儿童肺炎支原体肺炎的耐药现状及药物治疗 研究进展

Current Status of Drug Resistance and Research Progress in Drug Therapy for Mycoplasma Pneumoniae Pneumonia in Children

摘要: 肺炎支原体(Mycoplasma pneumoniae, MP)是儿童社区获得性肺炎最常见的非细菌性病原体，在5岁以上儿童呼吸道感染中占比超过30%。近年来，大环内酯类耐药肺炎支原体(Macrolide-Resistant Mycoplasma pneumoniae, MRMP)在我国呈现高流行、高致病、高传播的特点，不仅显著延长患儿发热时间与住院周期，还明显提升重症肺炎、难治性肺炎、肺外并发症及后遗症的发生率，已成为儿科呼吸领域亟待解决的公共卫生问题。本文结合国内外最新指南、临床研究与基础研究成果，系统阐述儿童肺炎支原体肺炎的耐药流行病学特征、分子耐药机制、临床药物治疗方案、耐药检测技术及防控策略，全面梳理当前研究进展，为临床精准诊疗、合理用药及耐药管控提供理论参考与循证依据。

Abstract: Mycoplasma pneumoniae (MP) is the most common non-bacterial pathogen causing community-acquired pneumonia in children, accounting for over 30% of respiratory infections in children over the age of five. In recent years, macrolide-resistant Mycoplasma pneumoniae (MRMP) in China has shown high prevalence, high pathogenicity, and high transmissibility. It not only significantly prolongs fever duration and hospitalization in affected children but also markedly increases the incidence of severe pneumonia, refractory pneumonia, extrapulmonary complications, and sequelae, becoming an urgent public health issue in pediatric respiratory medicine. This article systematically reviews the epidemiological characteristics of antibiotic resistance, molecular mechanisms of resistance, clinical drug treatment regimens, resistance detection techniques, and prevention and control strategies for pediatric Mycoplasma pneumoniae pneumonia, based on the latest guidelines, clinical research, and basic research findings both domestically and internationally. It aims to provide a comprehensive overview of current research progress and offer theoretical reference and evidence-based guidance for precise clinical diagnosis and treatment, rational drug use, and resistance management.