2023年4月至2024年3月海南省三亚市某医院儿童呼吸道肺炎支原体感染的临床特征分析

李沙; 吴利; 陈婷; 何吕芬; 朱雄

doi:10.3784/jbjc.202402190107

2023年4月至2024年3月海南省三亚市某医院儿童呼吸道肺炎支原体感染的临床特征分析

Clinical characteristics of respiratory tract infection with Mycoplasma pneumoniae in children in a hospital in Sanya, Hainan province, April 2023-March 2024

摘要

摘要:
目的研究2023年4月至2024年3月海南省三亚市某医院1 842例就诊儿童（0～14岁）呼吸道感染患者肺炎支原体（MP）感染的临床特征，为临床诊治及疾病防控提供依据。
方法回顾性分析2023年4月至2024年3月三亚市某医院就诊的1 842例儿童呼吸道感染患者，采用靶向测序（tNGS）检测呼吸道病原体MP感染情况及MP 23S rRNA基因耐药位点A2063G、A2064G、A2067G、C2617G突变情况，计数资料采用χ²检验进行统计分析。
结果 1 842例就诊儿童呼吸道感染患者MP感染628例，阳性率为34.09%；男性儿童MP感染337例，阳性率为31.12%，女性儿童MP感染291例，阳性率为38.34%，女性儿童MP阳性率38.34%高于男性儿童31.12%（χ²=10.360，P=0.001）；1 842例就诊儿童呼吸道感染患者年龄＜1岁、1～＜3岁、3～＜6岁和6～14岁MP阳性率分别为5.10%、17.13%、32.55%和61.90%，不同年龄段MP阳性率差异具有统计学意义（χ²=372.407，P<0.001）；4个季度（第二、第三、第四及第一季度）呼吸道感染就诊病例的MP阳性率分别为5.91%、24.65%、47.93%和33.92%，不同季度MP阳性率差异具有统计学意义（χ²=144.499，P<0.001）；628例MP感染检出MP 23S rRNA基因耐药位点A2063G、A2064G、A2067G或C2617G 的突变共591例，耐药率为94.11%，以23S rRNA 基因A2063G位点突变为主。
结论 2023年4月至2024年3月海南省三亚市某医院1 842例呼吸道感染儿童的tNGS检测发现，呼吸道感染就诊患者的MP感染阳性率较高，为34.09%，女性儿童MP阳性率高于男性儿童，且学龄期儿童（6～14岁）MP感染阳性率最高为61.90%，MP感染存在明显季节性，以第四及第一季度为主，耐药现象较严重。

Abstract:
Objective To understand the clinical characteristics of Mycoplasma pneumoniae (MP) infection in 1842 children (0-14 years old) with respiratory tract illness in a hospital in Sanya from April 2023 to March 2024, and provide evidence for the clinical diagnosis, treatment, and prevention and control of respiratory tract infection with MP.
Methods A retrospective analysis was conducted in 1842 pediatric patients who visited our hospital due to respiratory tract infections from April 2023 to March 2024. Targeted next generation sequencing (tNGS) was used to detect the respiratory tract pathogen, i.e. MP, and mutations in the resistance foci A2063G, A2064G, A2067G, and C2617G of 23S rRNA gene of MP. The enumeration data were analyzed with χ² test.
Results In 1842 children with respiratory tract illness, 628 were infected with MP (34.09%). A total of 337 MP infection cases occurred in boys (31.12%), and 291 cases of MP infection cases occurred in girls (38.34%). The positive rate in girls was higher than that in boys (χ²=10.360, P=0.001). The positive rates of MP in age group <1 year, 1−<3 years, 3−<6 years, and 6−14 years were 5.10%, 17.13%, 32.55%, and 61.90%, respectively. The differences in MP positive rates among different age groups were statistically significant (χ²=372.407, P<0.001). The positive rates of MP in the four quarters (second, third, fourth, and first quarter) were 5.91%, 24.65%, 47.93%, and 33.92%, respectively. The differences in MP positive rates among different quarters were statistically significant (χ²=144.499, P<0.001). Among 628 cases of MP infection, 591 cases were detected with mutations in the resistance sites A2063G or A2064G of the MP 23S rRNA gene, with a resistance rate of 94.11%. The main mutation was at the A2063G site of the 23S rRNA gene.
Conclusions From April 2023 to March 2024, the positive rate of MP infection in children with respiratory tract infections in a hospital in Sanya was relatively high at 34.09%. The positive rate of MP infection in female children was higher than that in male children, and the highest positive rate of MP infection was 61.90% in school-age children (6−14 years old). There was a significant seasonal pattern in MP infection, mainly in the fourth and first quarters, and drug resistance was more severe.

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