Abstract Objective To investigate the association of drug resistance of Mycoplasma pneumoniae (MP) with DNA load and genotypes in children with MP pneumonia. Methods A total of 230 children who were hospitalized and diagnosed with MP pneumonia between January 2012 and December 2016 were enrolled. Throat swabs were collected from the 230 children, and a rapid drug sensitivity assay was used to determine the sensitivity of clinical isolates of MP to nine commonly used antibacterial agents. Quantitative real-time PCR was used to measure MP-DNA load in throat swabs. PCR sequencing was used to determine the genotype of 2063 locus of the MP 23S rRNA V domain. Results Of the 230 children, 86 (37.4%) had genotype A in 2063 locus, 134 (58.3%) had genotype G, 8 (3.5%) had genotype C, and 2 (0.9%) had genotype T. Mutant strains (genotype G+C+T) had a significantly higher MP-DNA load than wild-type strains (genotype A) (P < 0.05). The strains resistant to erythromycin, azithromycin, clarithromycin, and clindamycin had a significantly higher MP-DNA load than non-resistant strains (P < 0.05). MP had a high drug resistance rate to macrolide antibiotics. More than 60% of the cases with resistance to macrolides were found to have A2063G mutations. MP was rarely resistant to quinolones (less than 2%). Conclusions Mutations in 2063 locus of the MP 23S rRNA V domain may result in the resistance of MP to macrolides and the change in DNA load and can be used as a basis for selecting drugs for MP.
ZHANG Hui-Fen,BAI Hai-Tao,LI Ji-Ming et al. Association of drug resistance of Mycoplasma pneumoniae with DNA load and genotypes in children with Mycoplasma pneumoniae pneumonia[J]. CJCP, 2017, 19(11): 1180-1184.
ZHANG Hui-Fen,BAI Hai-Tao,LI Ji-Ming et al. Association of drug resistance of Mycoplasma pneumoniae with DNA load and genotypes in children with Mycoplasma pneumoniae pneumonia[J]. CJCP, 2017, 19(11): 1180-1184.
Lucier TS, Heitzman K, Liu SK, et al. Transition mutations in the 23S rRNA of erythromycin-resistant isolates of Mycoplasma pneumoniae[J]. Antimicrob Agents Chemother, 1995, 39(12):2770-2773.
[9]
Xin D, Mi Z, Han X, et al. Molecular mechanisms of macrolide resistance in clinical isolates of Mycoplasma pneumoniae from China[J]. Antimicrob Agents Chemother, 2009, 53(5):2158-2159.
[10]
Zhao F, Liu G, Wu J, et al. Surveillance of macrolide-resistant Mycoplasma pneumoniae in Beijing, China, from 2008 to 2012[J]. Antimicrob Agents Chemother, 2013, 57(3):1521-1523.
[11]
Cao B, Zhao CJ, Yin YD, et al. High prevalence of macrolide resistance in Mycoplasma pneumoniae isolates from adult and adolescent patients with respiratory tract infection in China[J]. Clin lnfect Dis, 2010, 51(2):189-194.
[12]
Wang Y, Qiu S, Yang G, et al. An outbreak of Mycoplasma pneumoniae caused by a macrolide-resistant isolate in a nursery school in China[J]. Antimicrob Agents Chemother, 2012, 56(7):3748-3752.
[13]
Pereyre S, Guyot C, Renaudin H, et al. In vitro selection and characterization of resistance to macrolides and related antibiotics in Mycoplasma pneumoniae[J]. Antimicrob Agents Chemother, 2004, 48(2):460-465.
[14]
Diaz MH, Benitez AJ, Cross KE, et al. Molecular detection and characterization of Mycoplasma pneumoniae among patients hospitalized with community-acquired pneumonia in the United States[J]. Open Forum Infect Dis, 2015, 2(3):ofv106.
[15]
Yan C, Sun H, Xue G, et al. A single-tube multiple-locus variable-number tandem-repeat analysis of Mycoplasma pneumoniae clinical specimens by use of multiplex PCR-capillary electrophoresis[J]. J Clin Microbiol, 2014, 52(12):4168-4171.
[16]
Xue G, Wang Q, Yan C, et al. Molecular characterizations of PCR-positive Mycoplasma pneumoniae specimens collected from Australia and China[J]. J Clin Microbiol, 2014, 52(5):1478-1482.
[17]
Qu J, Yu X, Liu Y, et al. Specific multilocus variable-number tandem-repeat analysis genotypes of Mycoplasma pneumoniae are associated with diseases severity and macrolide susceptibility[J]. PLoS One, 2013, 8(12):e82174.
[18]
Tian XJ, Dong YQ, Dong XP, et al. P1 gene of Mycoplasma pneumoniae in clinical isolates collected in Beijing in 2010 and relationship between genotyping and macrolide resistance[J]. Chin Med J (Engl), 2013, 126(20):3944-3948.
[19]
Aldred KJ, Kerns RJ, Osheroff N, et al. Mechanism of quinolone action and resistance[J]. Biochemistry, 2014, 53(10):1565-1574.
