摘要目的 了解北京地区成人社区获得性肺炎(CAP)患者中肺炎支原体对大环内酯等常用抗生素的耐药情况.方法 收集2010年9月至2012年6月北京地区3家医院就诊的CAP患者.采集咽拭子标本进行肺炎支原体培养.对分离到的肺炎支原体菌株进行体外药敏试验及对大环内酯类耐药相关基因突变位点检测.结果 321例患者纳入本研究,共分离出肺炎支原体53株,其中红霉素耐药38株(71.7％);阿奇霉素耐药32株(60.4％);未发现对喹诺酮及四环素类药物耐药的菌株.A2063G点突变是导致对大环内酯类抗生素耐药的主要点突变.结论 北京地区成人CAP肺炎支原体对大环内酯类抗生素耐药率高,未发现喹诺酮及四环素类耐药菌株.

abstractsObjective To explore the tendency of macrolide resistance in Mycoplasma pneumoniae infection in community-acquired pneumonia (CAP) patients in Beijing.Methods Adult CAP patients of ≥18 yrs were enrolled in 3 medical centers in Beijing,China.Throat swab samples were taken from all the patients to perform the culture of M.pneumoniae.All the isolated M.pneumoniae strains were subjected to susceptibility evaluation for 6 agents,including macrolides such as erythromycin and azithromycin.In strains showing macrolide resistance,the 23S rRNA gene was analyzed.Results A total 53 strains of M.pneumoniae were isolated from 321 enrolled patients.Thirty-eight of the isolated strains (71.7％) were resistant to erythromycin and 32 of them (60.4％) were resistant to azithromycin.Six strains with moderate or low level of erythromycin-resistance were still susceptible to azithromycin.No fluoroquinoloneresistant or tetracycline-resistant strains were observed in our study.Point transition of A2063G in the 23S ribosomal RNA gene was the main reason for the high prevalence of macrolide resistance.Conclusions The prevalence of macrolide resistance in M.pneumoniae is very high in adult CAP patients in Beijing.Studies are needed to clarify the clinical meaning of prevalence of macrolide-resistant M.pneamoniae in adults CAP patients.