no statistically significant difference in the detection rate of Mp drug-resistant gene mutations among the four seasons.In Conclusion,Mp infection was more prevalent in the summer and autumn in Ningbo city and females and children aged 7-17 were more susceptible.The epidemic of Mp infection in Ningbo occurred in the summer of 2019.After the COVID-19 pandemic in 2020,the positive rate of Mp rapidly decreased and later remained in a low incidence state.After the lifting of restrictive prevention and control measures in 2023,the Mp positive rate returned to an epidemic state.The positive rate of Mp drug-resistant gene(23S rRNA)mutations was relatively high.