Department of Clinical Laboratory, The Third People's Hospital of Shenzhen, Shenzhen, Guangdong, China; Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing, China.
Department of Clinical Trial, The Third People's Hospital of Shenzhen, Shenzhen, Guangdong, China.
Int J Infect Dis. 2019 Jun;83:26-31. doi: 10.1016/j.ijid.2019.03.028. Epub 2019 Mar 26.
Analysis of the molecular characteristics of isolates is very important for clinical and epidemiological study of community-acquired pneumonia (CAP) caused by Mycoplasma pneumoniae.
Between 2010 and 2012, an epidemic period, M. pneumoniae was isolated from oropharyngeal swabs of consecutive CAP patients. Minimum inhibitory concentrations of macrolides, 23S rRNA gene sequencing, P1 gene and multilocus variable-number tandem-repeat analysis (MLVA) genotyping was conducted.
88.3% (181/205) of the isolates were macrolide-resistant M. pneumoniae (MRMP) and all harbored an A2063 G mutation. The strains were clustered into 7 MLVA types, and P1 type 1 and type 2 lineages were co-circulated (86.3% and 13.7%). Compared with adults, no specific MLVA type contributed to higher M. pneumoniae infection in children (p = 0.14). Similar macrolide profile and genotypes of M. pneumoniae was found between outpatients and inpatients. Significant differences in proportion of P1 types and two main MLVA types 4/5/7/2 and 3/5/6/2 were observed between MRMP and macrolide-sensitive M. pneumoniae (MSMP) (p < 0.001).
This study demonstrates a comprehensive profile of M. pneumoniae molecular characterization among CAP patients of all age, and provides more evidences on a correlation between MLVA type 4/5/7/2 and macrolide resistance in the setting of high incidence of MRMP.
分析分离株的分子特征对于研究肺炎支原体（MP）引起的社区获得性肺炎（CAP）的临床和流行病学非常重要。
在 2010 年至 2012 年的流行期间，连续从 CAP 患者的咽拭子中分离出 MP。对大环内酯类药物的最小抑菌浓度、23S rRNA 基因测序、P1 基因和多位点可变数串联重复分析（MLVA）基因分型进行分析。
88.3%（181/205）的分离株为大环内酯耐药肺炎支原体（MRMP），均携带 A2063G 突变。菌株分为 7 种 MLVA 型，P1 型 1 和 2 谱系同时流行（86.3%和 13.7%）。与成人相比，儿童中特定的 MLVA 型并没有导致更高的 MP 感染（p=0.14）。门诊和住院患者的 MP 大环内酯谱和基因型相似。MRMP 和大环内酯敏感 MP（MSMP）之间 P1 型和两种主要 MLVA 型 4/5/7/2 和 3/5/6/2 的比例存在显著差异（p<0.001）。
本研究全面描述了 CAP 患者中 MP 的分子特征，为高发生率的 MRMP 中 MLVA 型 4/5/7/2 与大环内酯耐药之间的相关性提供了更多证据。
