2023年下半年新疆塔城地区儿童百日咳鲍特菌及肺炎支原体感染临床特点及耐药基因分析  

Analysis of clinical characteristics and drug resistance genes of children infection with Bordetella pertussis and Mycoplasma pneumoniae in Tacheng region of Xinjiang province in the latter half of 2023

作　　者：黄荣 阿依登·布尔勒克 潘丽 刘金花 刘晓花 张涛[5] Rong Huang;A-Yi-Deng Bu-Er-Le-Ke;Pan Li;Liu Jinhua;Liu Xiaohua;Zhang Tao(Department of Pediatrics,Tacheng Regional People's Hospital of China Medical University,Tacheng 834700,China;Department of Pediatrics,Tacheng People's Hospital,Tacheng 834700,China;Department of Pediatrics,Emin County People's Hospital,Tacheng 834600,China;Department of Pediatrics,Toli County People's Hospital,Tacheng 834500,China;Department of Pediatrics,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属塔城地区人民医院儿科,834700 [2]塔城市人民医院儿科,834700 [3]塔城市额敏县人民医院儿科,834600 [4]塔城市托里县人民医院儿科,834500 [5]中国医科大学附属盛京医院儿内科,沈阳110004

出　　处：《中国小儿急救医学》2024年第11期836-840,共5页Chinese Pediatric Emergency Medicine

基　　金：辽宁省自然科学基金面上项目(2023-MS-191)。

摘　　要：目的调查2023年下半年新疆塔城地区儿童百日咳鲍特菌及肺炎支原体(Mycoplasma pneumoniae,MP)感染的临床特点及病原耐药基因情况。方法回顾性收集2023年7月1日至2023年12月31日塔城地区4家医疗卫生机构儿童呼吸道感染患者的病原学检测结果及相关临床资料,选取百日咳鲍特菌及MP感染两组人群进行对比分析。采用靶向高通量测序技术检测病原及病原耐药基因位点是否出现突变。结果最终纳入MP样本127例,百日咳鲍特菌66例,合计193例。统计分析显示百日咳鲍特菌组患儿的年龄较MP组明显降低,同时少数民族患儿占比明显增多。191例(98.9%)患儿伴有咳嗽症状,114例(59.0%)患儿有发热症状。两组患儿的白细胞计数、C-反应蛋白、降钙素原及红细胞沉降率等指标均基本在正常水平,组间比较差异无统计学意义(P>0.05)。MP菌株耐药基因检测结果阳性共103例,均为A2063G位点突变;百日咳鲍特菌组检出13株耐药菌株,占比19.6%。结论MP及百日咳鲍特菌是调查期间新疆塔城地区儿童呼吸道感染性疾病的常见病原体,大龄儿童感染后临床症状均以咳嗽和发热为主,且白细胞计数、C-反应蛋白、降钙素原及红细胞沉降率等在疾病早期差异无统计学意义,难以鉴别。耐药基因检测显示本地区MP菌株耐药突变率较高,而百日咳鲍特菌株突变率较低。ObjectiveTo investigate the clinical characteristics and drug resistance genes of Bordetella pertussis(B.P)and Mycoplasma pneumoniae(MP)infection in children in Tacheng,Xinjiang Province in the latter half of 2023.MethodsWe retrospectively collected etiological detection results and clinical data of children with respiratory tract infection from 4 medical institutions in Tacheng area from July 1,2023 to December 31,2023,the B.P and MP infection groups were selected for comparative analysis.Targeted next-generation sequencing was used to detect the pathogens and their drug resistance-related gene mutations.ResultsA total of 193 cases were included in the study,including 127 MP cases and 66 B.P cases.Statistical analysis showed that the age of the B.P group was significantly younger than that of the MP group,and the proportion of minority patients was significantly higher in the B.P group.All 191(98.9%)patients with cough symptom and 114(59.0%)with fever symptom.The indices of white blood cell,C-reactive protein,procalcitonin and erythrocyte sedimentation rate in the two groups were basically normal,and there was no statistical difference(P>0.05).A total of 103 MP strains were detected positive with drug resistance gene,all of which were A2063G mutation.While only 13 strains were detected positive in the B.P group,accounting for 19.6%.ConclusionMP and B.P are the most common pathogens causing respiratory infections in children in Tacheng recently.The clinical symptoms are mainly cough and fever in older children,there is no significant difference in white blood cell,C-reactive protein,procalcitonin and erythrocyte sedimentation rate in the early stage of the disease,and it is difficult to distinguish.The drug-resistant mutation rate of MP strain is higher in this region,while the mutation rate of B.P strain is lower.

关 键 词：百日咳鲍特菌 肺炎支原体 儿童 呼吸道感染 耐药基因 

分 类 号：R725.1[医药卫生—儿科]