| 摘要: |
| 目的:探究 23S rRNA 基因检测在儿童肺炎支原体肺炎(MPP)大环内酯类药物耐药中的作用。 方法:回顾性分析 2022 年
10 月至 2023 年 11 月于六安市人民医院住院治疗的 104 例肺炎支原体(MP)感染患儿,采集所有患儿的咽拭子样本,应用药敏
试验检测常用抗菌药物对 MP 的敏感性,观察并分析 MPP 患儿的耐药情况,根据药敏试验结果将患儿分为耐药组与非耐药组,
同时采用实时荧光定量 PCR 法(RT-qPCR)检测 MP-DNA 载量,并对其与抗菌药物耐药性的关系进行分析,应用 PCR 基因测序
对 23S rRNA Ⅴ区 2063 位点基因进行检测,并对 2063 位点基因型与抗菌药物耐药性的关系进行分析,同时对 23S rRNA Ⅴ区
2063 位点基因型与 MP-DNA 载量的关系进行对比分析。 结果:检测结果显示,MP 在大环内酯类抗菌药物中的耐药性较高,其
中在红霉素与罗红霉素药物中的耐药性最高,分别为 71. 15%、73. 08%,阿奇霉素、克拉霉素、乙酰螺旋霉素、克林霉素、耐药率
分别为 25. 00%、34. 62%、52. 88%、55. 77%,在喹诺酮类抗菌药物中的耐药性较低,分别为 3. 85%、2. 88%、0. 00%;阿奇霉素、红
霉素、克拉霉素以及克林霉素耐药组患儿 MP-DNA 载量指数明显较该抗菌药物非耐药组患儿更低(P<0. 05);通过分析得出,
23S rRNA 基因 2063 位点基因突变对大环内酯类抗菌药物耐药产生了显著影响,通过对大环内酯类抗菌药物耐药的病例分析
得出,2063 位点基因 G 型突变率>60%;突变型基因组患儿 MP-DNA 的载量指数较野生型基因组更低(P<0. 05)。 结论:大环内
酯类抗菌药物在治疗 MP 感染患儿中表现出较高的耐药性,其中 23S rRNA Ⅴ区 2063 基因位点突变与 MP 耐药具有密切关联,因
此,MP 23S rRNA 基因测序能够作为临床治疗 MPP 患儿时进行耐药检测的有效手段,并为其合理使用抗菌药物提供参考。 |
| 关键词: 23S rRNA 基因 儿童 肺炎支原体 大环内酯类 抗菌药物 耐药性 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2025.02.007 |
|
| 基金项目:基金项目:2021 年度安徽高校自然科学研究项目,编号 KJ2021A1369。 |
|
| Application of 23S rRNA Gene Detection in Macrolide Resistance in Children with Mycoplasma PneumoniaePneumonia |
| Li Wenbo
1
, Zhang Fan
1
, Cheng Yun
1
, Zhang Zixuan
2 |
| (1. Lu’ an Hospital of Anhui Medical University ( Lu’ an People’ s
Hospital of Anhui Province), Anhui Lu’an 237000, China; 2. Anhui West Health Vocational College, Anhui Lu’an 237000, China) |
| Abstract: |
| Objective: To probe into the role of 23S rRNA gene detection in macrolide resistance in children with Mycoplasma
pneumoniae pneumonia (MPP). Methods: Retrospective analysis was performed on 104 children with M. pneumoniae (MP) infection
admitted into in Lu’an People’s Hospital of Anhui Province from Oct. 2022 to Nov. 2023. Throat swab samples were collected from all
children. Antibiotic sensitivity testing was performed to evaluate the sensitivity of commonly used antibiotics against MP. The drug
resistance of children with MPP was observed and analyzed, and the children were divided into drug-resistant group and non-drugresistant group according to drug sensitivity detection results. Real-time quantitative PCR (RT-qPCR) was employed to quantify MPDNA load, and its correlation with antibiotic resistance was analyzed. PCR gene sequencing was used to detect 2063 gene in 23S rRNA
Ⅴ region, and the correlation between 2063 genotype and antibiotic resistance was analyzed. Meanwhile, the correlation between 2063
genotype of 23S rRNA Ⅴ region and MP-DNA load was compared and analyzed. Results: High resistance rates were observed for
macrolide antibiotics, with the highest rates recorded for erythromycin (71. 15%) and roxithromycin (73. 08%). Moderate resistance
was seen for azithromycin ( 25. 00%), clarithromycin ( 34. 62%), acetylspiramycin ( 52. 88%), and clindamycin ( 55. 77%). In
contrast, low resistance rates were noted for quinolone antibiotics (3. 85%, 2. 88%, and 0. 00%, respectively). Notably, the MP-DNA
load index was significantly lower in the resistant groups for azithromycin, erythromycin, clarithromycin, and clindamycin compared with
their respective non-resistant counterparts (P<0. 05). Analysis revealed that the 2063 mutation in the 23S rRNA gene had a marked
impact on macrolide resistance. Analysis of macrolide-resistant cases yielded more than 60% of G-type mutations in the gene at 2063.
Furthermore, MP-DNA load was significantly lower in patients with the mutant genotype compared with those with the wild-type (P<
0. 05). Conclusion: Macrolide antibiotics shows high resistance in the treatment of MP infection in children, and the 23S rRNA Ⅴ
region 2063 gene mutation is closely associated with MP resistance. Therefore, 23S rRNA gene sequencing can serve as an effective tool
for detecting resistance in patients with MPP, providing a scientific basis for rational use of antibiotics. |
| Key words: 23S rRNA gene children Mycoplasma pneumonia macrolides antibiotics drug resistance |
