Ishiguro Nobuhisa, Koseki Naoko, Kaiho Miki, Kikuta Hideaki, Togashi Takehiro, Oba Koji, Morita Keisuke, Nagano Naoko, Nakanishi Masanori, Hazama Kyosuke, Watanabe Toru, Sasaki Satoshi, Horino Atsuko, Kenri Tsuyoshi, Ariga Tadashi
Department of Pediatrics, Hokkaido University Graduate School of Medicine.
Jpn J Infect Dis. 2016 May 20;69(3):186-90. doi: 10.7883/yoken.JJID.2015.054. Epub 2015 Jul 10.
Recently, macrolide-resistant (MR) Mycoplasma pneumonia appeared, and prevalence of macrolide resistance among M. pneumoniae infections varies by country. However, reports on regional differences in the prevalence of MR M. pneumonia within a country are scarce. In this study, 617 nasopharyngeal swab samples were collected from 617 pediatric patients, and DNA of M. pneumoniae was identified in 95 samples. In 51 of the 95 M. pneumonia positive samples, we detected the presence of mutation A2063G mutation (conferring macrolide resistance) in the 23S rRNA gene. The overall macrolide resistance rate was 53.7%, but there were regional differences: 0.0% in Muroran, 5.3% in Asahikawa, 55.3% in Sapporo, and 100.0% in Kushiro. Statistically significant pairwise differences in the prevalence of MR M. pneumoniae were observed among these cities except for the pair of Muroran and Asahikawa. After exclusion (in order to avoid the influence of macrolides) of patients who were prescribed macrolides before collection of nasopharyngeal swab samples, statistically significant differences persisted: 0.0% in Muroran, 5.6% in Asahikawa, 38.5% in Sapporo, and 100.0% in Kushiro.
最近，出现了对大环内酯类耐药（MR）的肺炎支原体，并且肺炎支原体感染中对大环内酯类耐药的发生率因国家而异。然而，关于一个国家内MR肺炎支原体发生率的区域差异的报道很少。在本研究中，从617名儿科患者中收集了617份鼻咽拭子样本，在95份样本中鉴定出肺炎支原体DNA。在95份肺炎支原体阳性样本中的51份中，我们在23S rRNA基因中检测到A2063G突变（赋予大环内酯类耐药性）的存在。总体大环内酯类耐药率为53.7%，但存在区域差异：室兰为0.0%，旭川为5.3%，札幌为55.3%，钏路为100.0%。除室兰和旭川外，在这些城市中观察到MR肺炎支原体发生率存在统计学上显著的两两差异。在排除（为避免大环内酯类的影响）在收集鼻咽拭子样本前使用过大环内酯类的患者后，统计学上的显著差异仍然存在：室兰为0.0%，旭川为5.6%，札幌为38.5%，钏路为100.0%。
