Objective:To explore the clinical application value of sequencing analysis of 23S rRNA gene of Mycoplasma Pneumoniae (MP) in children's respiratory tract.Methods:The samples of phlegm or pharynx swab with MP more than 1*104 copies were collected by fluorescence quantitative PCR, and domain V of the 23S rRNA gene was sequenced. Children were divided into mutation group and non-mutation group according to the sequencing results, and clinical data of the two groups were compared. In vitro culture and drug sensitivity experiments were performed in the same sample to comparethe sequencing analysis.Results:A total of 120 samples were collected, 98 cases were diagnosed with A2063G mutation (mutation group),the other 22 samples carried a wild type of 23S rRNA gene (non-mutation group). There were no differences in the general information such as gender, age, acute peripheral blood leukocytes and so on, but there were statistic differences in the hospitalization duration, total fever period, fever duration after macrolide therapy, cough period and the course of treatment. Compared to mutation group, the rates of extra-pulmonary complications and lobar pneumonia were higher in non-mutation group (P<0.05). Among the 120 samples, 48 of the samples (40%)were positive in MP vitro culture. 20 samples were resistant to macrolides, and the drug resistance rate was 16.67%, which significantly lower than the mutation rate of 23S rRNA (P<0.05). Conclusion:The mutation rate of MP 23S rRNA was high. The mutation group had more serious clinical symptoms, longer course of treatment and more complications, suggesting that gene mutation was related to MP resistant. Compared with gene sequencing, the positive rate and drug resistant rate were lower in vitro culture and drug susceptibility tests. MP 23S rRNA gene sequencing could be used as a means of drug resistant detection and had clinical value. |
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