2011-2024年南阳市肺炎支原体流行预测模型的建立及分子流行病学特征分析OA

Objective To analyze the epidemic trend,etiological characteristics,and genetic variation and evolution of Mycoplasma pneumoniae(MP)in Nanyang,thereby providing evidence for the assessment of clinical laboratory MP detection capabilities and epidemic prevention and control.Methods Retrospective collection was performed on MP detection data from 117,382 febrile patients admitted to Nanyang Central Hospital from January 2011 to March 2024.The epidemiological characteristics,drug resistance trends,and methodological differences in laboratory detection of MP infection were analyzed.Based on time-series analysis in R language,the ARIMA model was used to model the positive rate of laboratory-detected MP-IgM,and the optimal prediction model for MP infection was screened according to the Bayesian Information Criterion(BIC)of goodness-of-fit statistics.MP sequences were obtained from the GenBank database of the United States,and the adhesion protein(P1)region of each isolate was intercepted with reference to the MP prototype strain to construct a phylogenetic tree and perform genetic variation analysis.Results MP infection remained continuously epidemic in Nanyang from 2011 to 2024.From 2011 to 2019,MP infection occurred alternately or concurrently with other respiratory pathogens;from 2020 to 2022,MP showed a single epidemic with an upward trend;while from 2023 to 2024,mixed epidemics of MP and influenza A virus(IAV)were observed.Preschool children accounted for the majority of MP-infected patients.The resistance to macrolide antibiotics in MP was consistent with the epidemic trend,showing a wave pattern,with an average resistance rate exceeding 80%,peaking in 2024.All resistance mutations were located at the A2063G locus.Fluorescent quantitative PCR and Sanger sequencing(first-generation sequencing)showed significant advantages in detecting MP-DNA from bronchoalveolar lavage fluid.MP-IAV was the most common type of mixed infection.In patients under 14 years old,other mixed infections also included MP-influenza B virus,MP-rhinovirus,MP-parainfluenza virus,MP-respiratory syncytial virus,and MP-adenovirus.The optimal MP infection prediction model was screened as ARIMA(2,1,3)(0,1,1)12,which exhibited high predictive accuracy.Compared with the MP prototype strain,MP P1 had undergone varying degrees of evolution,and the current prevalent genotype in Nanyang was MP P1 type II.Conclusions MP infection is continuously prevalent in Nanyang.Combined detection of nucleic acid and IgM is reasonable for clinical MP testing.The high drug resistance rate and high mixed infection rate of MP necessitate widespread vaccination and rational use of clinical antibiotics.