RT-PCR法探讨支原体23S rRNA基因突变与支原体肺炎病情的关系

目的采用RT-PCR法检测支原体23S rRNA基因突变,探讨23S rRNA基因突变与患儿病情的临床关系。方法选取本院2017年9月-2018年9月在本院儿科就诊的支原体肺炎患儿90例,所有患者均经咽拭子收集病原体标本,采用RT-PCR检测支原体大环内酯类常见耐药基因位点A2063位点基因突变,若A2063G出现突变则定为观察组,未突变定为对照组,分析基因突变与支原体感染患者病情的关系,采用Logistic回归分析重症支原体肺炎的危险因素。结果A2063G突变组患者发热时间、最高体温、呼吸道症状时间、白细胞总数、住院时间、住院费用、红霉素耐药率均明显高于非突变组患者,A2063G突变组患者对各种抗生素耐药率明显高于A2063G非突变组患者,入院前发热时间(P=0.03)、A2063G突变(P=0.02)、既往使用大环内酯类药物的使用(P=0.01)是支原体感染患儿重症肺炎的独立危险因素。结论支原体23S rRNA基因突变,探讨23S rRNA基因突变与患儿病情的临床关系。

Study on the relationship between Mycoplasma 23S rRNA gene mutation and mycoplasma pneumonia by RT-PCR

Objective To detect 23S rRNA gene mutation in Mycoplasma by RT-PCR and to explore its relationship with the condition of children in clinics.Methods Ninety children with mycoplasma pneumonia in our hospital from September 2017 to September 2018 were selected.Pathogen samples were collected from all patients by pharyngeal swab.The gene mutation at A2063 locus of common Mycoplasma macrolides resistance gene was detected by RT-PCR.If the mutation occurred in A2063G,the samples were collected into the observation group;if not,the samples were collected into the control group.The relationship between gene mutation and mycoplasma infection was analyzed,and risk factors of severe mycoplasma pneumonia were analyzed by Logistic regression.Results The fever time,maximum body temperature,respiratory symptoms time,total white blood cells,hospitalization time,hospitalization expenses and erythromycin resistance rate in the A2063G mutation group were significantly higher than those in the non-mutation group.The antibiotic resistance rate of patients in the A2063G mutation group was significantly higher than that of patients in the A2063G non-mutation group.The fever time before admission(P=0.03),A2063G mutation(P=0.02),and previous use of macrolide drugs(P=0.01)were independent risk factors for severe pneumonia in children with mycoplasma infection.Conclusion The investigation of mycoplasma 23S rRNA gene mutation can be used to explore the clinical relationship between 23S rRNA gene mutation and the condition of children.