肺炎支原体的耐药情况及其对阿奇霉素耐药机制的研究  

The study of drug resistance and mechanism of azithromycin for Mycoplasma pneumoniae

作　　者：潘明安[1] 张天托[1] 朱家馨[1] 黄静[1] 刘慧[1] 

机构地区：[1]中山大学附属第三医院呼吸内科,广州510630

出　　处：《中国抗生素杂志》2010年第9期721-725,共5页Chinese Journal of Antibiotics

摘　　要：目的了解我院社区呼吸道感染肺炎支原体(Mycoplasma pneumoniae,Mp)感染状况及耐药机制。方法收集2007年8月到2008年3月我院社区获得性呼吸道感染病人的咽拭子、痰标本,分离培养Mp,检测对红霉素、阿奇霉素、环丙沙星、洛美沙星、氯霉素的药物敏感性,筛选阿奇霉素的耐药株,检测阿奇霉素耐药株的作用靶位23S rRNA V区基因、23S rRNA II区基因、rplD基因及rplV基因的耐药基因变异位点。结果入选者共493例,Mp培养阳性者4株。其中耐红霉素和阿奇霉素2株,耐环丙沙星和洛美沙星3株,4株临床株对氯霉素均敏感。耐阿奇霉素株在23S rRNA的V区基因的2063位发生A到G点突变。结论我院存在对大环内酯类和喹诺酮类抗生素耐药的Mp菌株,并且有多重耐药的现象。Mp对阿奇霉素耐药的机制可能与23S rRNA V区基因的点突变相关,与23S rRNA II区基因、rplD基因、rplV基因是否相关尚不能肯定。Objectives This study was to investigate the drug resistance situation of Mycoplasma pneumonia （Mp） infected patients with community-acquired respiratory tract infection in our hospital and the mechanisms of drug resistance. Methods We collected the throat swabs and sputum samples from patients with community-acquired respiratory tract infection in our hospital from August, 2007 to March, 2008. Then we isolated and cultured Mp to test their drug sensitivities to erythromycin, azithromycin, ciprofloxacin, lomefloxacin and chloramphenicol. We screened strains resistant to azithromycin and tested the mutated sites of drug-resistant genes in their functional sites： gene of V region of 23S rRNA, gene of Ⅱ region of 23S rRNA, rplD gene and rplVgene. Results 493 patients were selected and there were 4 positive Mp strains. Among them, 2 strains were resistant to erythromycin and azithromycin, 3 strains were resistant to ciprofloxacin and lomefloxacin, and all the strains were sensitive to chloramphenicol. Strains resistant to azithromycin had point mutation from A to G at the site 2063 in gene of Ⅴ region of 23S rRNA. Conclusion There were Mp strains resistant to antibiotics of macrolides and quinolones in our hospital and they had the phenomenon of multidrug resistant. The mechanisms of drug resistance caused by Mp to azithromycin were considered possibily concerned with point mutation in gene of Ⅴ region of 23 S rRNA. Whether they had relationship with gene of Ⅱ region of 23S rRNA, rplD gene and rplVgene was still uncertain.

关 键 词：肺炎支原体 阿奇霉素 耐药 

分 类 号：R378[医药卫生—病原生物学]