Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000, Ljubljana, Slovenia.
Division of Paediatrics, University Children's Hospital, University Medical Centre Ljubljana, Bohoričeva ulica 20, 1000, Ljubljana, Slovenia.
Eur J Clin Microbiol Infect Dis. 2018 Jan;37(1):99-107. doi: 10.1007/s10096-017-3106-5. Epub 2017 Sep 26.
Two nationwide Mycoplasma pneumoniae epidemics occurred in Slovenia between 2006 and 2016. The aim of this study was to assess which M. pneumoniae genotypes were present in our area during the selected timeframe, whether the origin of the epidemics was monoclonal or polyclonal and whether the proportion between detected genotypes changed over time. We were also interested in the presence of macrolide resistance (MR) and whether it could be linked to specific genotypes. We performed pyrosequencing of the P1 gene and multiple-locus variable-number tandem repeat (VNTR) analysis (MLVA) typing from 872 M. pneumoniae isolates obtained from respiratory tract infections (RTI)-suffering patients. Additionally, isolates were tested for the presence of MR implicated mutations in the 23S rRNA gene. The MLVA typing results revealed that three main genotypes, MLVA-3,5,6,2, MLVA-3,6,6,2 and MLVA-4,5,7,2, were constantly present and occasionally joined by less abundant, short-lived genotypes, which were detected mostly, but not exclusively, during epidemics. We also noticed a switch in abundance from MLVA-3,5,6,2 and MLVA-3,6,6,2, which dominated in the first epidemic (77.0%; 97/126), to MLVA-4,5,7,2 (71.6%; 428/598), which dominated in the second. Similar to this finding, the dominant P1 type also shifted from type 2 to type 1, although a complete P1 type shift was not observed, since both types remained in circulation. MR was detected in 0.8% (7/872) of M. pneumoniae isolates. Our results seem to suggest that MR remains sporadic in Slovenia at this point in time and that both recent epidemics were polyclonal in nature and, possibly, to some extent, fuelled by the P1 type dominance change.
2006 年至 2016 年期间,斯洛文尼亚发生了两次全国性肺炎支原体流行。本研究旨在评估在选定的时间范围内,本地区存在哪些肺炎支原体基因型,流行的起源是单克隆还是多克隆,以及随着时间的推移,检测到的基因型比例是否发生变化。我们还对大环内酯类耐药性(MR)的存在以及它是否与特定基因型有关感兴趣。我们对 872 例从呼吸道感染(RTI)患者中分离的肺炎支原体进行了 P1 基因焦磷酸测序和多位点可变数串联重复(VNTR)分析(MLVA)分型,此外还对 23S rRNA 基因中存在的 MR 相关突变进行了检测。MLVA 分型结果显示,三种主要基因型 MLVA-3、5、6、2、MLVA-3、6、6、2 和 MLVA-4、5、7、2 始终存在,偶尔会出现数量较少、寿命较短的基因型,这些基因型主要在流行期间出现,但并非仅在流行期间出现。我们还注意到,从第一次流行(77.0%;97/126)占主导地位的 MLVA-3、5、6、2 和 MLVA-3、6、6、2 向第二次流行(71.6%;428/598)占主导地位的 MLVA-4、5、7、2 转变。与这一发现相似,主要 P1 型也从 2 型转变为 1 型,尽管没有完全发生 P1 型转变,因为两种类型仍在传播。在 872 例肺炎支原体分离株中,检测到 0.8%(7/872)的 MR。我们的结果似乎表明,在斯洛文尼亚,MR 目前仍呈散发性,最近的两次流行均为多克隆性,可能在一定程度上与 P1 型优势变化有关。