摘要
目的研究儿童肺炎支原体突变体对大环内酯类药物耐药性的研究机制。方法选择从2011年6月至2014年5月于我院确诊的73例肺炎支原体患儿，对其鼻咽分泌物进行肺炎支原体培养和药敏试验，通过PCR扩增与大环内酯类抗生素耐药性有关的23SrRNA结构域V区及核糖体蛋白L4、L22的基因，扩增产物进行全自动DNA测序，同美国国立生物信息中心已登录的肺炎支原体标准株M129的相应基因序列对比。结果肺炎支原体对大环内酯类药物有不同程度的耐药，其中以红霉素耐药性较高，耐药率为57．5％，而克拉霉素、阿奇霉素、交沙霉素的耐药性相对较低，耐药率分别为31．5％、27．4％、28．8％。分离耐红霉素的42株菌株中，其中33株肺炎支原体的核糖体蛋白L4基因序列与NCBI的M129的相应基因序列一致，5株及标准株FH则出现了162位C→A，4株分别出现81位G→T、66位T→G、C→A和430位A→G。分离耐红霉素的42株菌株中，有12株出现了508位T→C点突变，7株出现了与标准株FH一样的279位T→C点突变，其余均出现了23SrRNA结构域V区大环内酯类抗生素作用靶位的基因突变。结论大环内酯类药物在治疗支原体肺炎时存在较严重的耐药，其中以红霉素的耐药性最高，且对耐药菌株分离发现其耐药机制与235rRNA结构域V区大环内酯类抗生素作用靶位的基因突变有关。
Objective To study the mechanism of the macrolides about mycoplasma of pneumonia in children. Methods 73 cases of Mycoplasma pneumonia in children were selected from June 2011 to May 2014 in our hospital,and their nasopharyngeal secretions were used for culture and sensitivity about Mycoplasma pneumoniae. 23S rRNA structure V region and ribosomal protein L4, L22 gene related to macrolide antibiotic resistance were amplified by PCR, and corresponding gene sequence were contrasted with Mycoplasma pneumonia standard strain M129 logged in National Center for Biotechnology Information. Results Mycoplasma pneumoniae was resistant to macrolide drugs at different degrees,in which the resistance rate of erythromycin was high, about 57.5%, while the resistance rates of clarithromycin, azithromycin, josamycin were 31.5%, 27.4 %, 28.8% , respectively. In 42 erythromycinresistant strains,the gene sequence of ribosomal protein L4 in 33 strains of Mycoplasma pneumonia was consistent with that of M129,162 C → A appeared in five strains and the standard strain FH,81G → T, 66T→ G,C → A and 430A → G appeared in four strains. In 42 erythromycin-resistant strains,508 T→ C mutation appeared in 12 strains, 279 T→C mutation appeared in seven strains and standard strain FH, the rest appeared 23S rRNA domain V mutation related macrolide antibiotics. Conclusions Macrolides exist serious resistance in the treatment of Mycoplasma pneumonia,in which resistance to erythromycin is the highest, and resistance mechanisms may be 2aS rRNA domain V mutation related macrolide antibiotics.
出处
《国际呼吸杂志》
2015年第19期1465-1467,共3页
International Journal of Respiration
