Université Bordeaux, USC Infections Humaines à Mycoplasmes et Chlamydiae, Bordeaux, France.
PLoS One. 2012;7(6):e38585. doi: 10.1371/journal.pone.0038585. Epub 2012 Jun 6.
Mycoplasma pneumoniae infections occur both endemically and epidemically, and macrolide resistance has been spreading for 10 years worldwide. A substantial increased incidence of M. pneumoniae infections has been reported in several countries since 2010. Whether this increased incidence is attributed to different or to the same M. pneumoniae genotype is unknown. We have developed a multilocus variable-number tandem-repeat (VNTR) analysis (MLVA) for the molecular typing of M. pneumoniae isolates. In this study, the MLVA typing method was modified and validated to be applicable directly to respiratory tract specimens without culture. This method was applied to 34 M. pneumoniae-positive specimens received at the Bordeaux Hospital, France, between 2007 and 2010 in an endemic setting, and to 63 M. pneumoniae-positive specimens collected during an epidemic surge of M. pneumoniae infections in 2010 in Jerusalem, Israel. The M. pneumoniae endemic spread was shown to be polyclonal in France, with 15 MLVA types identified. Strikingly, the Israeli epidemic surge was also a multi-clonal phenomenon, with 18 circulating MLVA types. The macrolide resistance-associated substitution, A2058G, was found in 22% of the Israeli patients. Macrolide-resistant M. pneumoniae belonged to four MLVA types, the MLVA type Z being the most frequent one. An association between the MLVA type Z and macrolide resistance might exist since macrolide resistance was present or generated during the course of illness in all patients infected with this MLVA type. In conclusion, the discriminatory power of the MLVA showed that the spread of M. pneumoniae strains in France in an endemic setting was polyclonal as well as the surge of M. pneumoniae infections in Israel in 2010.
肺炎支原体感染呈地方性和流行性分布，大环内酯类耐药已在全球流行 10 年。自 2010 年以来，许多国家报告肺炎支原体感染的发病率显著增加。这种发病率的增加是否归因于不同的或相同的肺炎支原体基因型尚不清楚。我们已经开发了一种用于肺炎支原体分离株分子分型的多位点可变数串联重复（VNTR）分析（MLVA）。在这项研究中，对 MLVA 分型方法进行了修改和验证，使其能够直接应用于呼吸道标本，而无需培养。该方法应用于 2007 年至 2010 年法国波尔多医院在地方性环境中收到的 34 份肺炎支原体阳性标本，以及 2010 年在以色列耶路撒冷肺炎支原体感染流行期间收集的 63 份肺炎支原体阳性标本。结果表明，法国的肺炎支原体地方性传播呈多克隆性，共发现 15 种 MLVA 型。引人注目的是，以色列的流行疫情也是一种多克隆现象，有 18 种循环 MLVA 型。大环内酯类耐药相关取代 A2058G 见于 22%的以色列患者。大环内酯类耐药肺炎支原体属于四种 MLVA 型，其中 MLVA 型 Z 最为常见。MLVA 型 Z 与大环内酯类耐药之间可能存在关联，因为在所有感染这种 MLVA 型的患者中，大环内酯类耐药是在疾病过程中存在或产生的。总之，MLVA 的分辨力表明，法国地方性环境中肺炎支原体菌株的传播呈多克隆性，2010 年以色列肺炎支原体感染的流行也是如此。
