在成人患者中Mycoplasma pneumoniae的宏类耐药性
Panpan Xie1,2, Yue Zhang1,3, Yanhong Qin1,3
1Department of Respiratory and Critical Care Medicine, Senior Department of Infectious Diseases, the Fifth Medical Center of PLA General Hospital, Beijing, China.
Frontiers in cellular and infection microbiology
|April 1, 2025
概括
抗宏化物耐药的Mycoplasma pneumoniae在成年人中很常见,主要是由于23S rRNA基因突变. 排泄也会导致耐药性,这表明米德卡米辛作为一种潜在的替代治疗方法.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 抗微生物耐药性 抗微生物耐药性
背景情况:
- 肺炎菌会导致严重的呼吸道感染.
- 麦克罗利德是第一线治疗方法,但耐药性正在增加.
- 与儿科病例相比,成年人的抗药机制仍未得到充分研究.
研究的目的:
- 调查成年患者的M.肺炎中宏类耐药性的研究.
- 为了阐明成年分离体中潜在的耐药性机制.
- 评估潜在的替代治疗方法.
主要方法:
- 从患有呼吸道感染的成年患者中采集了喉拭子.
- 已分离和确定的M.肺炎菌株.
- 使用微稀释评估了抗微生物敏感性.
- 测序了23S rRNA基因,并对抗性基因 (erm, mef, mphC) 进行了PCR.
- 确定的最小抑制度 (MICs) 含有和没有保留素.
主要成果:
- 在72个M. pneumoniae分离物中,41.7%的分离物对化物有耐药性.
- 所有耐药菌株都在23S rRNA基因的2063位点发生了突变.
- 在两种隔离品中发现了排泄基因 (msrA/B, mefA).
- 在这两种菌株中,reserpine 降低了 75% 的阿齐思罗米辛 MIC.
- 米德卡米辛对M.肺炎的活性最大 (MIC90:16μg/ml).
结论:
- 抗宏化物耐药的M.肺炎在北京的成年患者中普遍存在.
- 23S rRNA基因中的点突变是主要的抵抗机制.
- 溢出在宏抗性中起着部分作用.
- 米德卡米辛是治疗M. pneumoniae感染的有希望的替代品,特别是对亚齐胺素耐药的病例.
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