我们收集了2023年末在北京诊断为肺炎的128名儿科患者的呼吸道标本。77.3%(99/128)的患者检出肺炎支原体,36.4%(4/11),82.9%(34/41),3岁以下儿童占80.3%(61/76),3-6年,超过7年,分别。肺炎支原体(M.肺炎)使用P1基因分型进行表征,23SrRNA基因的结构域V的MLVA分型和测序。P1基因1型(P1-1;76.1%,54/71)和MLVA类型4-5-7-2(73.7%,73/99)占主导地位。MLVA鉴定了一种新的基因型:3-4-6-2。在100%的样品中检测到大环内酯耐药相关的突变,A2063G占99%,A2064G占1%。肺炎支原体阳性率高于以往报道,尤其是3岁以下的儿童,表明肺炎支原体流行在2023年末出现在北京,呈现低龄趋势,中国。较高比例的大环内酯耐药肺炎支原体,P1-1和4-5-7-2基因型肺炎支原体表明大环内酯耐药率增加和基因分型移位现象,这可能归因于这种流行病。此外,我们分析了73例肺炎支原体肺炎住院患者的完整临床信息.重症肺炎支原体肺炎的发生率为56.2%(41/73)。肺炎支原体肺炎患者发热持续时间较长,中位数为10.0天(IQR,8.0-13.0),并发症发生率较高(74.0%,54/73)。然而,在这个队列中,我们发现肺炎支原体肺炎的严重程度,合并感染,或并发症与肺炎支原体P1基因或MLVA类型无关。临床医生应该意识到感染大环内酯耐药肺炎支原体的患者表现出更严重的临床表现。
We collected respiratory specimens from 128 pediatric patients diagnosed with pneumonia in Beijing in late 2023. Mycoplasma pneumoniae was detected in 77.3% (99/128) patients, with 36.4% (4/11), 82.9% (34/41), 80.3% (61/76) in children aged less than 3 years, 3-6 years, over 7 years, respectively. Mycoplasma pneumoniae (M. pneumoniae) was characterized using P1 gene typing, MLVA typing and sequencing of domain V of the 23S rRNA gene. P1 gene type 1 (P1-1; 76.1%, 54/71) and MLVA type 4-5-7-2 (73.7%, 73/99) were predominant. MLVA identified a new genotype: 3-4-6-2. Macrolide resistance-associated mutations were detected in 100% of samples, with A2063G accounting for 99% and A2064G for 1%. The positive rate of M. pneumoniae was higher compared to previous reports, especially in children less than 3 years, suggesting a M. pneumoniae
epidemic showing a younger age trend occurred in late 2023 in Beijing, China. Higher proportions of macrolide-resistant M. pneumoniae, P1-1 and 4-5-7-2 genotype M. pneumoniae indicated increased macrolide resistance rate and genotyping shift phenomenon, which might be attributable to this
epidemic. Additionally, complete clinical information from 73 M. pneumoniae pneumonia inpatients were analyzed. The incidence of severe M. pneumoniae pneumonia was 56.2% (41/73). Mycoplasma pneumoniae pneumonia patients exhibited longer duration of fever, with a median value of 10.0 days (IQR, 8.0-13.0), and higher incidence of complications (74.0%, 54/73). However, in this cohort, we found that the severity of M. pneumoniae pneumonia, co-infection, or complications were not associated with M. pneumoniae P1 gene or MLVA types. Clinicians should be aware that patients infected with macrolide-resistant M. pneumoniae exhibited more severe clinical presentations.