大环内酯类耐药肺炎支原体研究进展

doi:10.3969/j.issn.1673-8640.2020.10.024

摘要/Abstract

摘要：

肺炎支原体（MP）是社区获得性肺炎（CAP）的重要病原体。近年来,大环内酯类耐药肺炎支原体（MRMP）的检出率在全世界范围内迅速升高。国内外监测结果显示,MRMP在中国、韩国、日本等亚洲国家高度流行,但在北美洲、欧洲、非洲等地区检出率较低。23S rRNA基因的单位点突变是MP对大环内酯类抗菌药物耐药的主要机制,可使大环内酯类抗菌药物与核糖体亲和性下降,从而产生耐药性。MRMP P1-I型或MLVA4-5-7-2型的检出率显著高于其他亚型。控制耐药MP感染的关键是早期快速诊断,并合理使用抗菌药物。目前,虽然已有多种快速检测方法,但尚无统一的标准,也未常规应用于临床,探索最适用于临床的MP快速检测方法仍然非常必要。

关键词: 肺炎支原体, 大环内酯类耐药, 实验室检测

Abstract:

Mycoplasma pneumoniae（MP） is one of the predominant pathogens causing community-acquired pneumonia（CAP）. In recent years,the prevalence of macrolide-resistant Mycoplasma pneumoniae（MRMP） has rapidly increased in worldwide. MRMP was highly prevalent in Asia,especially in China,South Korea and Japan,while the prevalence is relatively low in North America,Europe and Africa. The resistance mechanism of MP mainly dues to the mutation of 23S rRNA gene. The single point mutation in the 23S rRNA gene is the main macrolide resistance mechanism of MRMP,which can reduce the affinity of macrolide antibiotics with ribosomes and then develop resistance.. The positive rate of MRMP P1-I or MLVA4-5-7-2 is higher than other types. The key for controlling the infection of MP is rapid diagnosis and rational use of antibiotics. Although there are several rapid determination methods reported,they do not have a uniform standard, and also not routinely used in clinical practice. It is still necessary to explore the most suitable rapid detection method for MP.

Key words: Mycoplasma pneumonia, Macrolide resistance, Laboratory determination

中图分类号:

R375

王冰洁, 张泓. 大环内酯类耐药肺炎支原体研究进展[J]. 检验医学, 2020, 35(10): 1070-1074.

WANG Bingjie, ZHANG Hong. Research progress of macrolide-resistant Mycoplasma pneumoniae[J]. Laboratory Medicine, 2020, 35(10): 1070-1074.

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