Genetic diversity and macrolide resistance of Mycoplasma pneumoniae isolates from two consecutive epidemics in Slovenia

Abstract

Two nationwide Mycoplasma pneumoniae epidemics occurred in Slovenia between 2006 and 2016. The aim of this study was to assess which M. pneumoniae genotypes were present in our area during the selected timeframe, whether the origin of the epidemics was monoclonal or polyclonal and whether the proportion between detected genotypes changed over time. We were also interested in the presence of macrolide resistance (MR) and whether it could be linked to specific genotypes. We performed pyrosequencing of the P1 gene and multiple-locus variable-number tandem repeat (VNTR) analysis (MLVA) typing from 872 M. pneumoniae isolates obtained from respiratory tract infections (RTI)-suffering patients. Additionally, isolates were tested for the presence of MR implicated mutations in the 23S rRNA gene. The MLVA typing results revealed that three main genotypes, MLVA-3,5,6,2, MLVA-3,6,6,2 and MLVA-4,5,7,2, were constantly present and occasionally joined by less abundant, short-lived genotypes, which were detected mostly, but not exclusively, during epidemics. We also noticed a switch in abundance from MLVA-3,5,6,2 and MLVA-3,6,6,2, which dominated in the first epidemic (77.0%; 97/126), to MLVA-4,5,7,2 (71.6%; 428/598), which dominated in the second. Similar to this finding, the dominant P1 type also shifted from type 2 to type 1, although a complete P1 type shift was not observed, since both types remained in circulation. MR was detected in 0.8% (7/872) of M. pneumoniae isolates. Our results seem to suggest that MR remains sporadic in Slovenia at this point in time and that both recent epidemics were polyclonal in nature and, possibly, to some extent, fuelled by the P1 type dominance change.

Positively interacting strains that circulate in a network structured population induce cycling epidemics of Mycoplasma Pneumoniae

“…The cycle of dominant strain shift ranges from 3 to 30 years (Figure 4G), which covers the observational ranges: 10–16 years (Kendri et al ., 2008; Kogoj et al ., 2017). Figure 4J indicates that when κ < κ ac , the cycle of dominant strain shift can be 1–6 times the duration of recurrent epidemics; when κ > κ ac , the cycle of dominant strain shift approximates the epidemic cycle.…”

“…Kenri et al (2008) noticed that more than one serotype of MP were circulating within Japanese populations. Kogoj et al . (2017) observed a shift in the dominant MP strain between two epidemics that occurred in Slovenia in 2006 and 2016.…”

“…The two distinctive aspects of the MP epidemics: the prevalent serotype shifts among epidemics (Kenri etal ., 2008; Suzuki etal ., 2015; Zhao etal ., 2015; Brown etal ., 2016; Kogoj et al ., 2017) and cycling of MP incidence may be interconnected. This has been proposed before.…”

Mycoplasma pneumoniae infections, 11 countries in Europe and Israel, 2011 to 2016

“…This association was most clear during the 2011/12 epidemic period, but also held true for the subsequent epidemic periods of 2014/15 and 2015/16. Previous national-based studies have shown epidemics to be polyclonal in nature [25][26][27][28][29][30]. Establishing whether the microbiological nature of the epidemics across Europe are clonal or not, may be beneficial and influence future sentinel surveillance design.…”

Molecular Characterization of Mycoplasma pneumoniae Isolates in the United States from 2012 to 2018

“…In this study period (2012 to 2018), the three MLVA types were still dominant but the proportions changed: 4-5-7-2 (35.3%), 3-5-6-2 (41.8%), and 3-6-6-2 (16.6%). Since 2011 to 2014, the proportion of MLVA type 4-5-7-2 has been changing in two directions worldwide, increasing in some European countries (40,49,65) and decreasing in Japan and China (24,30,62). This change corresponded to the P1 subtype shift in these regions.…”