目的 调查2013-2015年南通市第一人民医院儿童肺炎支原体感染病原菌的分布及其耐药性。方法 选择2013年1月-2015年12月南通市第一人民医院儿科住院患儿950例,分析患儿的年龄、性别、疾病类型、季节分布,肺炎支原体对常用抗菌药物的耐药性及基因突变情况。结果 950例患儿送检样本中检测出120例阳性肺炎支原体,检出率为12.63%。其中0~6个月婴儿的肺炎支原体阳性检出率最低,3~14岁患儿的检出率最高;55例男患儿检测出阳性肺炎支原体,检出率为10.19%,65例女患儿检测出阳性肺炎支原体,检出率为15.85%;上呼吸道感染患儿阳性检出率为20.00%,下呼吸道感染患儿阳性检出率为10.97%;夏季患儿出现肺炎支原体感染的阳性检出率为17.52%,高于春、秋、冬季;肺炎支原体对吉他霉素、氧氟沙星、克林霉素、加替沙星、左氧氟沙星及多西环素敏感率较高,对其他抗菌药物的敏感率较低;120株标本中耐药组有34株,非耐药组有86株,其中耐药组有21株发生基因突变,非耐药组有10株发生基因突变,基因突变率显著低于耐药组。结论 南通市第一人民医院儿童肺炎支原体感染多发生在3~14岁上呼吸道感染的儿童,夏季发生率较高,临床上应根据致病菌株及耐药情况选择针对性抗菌药物,避免抗生素的滥用。

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.

南通市卫生局青年医学人才科研基金项目(WQ2015008)