Beijing Chaoyang Hospital,Capital Medical University, Beijing, China.
Tropical Medicine Research Institute, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Epidemiol Infect. 2024 Apr 18;152:e75. doi: 10.1017/S0950268824000323.
This paper retrospectively analysed the prevalence of macrolide-resistant (MRMP) in some parts of China. Between January 2013 and December 2019, we collected 4,145 respiratory samples, including pharyngeal swabs and alveolar lavage fluid. The highest PCR-positive rate of M. pneumoniae was 74.5% in Beijing, the highest resistance rate was 100% in Shanghai, and Gansu was the lowest with 20%. The highest PCR-positive rate of was 74.5% in 2013, and the highest MRMP was 97.4% in 2019; the PCR-positive rate of for adults in Beijing was 17.9% and the MRMP was 10.48%. Among the children diagnosed with community-acquired pneumonia (CAP), the PCR-positive and macrolide-resistant rates of were both higher in the severe ones. A2063G in domain V of 23S rRNA was the major macrolide-resistant mutation, accounting for more than 90%. The MIC values of all MRMP to erythromycin and azithromycin were ≥ 64 μg/ml, and the MICs of tetracycline and levofloxacin were ≤ 0.5 μg/ml and ≤ 1 μg/ml, respectively. The macrolide resistance varied in different regions and years. Among inpatients, the macrolide-resistant rate was higher in severe pneumonia. A2063G was the common mutation, and we found no resistance to tetracycline and levofloxacin.
本文回顾性分析了中国部分地区大环内酯类药物耐药（MRMP）的流行情况。2013 年 1 月至 2019 年 12 月，我们收集了 4145 份呼吸道样本，包括咽拭子和肺泡灌洗液。肺炎支原体的 PCR 阳性率最高为 74.5%，上海耐药率最高为 100%，甘肃最低为 20%。最高的阳性率为 2013 年的 74.5%，最高的 MRMP 为 2019 年的 97.4%；北京成人的 PCR 阳性率为 17.9%，MRMP 为 10.48%。在诊断为社区获得性肺炎（CAP）的儿童中，严重 CAP 的肺炎支原体 PCR 阳性率和大环内酯类药物耐药率均较高。23S rRNA 结构域 V 中的 A2063G 是主要的大环内酯类药物耐药突变，占比超过 90%。所有 MRMP 对红霉素和阿奇霉素的 MIC 值均≥64μg/ml，四环素和左氧氟沙星的 MIC 值分别为≤0.5μg/ml 和≤1μg/ml。大环内酯类药物耐药性在不同地区和年份有所不同。在住院患者中，严重肺炎的大环内酯类药物耐药率较高。A2063G 是常见的突变，我们没有发现对四环素和左氧氟沙星的耐药性。
