Characteristics of Macrolide‐Resistant Mycoplasma pneumoniae Strains Isolated from Patients and Induced with Erythromycin In Vitro

Okazaki, Norio; Narita, Mitsuo; Yamada, Satoshi; Izumikawa, Kinichi; Umetsu, Masao; Kenri, Tsuyoshi; Sasaki, Yuko; Arakawa, Yoshichika; Sasaki, Tsuguo

doi:10.1111/j.1348-0421.2001.tb01293.x

Cited by 159 publications

(152 citation statements)

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“…Macrolides are generally considered the drugs of choice for treatment of children with M. pneumoniae infection (2). Since approximately the year 2000, macrolide-resistant (MR) M. pneumoniae has been appearing in Asia, Europe, Canada, and the USA (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). The rate of macrolide resistance among M. pneumoniae infections ranges from 3 to 26z in Europe (9,15), from 63 to 97z in China (16)(17)(18)(19), and from 25 to 93z in Japan (20)(21)(22).…”

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Regional Differences in Prevalence of Macrolide Resistance among Pediatric Mycoplasma pneumoniae Infections in Hokkaido, Japan

et al. 2016

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SUMMARY:Recently, macrolide-resistant (MR) Mycoplasma pneumonia appeared, and prevalence of macrolide resistance among M. pneumoniae infections varies by country. However, reports on regional differences in the prevalence of MR M. pneumonia within a country are scarce. In this study, 617 nasopharyngeal swab samples were collected from 617 pediatric patients, and DNA of M. pneumoniae was identified in 95 samples. In 51 of the 95 M. pneumonia positive samples, we detected the presence of mutation A2063G mutation (conferring macrolide resistance) in the 23S rRNA gene. The overall macrolide resistance rate was 53.7z, but there were regional differences: 0.0z in Muroran, 5.3z in Asahikawa, 55.3z in Sapporo, and 100.0z in Kushiro. Statistically significant pairwise differences in the prevalence of MR M. pneumoniae were observed among these cities except for the pair of Muroran and Asahikawa. After exclusion (in order to avoid the influence of macrolides) of patients who were prescribed macrolides before collection of nasopharyngeal swab samples, statistically significant differences persisted: 0.0z in Muroran, 5.6z in Asahikawa, 38.5z in Sapporo, and 100.0z in Kushiro.

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confidence: 99%

Regional Differences in Prevalence of Macrolide Resistance among Pediatric Mycoplasma pneumoniae Infections in Hokkaido, Japan

et al. 2016

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“…pneumonia isolates had mutations in domain V of the 23S rRNA gene (1,2,10,11). Several studies indicated that macrolide resistance in M. pneumoniae may have clinical significance in terms of diminished response to treatment with drugs in this class (2,12,13).…”

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In Vitro Activities of 11 Antimicrobial Agents against Macrolide-Resistant Mycoplasma pneumoniae Isolates from Pediatric Patients: Results from a Multicenter Surveillance Study

et al. 2012

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SUMMARY: Macrolide-resistant Mycoplasma pneumoniae is emerging in several countries, and it is mainly observed in children. To our knowledge, we conducted the first multicenter prospective epidemiological study of macrolide-resistant M. pneumoniae in order to investigate regional differences in the susceptibility of macrolide-resistant M. pneumoniae to antibacterial agents. The in vitro activities of 11 antimicrobial agents against macrolide-resistant M. pneumoniae isolates from 5 different areas of Japan were investigated. Among 190 M. pneumoniae isolates from pediatric patients, 124 (65.2z) isolates showed macrolide resistance and possessed an A2063G transition in domain V of the 23S rRNA. These isolates showed high resistance to erythromycin, clarithromycin, and azithromycin with minimum inhibitory concentrations (MICs) AE16 mg/ml. Conversely, quinolones such as garenoxacin, moxifloxacin, tosufloxacin, and levofloxacin exhibited potent antimycoplasmal activity. No regional differences were observed with respect to the MICs among the 5 areas in Japan.

