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[中国北京成年社区获得性肺炎患者肺炎支原体大环内酯类耐药性调查]

[Survey of macrolide resistance in Mycoplasma pneumoniae in adult patients with community-acquired pneumonia in Beijing, China].

作者信息

Yin Yu-dong, Cao Bin, Wang Hui, Wang Ren-tao, Liu Ying-mei, Gao Yan, Qu Jiu-xin, Han Guo-jing, Liu You-ning

机构信息

Department of Infectious Diseases and Clinical Microbiology and Beijing Institute of Respiratory Medicine, Beijing Chao yang Hospital, Capital Medical University, Beijing 100020, China.

Email:

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2013 Dec;36(12):954-8.

Abstract

OBJECTIVE

To explore the tendency of macrolide resistance in Mycoplasma pneumoniae infection in community-acquired pneumonia (CAP) patients in Beijing.

METHODS

Adult CAP patients of ≥ 18 yrs were enrolled in 3 medical centers in Beijing , China. Throat swab samples were taken from all the patients to perform the culture of M. pneumoniae . All the isolated M. pneumoniae strains were subjected to susceptibility evaluation for 6 agents, including macrolides such as erythromycin and azithromycin. In strains showing macrolide resistance, the 23S rRNA gene was analyzed.

RESULTS

A total 53 strains of M. pneumoniae were isolated from 321 enrolled patients. Thirty-eight of the isolated strains (71.7%) were resistant to erythromycin and 32 of them (60.4%) were resistant to azithromycin. Six strains with moderate or low level of erythromycin-resistance were still susceptible to azithromycin. No fluoroquinolone-resistant or tetracycline-resistant strains were observed in our study. Point transition of A2063G in the 23S ribosomal RNA gene was the main reason for the high prevalence of macrolide resistance.

CONCLUSIONS

The prevalence of macrolide resistance in M. pneumoniae is very high in adult CAP patients in Beijing. Studies are needed to clarify the clinical meaning of prevalence of macrolide-resistant M. pneumoniae in adults CAP patients.

摘要

目的

探讨北京社区获得性肺炎(CAP)患者中肺炎支原体感染的大环内酯类耐药趋势。

方法

纳入中国北京3家医疗中心年龄≥18岁的成年CAP患者。采集所有患者的咽拭子样本进行肺炎支原体培养。对所有分离出的肺炎支原体菌株进行6种药物的敏感性评估,包括红霉素和阿奇霉素等大环内酯类药物。对显示大环内酯类耐药的菌株进行23S rRNA基因分析。

结果

从321例纳入患者中总共分离出53株肺炎支原体。分离出的菌株中38株(71.7%)对红霉素耐药,其中32株(60.4%)对阿奇霉素耐药。6株对红霉素耐药程度为中度或低度的菌株对阿奇霉素仍敏感。本研究中未观察到对氟喹诺酮类或四环素类耐药的菌株。23S核糖体RNA基因中A2063G的点突变是大环内酯类耐药高流行率的主要原因。

结论

北京成年CAP患者中肺炎支原体大环内酯类耐药率很高。需要开展研究以阐明成年CAP患者中肺炎支原体大环内酯类耐药流行率的临床意义。

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