婴幼儿呼吸道感染中肺炎支原体的耐药性探讨

目的采用肺炎支原体（MP）选择性培养-药敏法初步探讨住院婴幼儿呼吸道感染中MP的耐药状况。方法对住院的咳嗽3 d以上的呼吸道感染婴幼儿400例,取咽拭子标本培养检测MP,并用显微镜观察标本培养过程中培养基中有无真菌;对MP阳性且培养基中无真菌的病例测其血清MP-IgM,另取咽拭子标本培养行药敏检测,观察MP对10种药物的耐药情况。结果咽拭子培养MP阳性且培养基中无真菌者100例,占25.0%,其中27例血清MP-IgM阳性;MP对红霉素等大环内酯类药物耐药率达33%-38%,而甲砜霉素和环丙沙星等耐药率为6%-11%。结论MP是住院婴幼儿呼吸道感染的重要病原,约1/3病例对大环内酯类耐药;采用培养-药敏法检测MP及其耐药性时应排除真菌等的干扰。

Drug resistance of mycoplasma pneumoniae in patients with respiratory tract infection under 3-year-old children

Aim To explore the drug resistance of mycoplasma pneumoniae in patients with respiratory tract infection under 3-year-old children using MP-selected culture broth and reagent of drug susceptibility.Methods MP-selected culture of 400 samples of nasopharyngeal aspirates were performed in patients with respiratory tract infection accompanied cough more than 3 days under 3-year-old children.Fungus detection in culture broth were taken by stethscope.Serum samples were collected and other nasopharyngeal aspirates were collected in patients with positive MP-selected culture with negative fungus detection. The drug resistance of MP strains to ten common drugs were detected. Results 100 cases have positive MP-selected culture with negative fungus detection,the ratio being 25%. 27 out of 100 cases have positive MP-IgM. Macrolides-resistant MP strains account for 33% to 38% ,MP strains resistant to thiamphenicol and ciprofloxacin are 6% - 11%. Conclusion Mycoplasma pneumoniae are very important pathogic organism of respiratory infection in children under 3-year-old. About one third MP strains are macrolides-resistant. Detection of MP and drug-resistance of MP strains using MP-selected culture broth to samples of nasopharyngeal aspirates must consider the interference of fungus in samples.