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“…A culture-independent MLVA method for use directly from clinical specimens has also been described (7). Macrolideresistant M. pneumoniae clinical isolates were first reported in the 1990s, and the incidence has been increasing ever since, with various rates in different geographic regions (16)(17)(18)(19)(20).In this study, we used MLVA, P1-RFLP analysis, and detection of macrolide resistance-associated mutations to compare characteristics of M. pneumoniae detected by PCR in clinical specimens from Beijing, China, and Sydney, Australia. Positive samples were identified using real-time PCR as described previously (21); only one sample from each patient was included.…”

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Molecular Characterizations of PCR-Positive Mycoplasma pneumoniae Specimens Collected from Australia and China

et al. 2014

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bMycoplasma pneumoniae is an important cause of community-acquired pneumonia (CAP). In this study, M. pneumoniae strains in PCR-positive specimens collected from patients in Sydney, Australia (30 samples), and Beijing, China (83 samples), were characterized using multilocus variable-number tandem-repeat (VNTR) analysis (MLVA), P1-restriction fragment length polymorphism (RFLP) analysis, and sequencing of domain V of the 23S rRNA gene to compare genotype distribution and macrolide resistance rates between locations. Eighteen distinct MLVA types were identified in specimens from Sydney, of which 10 were known (types E, G, J, M, N, P, U, V, S, and X) and 8 previously unknown. Strains were equally distributed between P1-RFLP type 1 and type 2 variants. Among samples from Beijing, MLVA types E, G, J, P, U, X, and Z and four new types were identified. Most specimens belonged to P1-RFLP type 1. A nomenclature based on five VNTR loci is proposed to designate MLVA patterns. Macrolide resistance-associated mutations were identified in only 1 of 30 specimens (3.3%) from Sydney and 71 of 83 (85.5%) from Beijing (P < 0.05). This study demonstrated that although multiple individual M. pneumoniae strains were circulating in Beijing, the genotypes were less diverse than those in Sydney. However, the greatest regional difference was in the incidence of macrolide resistance, which may reflect differences in antibiotic use and/or measures in resistance control. Mycoplasma pneumoniae is an important pathogen causing community-acquired pneumonia (CAP), especially in children and young adults (1, 2). M. pneumoniae infections are increasingly recognized epidemically worldwide and as being endemic to some regions (3, 4). Previous reports showed regional differences in molecular profiles of M. pneumoniae (3, 5-7). Knowledge of these molecular characteristics is essential for outbreak investigation and to monitor the epidemiology of M. pneumoniae infections.For the past 20 years, P1 gene restriction fragment length polymorphism (P1-RFLP) has been the most common molecular typing method for M. pneumoniae (8)(9)(10). Recombination events at two repetitive sequence loci, RepMP2/3 and RepMP4, (11) in the P1 gene contribute to gene variation, as reflected in sequence variants and subtypes, but the discriminatory power of this method is limited (12)(13)(14). Recently, a multilocus variable-number tandemrepeat (VNTR) analysis (MLVA) method was developed by Dégrange et al. for M. pneumoniae isolates; this has a higher discriminatory power and can differentiate more than 26 distinct types (15). A culture-independent MLVA method for use directly from clinical specimens has also been described (7). Macrolideresistant M. pneumoniae clinical isolates were first reported in the 1990s, and the incidence has been increasing ever since, with various rates in different geographic regions (16)(17)(18)(19)(20).In this study, we used MLVA, P1-RFLP analysis, and detection of macrolide resistance-associated mutations to compare characteristics of M. pneumoniae...

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Characteristics of Macrolide‐Resistant Mycoplasma pneumoniae Strains Isolated from Patients and Induced with Erythromycin In Vitro

Cited by 159 publications

References 12 publications

Regional Differences in Prevalence of Macrolide Resistance among Pediatric <i>Mycoplasma pneumoniae</i> Infections in Hokkaido, Japan

Regional Differences in Prevalence of Macrolide Resistance among Pediatric <i>Mycoplasma pneumoniae</i> Infections in Hokkaido, Japan

In Vitro Activities of 11 Antimicrobial Agents against Macrolide-Resistant Mycoplasma pneumoniae Isolates from Pediatric Patients: Results from a Multicenter Surveillance Study

Molecular Characterizations of PCR-Positive Mycoplasma pneumoniae Specimens Collected from Australia and China

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