Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Ann Lab Med. 2013 Nov;33(6):410-4. doi: 10.3343/alm.2013.33.6.410. Epub 2013 Oct 17.
This study aimed to evaluate the prevalence of Mycoplasma pneumoniae in primary and tertiary care hospitals and its macrolide resistance rate.
Nasopharyngeal swabs were collected from 195 pediatric patients in primary and tertiary care hospitals from October to November 2010. The AccuPower MP real-time PCR kit (Bioneer, Korea) was used for the detection of M. pneumoniae. Direct amplicon sequencing was performed to detect point mutations conferring resistance to macrolides in the 23S rRNA gene.
Among the 195 specimens, 17 (8.7%) were M. pneumoniae positive, and 3 of the strains (17.6%) obtained from these 17 specimens displayed the A2063G mutation in 23S rRNA. Three macrolide-resistant M. pneumoniae isolates were isolated from patients hospitalized at the primary care hospital. The positive rates of M. pneumoniae for the primary and tertiary care hospitals were 12.1% (15/124) and 2.8% (2/71), respectively (P=0.033).
The positive rate of M. pneumoniae in the primary care hospital was higher than that in the tertiary care hospital. Simultaneous detection of M. pneumoniae and macrolide-resistant mutation genes in the 23S rRNA by real-time PCR is needed for rapid diagnosis and therapy of M. pneumoniae infections.
本研究旨在评估社区和三级医院肺炎支原体的流行率及其大环内酯类药物耐药率。
2010 年 10 月至 11 月，从社区和三级医院的 195 例儿科患者中采集鼻咽拭子。采用 AccuPower MP 实时 PCR 试剂盒（Bioneer，韩国）检测肺炎支原体。直接扩增子测序用于检测 23S rRNA 基因中导致大环内酯类药物耐药的点突变。
在 195 个标本中，17 个（8.7%）为肺炎支原体阳性，从这 17 个标本中获得的 3 株（17.6%）在 23S rRNA 中显示 A2063G 突变。从社区医院住院患者中分离出 3 株耐大环内酯类肺炎支原体。社区和三级医院肺炎支原体的阳性率分别为 12.1%（15/124）和 2.8%（2/71）（P=0.033）。
社区医院肺炎支原体的阳性率高于三级医院。需要通过实时 PCR 同时检测肺炎支原体和 23S rRNA 上的大环内酯类耐药基因突变，以便快速诊断和治疗肺炎支原体感染。
