目的 調(diào)查2013-2015年南通市第一人民醫(yī)院兒童肺炎支原體感染病原菌的分布及其耐藥性。方法 選擇2013年1月-2015年12月南通市第一人民醫(yī)院兒科住院患兒950例,分析患兒的年齡、性別、疾病類型、季節(jié)分布,肺炎支原體對常用抗菌藥物的耐藥性及基因突變情況。結(jié)果 950例患兒送檢樣本中檢測出120例陽性肺炎支原體,檢出率為12.63%。其中0~6個(gè)月嬰兒的肺炎支原體陽性檢出率最低,3~14歲患兒的檢出率最高;55例男患兒檢測出陽性肺炎支原體,檢出率為10.19%,65例女患兒檢測出陽性肺炎支原體,檢出率為15.85%;上呼吸道感染患兒陽性檢出率為20.00%,下呼吸道感染患兒陽性檢出率為10.97%;夏季患兒出現(xiàn)肺炎支原體感染的陽性檢出率為17.52%,高于春、秋、冬季;肺炎支原體對吉他霉素、氧氟沙星、克林霉素、加替沙星、左氧氟沙星及多西環(huán)素敏感率較高,對其他抗菌藥物的敏感率較低;120株標(biāo)本中耐藥組有34株,非耐藥組有86株,其中耐藥組有21株發(fā)生基因突變,非耐藥組有10株發(fā)生基因突變,基因突變率顯著低于耐藥組。結(jié)論 南通市第一人民醫(yī)院兒童肺炎支原體感染多發(fā)生在3~14歲上呼吸道感染的兒童,夏季發(fā)生率較高,臨床上應(yīng)根據(jù)致病菌株及耐藥情況選擇針對性抗菌藥物,避免抗生素的濫用。

Objective To analyze the distribution and drug resistance of pathogens infected by Mycoplasma pneumoniae in children in Nantong First People's Hospital during 2013-2015. Methods Hospitalized children (950 cases) were selected from Nantong First People's Hospital from January 2013 to December 2015. Age, gender, disease type, season distribution, drug resistance of M. pneumoniae against main antibiotics, and gene mutation were analyzed. Results Positive M. pneumoniae (120 cases) were detected from a total of 950 strains of samples, and the detection rate was 12.63%. The positive detection rate ofM. pneumoniae in 0-6 months infants was the lowest, while the positive detection rate in 3-14 years old children was the highest. There were 55 cases of male children who were detected of positive M. pneumoniae, and the detection rate was 10.19%. While there were 65 cases of female children who were detected of positive M. pneumoniae, and the detection rate was 15.85%. The positive detection rate of children with upper respiratory tract infection was 20.00%, while the positive detection rate of children with lower respiratory tract infection was 10.97%. The positive detection rate of children infected by M. pneumoniaein summer was 17.52%, higher than that in spring, autumn, and winter. The sensitive rate of M. pneumoniae against kitasamycin, ofloxacin, clindamycin, gatifloxacin, levofloxacin, and doxycycline was high, while the sensitive rate of M. pneumoniae against other antibiotics was lowerer. In 120 strains of specimens, there were 34 strains in the resistant group and 86 strains in the non resistant group. 21 Strains of specimens in the resistant group and 10 strains in the non resistant group had gene mutation. And the mutation rate was significantly lower than that in the resistant group. Conclusion The infection of M. pneumoniae occurs in 3-14 years old children, and the incidence is higher in summer. They should be selected according to the drug resistance of pathogens in clinic, and to avoid the overuse of antibiotics.

南通市衛(wèi)生局青年醫(yī)學(xué)人才科研基金項(xiàng)目(WQ2015008)