儿科药学杂志2025，Vol.31Issue(2)：32-36,5.DOI:10.13407/j.cnki.jpp.1672-108X.2025.02.007
23S rRNA基因检测在儿童肺炎支原体肺炎大环内酯类耐药中的应用关联研究
Application of 23S rRNA Gene Detection in Macrolide Resistance in Children with Mycoplasma Pneumoniae Pneumonia
摘要
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-drug-resistant group according to drug sensitivity detection results.Real-time quantitative PCR(RT-qPCR)was employed to quantify MP-DNA 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 Ⅴregion 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.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Key words
23S rRNA gene/children/Mycoplasma pneumonia/macrolides/antibiotics/drug resistance分类
医药卫生引用本文复制引用
李文博,张帆,程云,张子轩..23S rRNA基因检测在儿童肺炎支原体肺炎大环内酯类耐药中的应用关联研究[J].儿科药学杂志,2025,31(2):32-36,5.基金项目
2021年度安徽高校自然科学研究项目,编号KJ2021A1369. （）
