Molecular Detection and Characterization of Mycoplasma pneumoniae Among Patients Hospitalized With Community-Acquired Pneumonia in the United States.
Molecular Detection and Characterization of Mycoplasma pneumoniae Among Patients Hospitalized With Community-Acquired Pneumonia in the United States.
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DOI：
10.1093/ofid/ofv106
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发表时间：
2015-09
影响因子：
4.2
通讯作者：
Winchell JM
中科院分区：
文献类型：
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作者：
Diaz MH;Benitez AJ;Cross KE;Hicks LA;Kutty P;Bramley AM;Chappell JD;Hymas W;Patel A;Qi C;Williams DJ;Arnold SR;Ampofo K;Self WH;Grijalva CG;Anderson EJ;McCullers JA;Pavia AT;Wunderink RG;Edwards KM;Jain S;Winchell JM
报道了M.肺炎患儿和成人CAP住院患者的呼吸道标本。P1基因型1型和MLVA基因型4/5/7/2占优势，但儿童和成人的类型比例不同。大环内酯类耐药罕见。背景：肺炎支原体是社区获得性肺炎（CAP）的常见病因。 在美国CAP住院患者中检测到的肺炎支原体的分子特征描述不多。方法：我们对社区疾病控制和预防中心肺炎病原学研究（EPIC）中因CAP住院的儿童和成人鼻咽/口咽拭子中的肺炎支原体进行了分子鉴定，包括P1分型、多位点可变数目串联重复序列分析（MLVA）和大环内酯类药物敏感性基因分型。 结果：在216例肺炎支原体聚合酶链反应阳性标本中，40例（18.5%）来自成人，176例（81.5%）来自儿童。 P1型分布在成人（64%的1型和36%的2型）和儿童（84%的1型，13%的2型和3%的变异）之间存在差异（P <0.05）和不同地点之间（P <0.01）。不同年龄组（P <0.01）和不同部位（P <0.01）的MLVA类型4/5/7/2和3/5/6/2的比例也存在显著差异。在7例（3.5%）标本中发现了大环内酯类药物耐药基因型，其中5例来自最近接受大环内酯类药物治疗的患者。在不同菌株类型的患者之间或大环内酯类耐药和敏感肺炎支原体感染之间，临床特征无显著差异。结论：P1 1型基因型和MLVA 4/5/7/2型占优势，但在儿童和成人之间以及不同地点之间存在差异。 大环内酯类耐药罕见。菌株类型的差异似乎与临床结局的差异无关。肺炎支原体的全基因组测序可能有助于确定更好的方法来表征菌株。
We report molecular characteristics of M. pneumoniae in respiratory specimens from children and adults hospitalized with CAP. The P1 type 1 genotype and MLVA type 4/5/7/2 predominated, but proportions of types differed between children and adults. Macrolide resistance was rare. Background. Mycoplasma pneumoniae is a common cause of community-acquired pneumonia (CAP). The molecular characteristics of M pneumoniae detected in patients hospitalized with CAP in the United States are poorly described. Methods. We performed molecular characterization of M pneumoniae in nasopharyngeal/oropharyngeal swabs from children and adults hospitalized with CAP in the Centers for Disease Control and Prevention Etiology of Pneumonia in the Community (EPIC) study, including P1 typing, multilocus variable-number tandem-repeat analysis (MLVA), and macrolide susceptibility genotyping. Results. Of 216 M pneumoniae polymerase chain reaction-positive specimens, 40 (18.5%) were obtained from adults and 176 (81.5%) from children. P1 type distribution differed between adults (64% type 1 and 36% type 2) and children (84% type 1, 13% type 2, and 3% variant) (P < .05) and among sites (P < .01). Significant differences in the proportions of MLVA types 4/5/7/2 and 3/5/6/2 were also observed by age group (P < .01) and site (P < .01). A macrolide-resistant genotype was identified in 7 (3.5%) specimens, 5 of which were from patients who had recently received macrolide therapy. No significant differences in clinical characteristics were identified among patients with various strain types or between macrolide-resistant and -sensitive M pneumoniae infections. Conclusions. The P1 type 1 genotype and MLVA type 4/5/7/2 predominated, but there were differences between children and adults and among sites. Macrolide resistance was rare. Differences in strain types did not appear to be associated with differences in clinical outcomes. Whole genome sequencing of M pneumoniae may help identify better ways to characterize strains.