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目的分析肺炎支原体突变敏感性分子开关检测对抗菌药物敏感性检测的价值。方法选择2015年1月至2016年2月在河北省儿童医院呼吸科住院收治的450例社区获得性肺炎患儿的肺泡灌洗液标本,进行MP培养与药敏分析,抗菌药物选择红霉素与阿奇霉素,对MP培养阳性菌株使用分子开关技术检测23SrRNA V区2063/2064基因的突变情况,并进行测序分析,最后明确分子开关检测MP耐药基因与其对抗菌药物敏感性的相关性。结果在450例患儿中,MP检测阳性80例,阳性率为17.8%。在80株MP中,72株对红霉素耐药,耐药率为90.0%;31株对阿奇霉素耐药,耐药率为38.8%,为此MP对于红霉素的耐药率明显高于阿奇霉素(χ2=9.134,P=0.000)。76株MP株的23SrRNA的2063/2064位发生了基因突变,其中有70株检测出A2063G的突变,6株有A2064G的突变。而在76株23S rRNA 2063/2064基因位点突变的MP中,有72株MP对红霉素产生高水平耐药,并对阿奇霉素发生交叉耐药,未发生突变的4株MP均对红霉素与阿奇霉素敏感。结论肺炎支原体对红霉素与阿奇霉素都有高度的耐药性,分子开关检测可识别23SrRNA V区基因2063/2064位点突变,有利于反映MP对红霉素与阿奇霉素的敏感性,具有很好的检测价值。
Objective To analyze the value of molecular switch detection of mycoplasma pneumoniae mutation susceptibility testing. Methods From January 2015 to February 2016, 450 patients with pneumonia in community-acquired pneumonia admitted to Department of Respiratory Department of Children’s Hospital of Hebei Province were enrolled in the study. The culture of bronchoalveolar lavage fluid and drug susceptibility analysis were performed. The antibiotics selected erythromycin And azithromycin were used to detect the mutation of 2063/2064 gene in 23SrRNA V region by using molecular switch technique on the positive MP culture strains. Sequencing analysis was carried out. Finally, the molecular switch was used to detect the correlation between MP resistance gene and antimicrobial susceptibility. Results Of the 450 children, MP was detected in 80 cases, the positive rate was 17.8%. Among the 80 MPs, 72 strains were resistant to erythromycin, with a resistance rate of 90.0%. 31 strains were resistant to azithromycin and the resistance rate was 38.8%. Therefore, the resistance rate of MP to erythromycin was significantly higher than that of erythromycin Azithromycin (χ2 = 9.134, P = 0.000). 76 strains of MP 23SrRNA 2063/2064 bit mutation occurred, of which 70 strains detected A2063G, 6 strains have A2064G mutations. Of the 76 strains of MPs with mutations in the 23S rRNA 2063/2064 gene locus, 72 strains of MP were highly resistant to erythromycin and cross-resistant to azithromycin, Azithromycin is sensitive. Conclusions Mycoplasma pneumoniae is highly resistant to both erythromycin and azithromycin. The molecular switch detection can identify the mutation of 2063/2064 in the 23SrRNA V region, which is good for reflecting the sensitivity of MP to erythromycin and azithromycin The detection value.