Community-acquired Pneumonia Caused by Macrolide-resistant &lt;i&gt;Mycoplasma pneumoniae&lt;/i&gt; in Adults

Hanada, Shigeo; Morozumi, Miyuki; Takahashi, Yasuhiro; Mochizuki, Seibu; Sato, Toshitaka; Suzuki, Shinichi; Uruga, Hironori; Takaya, Hisashi; Miyamoto, Atsushi; Morokawa, Nasa; Ubukata, Kimiko; Kishi, Kazuma

doi:10.2169/internalmedicine.53.1418

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…MRMPs are isolated more frequently from adolescent and pediatric patients than from adults, which is likely related to the frequent use of macrolides for treatments of mycoplasmal infections at younger ages. However, isolation of MRMPs from adult patients is also on the rise ( Isozumi et al, 2009 ; Miyashita et al, 2012 ; Yoo et al, 2012 ; Hanada et al, 2014 ; Zhou et al, 2015 ). Most of the MRMPs isolated in Japan carry the A2063G mutation in domain V of the 23S rRNA gene that confers strong resistance to 14- and 15-membered macrolides and lincosamides.…”

Section: Emergence Of Macrolide-resistant M Pneumoniae mentioning

confidence: 99%

Epidemiology of Mycoplasma pneumoniae Infections in Japan and Therapeutic Strategies for Macrolide-Resistant M. pneumoniae

Yamazaki¹,

Kenri

2016

Front. Microbiol.

115

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Pneumonia caused by Mycoplasma pneumoniae (M. pneumoniae pneumonia) is a major cause of community-acquired pneumonia worldwide. The surveillance of M. pneumoniae pneumonia is important for etiological and epidemiological studies of acute respiratory infections. In Japan, nation-wide surveillance of M. pneumoniae pneumonia has been conducted as a part of the National Epidemiological Surveillance of Infectious Diseases (NESID) program. This surveillance started in 1981, and significant increases in the numbers of M. pneumoniae pneumonia patients were noted in 1984, 1988, 2006, 2010, 2011, 2012, and 2015. The epidemics in 2011 and 2012 were particularly widespread and motivated researchers to conduct detailed epidemiological studies, including genotyping and drug resistance analyses of M. pneumoniae isolates. The genotyping studies based on the p1 gene sequence suggested that the p1 gene type 1 lineage has been dominant in Japan since 2003, including the epidemic period during 2011–2012. However, more detailed p1 typing analysis is required to determine whether the type 2 lineages become more relevant after the dominance of the type 1 lineage. There has been extensive research interest in implications of the p1 gene types on the epidemiology of M. pneumoniae infections. Serological characterizations of sera from patients have provided a glimpse into these associations, showing the presence of type specific antibody in the patient sera. Another important epidemiological issue of M. pneumoniae pneumonia is the emergence of macrolide-resistant M. pneumoniae (MRMP). MRMPs were noted among clinical isolates in Japan after 2000. At present, the isolation rate of MRMPs from pediatric patients is estimated at 50–90% in Japan, depending on the specific location. In view of the situation, Japanese societies have issued guiding principles for treating M. pneumoniae pneumonia. In these guiding principles, macrolides are still recommended as the first-line drug, however, if the fever does not subside in 48–72 h from first-line drug administration, a change of antibiotics to second-line drugs is recommended.

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Section: Emergence Of Macrolide-resistant M Pneumoniae mentioning

confidence: 99%

Epidemiology of Mycoplasma pneumoniae Infections in Japan and Therapeutic Strategies for Macrolide-Resistant M. pneumoniae

Yamazaki¹,

Kenri

2016

Front. Microbiol.

