摘要
目的了解成人及青少年社区获得性肺炎(CAP)中肺炎支原体(MP)感染状况及其对常用抗菌药物的敏感性,明确MP对大环内酯类的耐药机制。方法 2010年10月-2012年3月129例CAP患者取急性期咽拭子标本进行肺炎支原体分离培养,应用聚合酶链反应(PCR)对临床分离株进行分子鉴定;采用微量稀释法测定肺炎支原体对大环内酯类、喹诺酮类及四环素类抗菌药物的最低抑菌浓度(MIC);对大环内酯类耐药株进行23S rRNA基因测序,并与标准菌株MPFH(ATCC 15531)基因序列对比分析。结果 129例CAP患者咽拭子标本中共分离肺炎支原体20株,分离率15.50%;对四环素类及氟喹诺酮类敏感性较好,对大环内酯类抗菌药物均耐药,耐药机制均为23SrRNA基因2063位点由A突变为G。结论肺炎支原体对大环内酯类抗菌药物耐药形式严峻,23SrRNA基因位点突变是耐药性产生的主要机制。
OBJECTIVE To investigate the prevalence of Mycoplasma pneumoniae infection in the adults and teenagers with community-acquired pneumonia （CAP） ,observe the drug susceptibility to the commonly used antibiotics ,and define the drug resistance mechanisms to the macrolides .METHODS From Oct 2010 to Mar 2012 , the throat swab specimens were collected during the acute stage to isolate and culture the M .pneumoniae .The molecular identification of the clinical isolates was performed by using polymerase-chain-reaction , the minimal inhibitory concentrations （MICs） of macrolides ,quinolones ,and tetracyclines were determined with the use of microdilution method .The 23S rRNA gene sequencing was performed for the macrolides-resistant strains and was compared with the gene sequencing of the standard strain MPFH （ATCC 15531） .RESULTS A total of 20 strains of M .pneumoniae have been isolated from the throat swab specimens obtained from the 129 CAP patients ,with the isolation rate of 15 .50% ;the strains were highly susceptible to tetracyclines and fluoroquinolones and were resistant to all the macrolides ,and both of the resistance mechanisms were the mutation of locus 2063 of 23 rRNA from A to G .CONCLUSIONS The situation of the drug resistance of M .pneumoniae to macrolides is harsh ,and the mutation of locus of the 23S rRNA is the major drug resistance mechanism .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第20期5027-5029,共3页
Chinese Journal of Nosocomiology
基金
烟台市科技发展基金资助项目(2012072)
关键词
肺炎支原体
社区获得性肺炎
最低抑菌浓度
大环内酯类
耐药
Mycoplasma pneumoniae
Community-acquired pneumonia
Minimal inhibitory concentration
Macrolide
Drug resistance
作者简介
通信作者：宋波，E-mail：bosong78@163．com
