肺炎支原体对抗菌药物敏感性及对大环内酯类的耐药机制研究

发布时间：2019-01-23 16:19

【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。
[Abstract]:Objective to investigate the infection status of mycoplasma pneumoniae (MP) in adult and adolescent community acquired pneumonia (CAP) and its sensitivity to common antimicrobial agents, and to clarify the mechanism of MP resistance to macrolides. Methods from October 2010 to March 2012, 129 patients with CAP were collected for mycoplasma pneumoniae isolation and culture. The clinical isolates were identified by polymerase chain reaction (PCR). Determination of minimal inhibitory concentration (MIC);) of mycoplasma pneumoniae against macrolides, quinolones and tetracyclines by microdilution method The 23s rRNA gene of macrolide resistant strain was sequenced and compared with that of standard strain MPFH (ATCC 15531. Results A total of 20 strains of Mycoplasma pneumoniae were isolated from the throat swabs of 129 patients with CAP, and the isolation rate was 15.50%. They were sensitive to tetracyclines and fluoroquinolones, and were resistant to macrolides. The mechanism of drug resistance was that the 23SrRNA gene 2063 was mutated from A to G. Conclusion Mycoplasma pneumoniae has severe resistance to macrolides, and mutation of 23SrRNA gene is the main mechanism of drug resistance.
【作者单位】：烟台毓璜顶医院感染科;
【基金】：烟台市科技发展基金资助项目(2012072)
【分类号】：R563.1

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