115

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“…Macrolide-resistant M. pneumoniae was first reported in Japan in Okazaki et al (2001) and has since been continuously reported in increasing percentages among the population ( Matsuoka et al, 2004 ; Miyashita et al, 2012 , 2013 ; Kawai et al, 2013 ; Hanada et al, 2014 ). However, the prevalence of macrolide-resistant M. pneumoniae varies among countries.…”

Section: Chemotherapy and Vaccinesmentioning

confidence: 99%

A Compendium for Mycoplasma pneumoniae

2016

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Historically, atypical pneumonia was a term used to describe an unusual presentation of pneumonia. Currently, it is used to describe the multitude of symptoms juxtaposing the classic symptoms found in cases of pneumococcal pneumonia. Specifically, atypical pneumonia is a syndrome resulting from a relatively common group of pathogens including Chlamydophila sp., and Mycoplasma pneumoniae. The incidence of M. pneumoniae pneumonia in adults is less than the burden experienced by children. Transmission rates among families indicate children may act as a reservoir and maintain contagiousness over a long period of time ranging from months to years. In adults, M. pneumoniae typically produces a mild, "walking" pneumonia and is considered to be one of the causes of persistent cough in patients. M. pneumoniae has also been shown to trigger the exacerbation of other lung diseases. It has been repeatedly detected in patients with bronchitis, asthma, chronic obstructive pulmonary disorder, and cystic fibrosis. Recent advances in technology allow for the rapid diagnosis of M. pneumoniae through the use of polymerase chain reaction or rapid antigen tests. With this, more effort has been afforded to identify the causative etiologic agent in all cases of pneumonia. However, previous practices, including the overprescribing of macrolide treatment in China and Japan, have created increased incidence of macrolide-resistant M. pneumoniae. Reports from these countries indicate that >85% of M. pneumoniae pneumonia pediatric cases are macrolide-resistant. Despite its extensively studied past, the smallest bacterial species still inspires some of the largest questions. The developments in microbiology, diagnostic features and techniques, epidemiology, treatment and vaccines, and upper respiratory conditions associated with M. pneumoniae in adult populations are included within this review.

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“…In addition to these virulence factors, the emergence of macrolide-resistant M. pneumoniae strains [58][59][60] (by point mutations in the 23S RNA gene [61]) and the frequency of extrapulmonary complications (neurological, cardiac, dermatological, musculoskeletal, and hematological) reportedly make treatment more difficult [62]. Extrapulmonary complications are associated with an active immune response to the pathogen and excessive expression of cytokines such as IL-18, which was demonstrated in the case-control study of pneumonia caused by M. pneumoniae reported by Tanaka et al [63].…”

Section: Mycoplasma Pneumoniaementioning

confidence: 99%

Community-acquired pneumonia related to intracellular pathogens

Cillóniz¹,

Niederman

Eerden

et al. 2016

Intensive Care Med

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Community-acquired pneumonia (CAP) is associated with high rates of morbidity and mortality worldwide; the annual incidence of CAP among adults in Europe has ranged from 1.5 to 1.7 per 1000 population. Intracellular bacteria are common causes of CAP. However, there is considerable variation in the reported incidence between countries and change over time. The intracellular pathogens that are well established as causes of pneumonia are Legionella pneumophila, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Chlamydophila psittaci, and Coxiella burnetii. Since it is known that antibiotic treatment for severe CAP is empiric and includes coverage of typical and atypical pathogens, microbiological diagnosis bears an important relationship to prognosis of pneumonia. Factors such as adequacy of initial antibiotic or early de-escalation of therapy are important variables associated with outcomes, especially in severe cases. Intracellular pathogens sometimes appear to cause more severe disease with respiratory failure and multisystem dysfunction associated with fatal outcomes. The clinical relevance of intracellular pathogens in severe CAP has not been specifically investigated. We review the prevalence, general characteristics, and outcomes of severe CAP cases caused by intracellular pathogens.

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Community-acquired Pneumonia Caused by Macrolide-resistant <i>Mycoplasma pneumoniae</i> in Adults

Cited by 6 publications

References 9 publications

Epidemiology of Mycoplasma pneumoniae Infections in Japan and Therapeutic Strategies for Macrolide-Resistant M. pneumoniae

Epidemiology of Mycoplasma pneumoniae Infections in Japan and Therapeutic Strategies for Macrolide-Resistant M. pneumoniae

A Compendium for Mycoplasma pneumoniae

Community-acquired pneumonia related to intracellular pathogens

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