| 摘要: |
| 目的：了解儿童肺炎支原体肺炎（MPP）对大环内酯类抗生素的耐药情况，观察阿奇霉素治疗耐药MPP的临床疗效。方法：于2012年10月至2014年3月采集儿科病房疑似MPP患儿咽拭子标本共100例，应用巢式PCR扩增及DNA测序检测红霉素作用靶位23SrRNA基因。在此基础上将患儿分为敏感组（MS-MPP）及耐药组（MR-MPP），比较两组患儿对阿奇霉素治疗反应的差异。结果：经PCR扩增，100例咽拭子标本中91例阳性，26例无点突变，65例存在点突变，其中58例为2063位A→G点突变，7例为2064位A→G点突变，耐药率65.7%。32例MR-MPP患儿与17例MS-MPP患儿比较，阿奇霉素治疗后敏感组发热时间、总热程、住院时间均短于耐药组，差异有统计学意义（P<0.05）。结论：儿童MPP耐药情况严重，对阿奇霉素治疗反应性降低，发热时间、总热程、住院时间延长。 |
| 关键词: 肺炎支原体 肺炎 耐药 阿奇霉素 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2018.12.007 |
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| 基金项目:廊坊市科学技术研究与发展计划项目，编号2012013026。 |
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| Observation of Macrolide-Resistance and Azithromycin Clinical Efficiency in Children’s Mycoplasma Pneumoniae Pneumonia |
| Han Xu, Wen Huimin, Miao Naiying, Wang Caihong |
| (Central Hospital of China National Petroleum Corporation, Hebei Langfang 065000, China) |
| Abstract: |
| Objective: To observe macrolide-resistance and azithromycin clinical efficiency in children’s Mycoplasma pneumoniae pneumonia (MPP). Methods: 100 throat swab specimens were collected from 100 inpatient children suspected with MPP from October 2012 to March 2014, and erythromycin target site 23SrRNA gene were determined by nested PCR and DNA sequencing. Patients were divided into two groups: macrolide-susceptible MPP (MS-MPP) and macrolide-resistant-MPP (MR-MPP), azithromycin efficiency were compared between two groups. Results: 91 of 100 specimens were positive by nested PCR. DNA sequencing showed 26 had no mutation in 23SrRNA, 65 had point mutation, among them 58 had A→G mutation at 2063, 7 had A→G mutation at 2064. The ratio with macrolide-resistant gene were 65.7%. 32 MR-MPP and 17 MS-MPP patients showed significant differences in febrile days after azithromycin therapy（P=0.026）, total febrile days（P=0.040）, length of stay（P=0.009）. Conclusion: Macrolide-resistance is severe in children，s MPP, clinical efficiency of azithromyc was lower in MR-MPP patients, febrile days after azithromycin therapy, total febrile days and length of stay were longer. |
| Key words: Mycoplasma pneumoniae Pneumonia Resistance Azithromycin |
