Clinical features and seasonal variations in the prevalence of macrolide‐resistant Mycoplasma pneumoniae

Abstract

Background Mycoplasma pneumoniae is a common pathogen causing pneumonia; macrolide‐resistant strains are rapidly spreading across Japan. However, the clinical features of macrolide‐resistant M. pneumoniae pneumonia have not been well established. Here, we evaluated the clinical characteristics and seasonal variations in the prevalence of M. pneumoniae with macrolide‐resistant mutations (MRM).MethodsThe monthly prevalence of MRM in M. pneumoniae strains isolated from May 2016 to April 2017 was retrospectively analyzed, and the clinical characteristics of pneumonia cases with MRM were compared to those of cases without MRM. The M. pneumoniae isolates and point mutations at site 2063 or 2064 in domain V of 23S rRNA were evaluated by the GENECUBE system and GENECUBE Mycoplasma detection kit.Results Mycoplasma pneumoniae infection was identified in 383 cases, including 221 cases of MRM (57.7%). The MRM prevalence was 86.3% (44/51) between May and July 2016, demonstrating an apparent decrease in September 2016, subsequently reaching 43.0% (34/79) in November 2016. Mycoplasma pneumoniae pneumonia was diagnosed in 275 cases, including 222 pediatric and 53 adult cases. Macrolide use preceding evaluation was found to be the only feature of MRM pneumonia cases both in children (odds ratio [OR] 3.86, 95% confidence interval [CI]:1.72–8.66) and in adults (OR 7.43, 95% CI: 1.67–33.1).ConclusionsThe determination rate of MRM varied widely throughout the year, and our study demonstrated the challenges in predicting M. pneumoniae with MRM based on clinical features at diagnosis. Therefore, continuous monitoring of the prevalence of MRM is warranted, which may help in selecting an effective treatment.

Nomogram for Prediction of Bronchial Mucus Plugs in Children with Mycoplasma pneumoniae Pneumonia

“…M. pneumoniae pneumonia (MPP) accounts for up to 40% or more of CAP in children, increasing the rate of morbidity, mortality, as well as the cost of health care in China [5][6][7][8] . Although MPP is usually a benign and self-limited disease, a number of cases had been reported to develop into refractory MPP 5,[9][10][11][12] . Furthermore, more than a third of refractory MPP were found to have bronchial mucus plugs (BMP) formation 9 .…”

Predicting Mycoplasma pneumoniae and Chlamydophila pneumoniae in community-acquired pneumonia (CAP) pneumonia: epidemiological study of respiratory tract infection using multiplex PCR assays

“…Patients with macrolide-resistant Mycoplasma pneumonia have presented prolonged fever and cough with high prevalence of extrapulmonary complications, sometimes resulting in life-threatening infection [ 30 – 32 ]. Mutation analysis with molecular methods can reliably determine the presence of macrolide resistance [ 30 , 33 ]. Among CAP patients, the reported macrolide resistance rate has been reported as 88.3% in China, 70.3% in Korea, 49.4% in Japan, 20% in Italy, 10% in the United States and 3.1% in Germany [ 34 – 39 ].…”

Immunological Features of Pediatric Interstitial Pneumonia Due to Mycoplasma pneumoniae

“…Mycoplasma pneumoniae pneumonia (MPP) accounts for up to 40% or more of CAP in children, increasing the rate of morbidity, mortality, as well as the cost of health care in China (3)(4)(5)(6). Although MPP is usually a benign and self-limited disease, a number of cases were reported to develop into refractory MPP (3,(7)(8)(9)(10). Children with refractory MPP frequently presented with delayed radiographic resolution and long-standing pulmonary sequelae such as bronchiectasis and atelectasis, even causing plastic bronchitis or requiring intensive care (3,7,11,12).…”