Department of Pediatrics, Jeju National University Hospital, Jeju, Korea.
Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea.
J Korean Med Sci. 2017 Oct;32(10):1642-1646. doi: 10.3346/jkms.2017.32.10.1642.
Mycoplasma pneumoniae is the major pathogen of community-acquired pneumonia in children. The prevalence of macrolide-resistant M. pneumoniae (MRMP) is important owing to the limited alternative therapies for children. We analyzed 111 M. pneumoniae obtained from 107 children admitted for lower respiratory tract infection at Jeju National University Hospital between 2010 and 2015. Macrolide resistance of M. pneumoniae was searched for using polymerase chain reaction (PCR) and sequencing. Of 107 clinical M. pneumoniae, 11 (10.3%) carried macrolide resistance mutations in the 23S rRNA gene. All macrolide resistance mutations were A2063G transitions. We found an acquired A2063G mutation of M. pneumoniae from a patient during macrolide treatment. Patients' characteristics and clinical severity did not differ between those with MRMP and macrolide-sensitive M. pneumoniae, with the exception of frequent pleural effusion in the MRMP group. The prevalence of MRMP (10.3%) in Jeju Island was relatively lower than those of surrounding countries in East Asia. Previous antimicrobial usage and timing of diagnostic test should be considered when determining of macrolide resistance of M. pneumoniae.
肺炎支原体是儿童社区获得性肺炎的主要病原体。由于儿童的替代治疗方法有限，大环内酯类耐药肺炎支原体（MRMP）的流行情况非常重要。我们分析了 2010 年至 2015 年期间在济州国立大学医院因下呼吸道感染住院的 107 名儿童中获得的 111 株肺炎支原体。使用聚合酶链反应（PCR）和测序法检测肺炎支原体的大环内酯类耐药性。在 107 株临床分离的肺炎支原体中，11 株（10.3%）在 23S rRNA 基因中携带大环内酯类耐药突变。所有大环内酯类耐药突变均为 A2063G 转换。我们发现一名接受大环内酯类治疗的患者的肺炎支原体发生了获得性 A2063G 突变。MRMP 组和大环内酯类敏感肺炎支原体组患者的特征和临床严重程度没有差异，除了 MRMP 组胸腔积液较频繁。济州岛的 MRMP 流行率（10.3%）相对低于东亚周边国家。在确定肺炎支原体的大环内酯类耐药性时，应考虑既往抗菌药物使用情况和诊断检测时间。
