[Metagenomic next-generation sequencing-based retrospective investigation of the drug resistance sites of mycoplasma pneumoniae in children].

Zhonghua er ke za zhi = Chinese journal of pediatrics Pub Date : 2024-04-16 DOI:10.3760/cma.j.cn112140-20240105-00019

Q. Wang, J. H. Yang, X. Chen, Y. J. Zhang, X. Y. Zhu, X. F. Li, J. Su, C. R. G. Sa, B. Yang, G. P. Lu, Y. Xu

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Abstract

Objective: To analyze the drug-resistant gene loci of Mycoplasma pneumoniae (MP) using metagenomic next-generation sequencing (mNGS). Methods: From November 2022 to October 2023, 697 clinical samples (including sputum, alveolar lavage fluid and blood) of 686 children with Mycoplasma pneumoniae positive detected by mNGS were retrospectively analyzed. Samples were divided into intensive care unit (ICU) group and non-ICU group, Chi-square test was used to compare groups, and Mann-Kendall trend test was used to analyze the change trend of the detection rate of drug resistance gene loci over time. Results: Of the 697 samples, 164 were from the ICU group and 533 were from the non-ICU group. The detection rate of Mycoplasma pneumoniae resistance gene was 44.3% (309/697), and all detected drug-resistant gene loci of MP were A2063G. The detection rate of Mycoplasma pneumoniae in ICU group was 50.0% (82/164), and the detection rates of Mycoplasma pneumoniae resistance gene loci in sputum, alveolus lavage fluid and blood samples were 75.0% (18/24) and 48.4% (62/128), respectively. The detection rate in sputum was higher than alveolus lavage fluid samples (χ2=5.72,P=0.017). The detection rate of Mycoplasma pneumoniae in non-ICU group was 42.6% (227/533), the detection rate of Mycoplasma pneumoniae resistance gene loci in sputum and alveolar lavage fluid was 40.0% (16/40), 44.3% (201/454), and no detection rate in blood samples (0/12). There was no significant difference in the detection rate of alveolar lavage fluid and sputum (χ2=0.27, P=0.602). From November 2022 to October 2023, the detection rate of submitted samples showed an increasing trend month by month (overall: Z=3.99, ICU inspection group: Z=2.93, non-ICU group: Z=3.01, all P<0.01). Among the bacteria commonly detected with Mycoplasma pneumoniae, Streptococcus pneumoniae accounted for the highest proportion, the detection rate was 15.5% (108/697), and Epstein-Barr virus accounted for the highest proportion of 17.6% (123/697). Conclusions: From November 2022 to October 2023, the detection rate of Mycoplasma pneumoniae drug resistance gene loci showed an increasing trend. The detection rate of drug resistance gene loci in sputum samples of ICU group was higher than alveolus lavage fluid. No new drug resistance site were detected.

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[基于元基因组新一代测序技术的儿童肺炎支原体耐药位点回顾性调查]。

目的利用元基因组新一代测序技术（mNGS）分析肺炎支原体（MP）的耐药基因位点。方法：从 2022 年 11 月至 2023 年 10 月，采集肺炎支原体样本：自 2022 年 11 月至 2023 年 10 月，回顾性分析了通过 mNGS 检测出肺炎支原体阳性的 686 名儿童的 697 份临床样本（包括痰、肺泡灌洗液和血液）。样本分为重症监护室（ICU）组和非重症监护室组，组间比较采用卡方检验（Chi-square test），耐药基因位点检出率随时间的变化趋势采用曼肯德尔趋势检验（Mann-Kendall trend test）。结果697 份样本中，164 份来自重症监护室组，533 份来自非重症监护室组。肺炎支原体耐药基因的检出率为 44.3%（309/697），所有检出的肺炎支原体耐药基因位点均为 A2063G。重症监护室组的肺炎支原体检出率为 50.0%（82/164），痰、肺泡灌洗液和血液样本中肺炎支原体耐药基因位点的检出率分别为 75.0%（18/24）和 48.4%（62/128）。痰液样本的检出率高于肺泡灌洗液样本（χ2=5.72,P=0.017）。非重症监护室组的肺炎支原体检出率为 42.6%（227/533），痰液和肺泡灌洗液中肺炎支原体耐药基因位点的检出率分别为 40.0%（16/40）、44.3%（201/454），血液样本中无检出率（0/12）。肺泡灌洗液和痰液的检出率无明显差异（χ2=0.27，P=0.602）。从 2022 年 11 月至 2023 年 10 月，送检样本的检出率呈逐月上升趋势（总体：Z=3.99，ICU 检测组：Z=2.93，非 ICU 组：Z=3.01，均为 P<0.01）。在肺炎支原体常检出的细菌中，肺炎链球菌所占比例最高，检出率为 15.5%（108/697），而 Epstein-Barr 病毒所占比例最高，为 17.6%（123/697）。结论2022年11月至2023年10月，肺炎支原体耐药基因位点检出率呈上升趋势。ICU 组痰液样本的耐药基因位点检出率高于肺泡灌洗液。未发现新的耐药位点。

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Zhonghua er ke za zhi = Chinese journal of pediatrics

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