Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022

Ishiwada, Naruhiko; Shinjoh, Masayoshi; Kusama, Yoshiki; Arakawa, Hirokazu; Ohishi, Tomohiro; Saitoh, Akihiko; Suzuki, Akira; Tsutsumi, Hiroyuki; Nishi, Junichiro; Hoshino, Tadashi; Mitsuda, Toshihiro; Miyairi, Isao; Iwamoto-Kinoshita, Noriko; Kobayashi, Hisato; Satoh, Kouichiro; Shimizu, Akihiko; Takeshita, Kenichi; Tanaka, Takaaki; Tamura, Daisuke; Tokunaga, Osamu; Tomita, Kentaro; Nagasawa, Koo; Funaki, Takanori; Furuichi, Muhehiro; Miyata, Ippei; Yaginuma, Mizuki; Yamaguchi, Yoshio; Yamamoto, Shota; Uehara, Suzuko; Kurosaki, Tomomichi; Okada, Kenji; Ouchi, Kazunobu

doi:10.1097/inf.0000000000004041

Cited by 5 publications

(2 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We retrospectively obtained information including demographic data, underlying conditions, laboratory data (routine blood examination, liver function, and coagulation function), chest imaging data, antibiotic therapy during hospitalization, fever duration, cough duration, diagnosis, and prognosis. The diagnostic criteria for MPP were based on the Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022 15 and the Chinese Guidelines for Diagnosis and Treatment of Mycoplasma Pneumoniae Pneumonia in Children (2023 Edition). 16 Macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) is defined as persistent fever ≥3 days after macrolide treatment.…”

Section: Methodsmentioning

confidence: 99%

Azithromycin Effectiveness in Children with Mutated Mycoplasma Pneumoniae Pneumonia

Cheng,

Liu,

Zhang

et al. 2024

IDR

View full text Add to dashboard Cite

Section: Methodsmentioning

confidence: 99%

Azithromycin Effectiveness in Children with Mutated Mycoplasma Pneumoniae Pneumonia

Cheng,

Liu,

Zhang

et al. 2024

IDR

View full text Add to dashboard Cite

“…Mycoplasma pneumoniae is the causative agent in community-acquired pneumonia, especially in children and young adults [ 1 ]. Macrolides are the first-line treatment for respiratory tract infections caused by M. pneumoniae [ 2 ]. However, macrolide-resistant M. pneumoniae (MRMP) was detected for the first time in 2001 in Japan [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Novel Knowledge of Macrolide Resistance in Mycoplasma pneumoniae by Azithromycin Exposure

Oishi,

Hattori,

Yoshioka

2024

Microorganisms

View full text Add to dashboard Cite

The rise of macrolide-resistant Mycoplasma pneumoniae (MRMP), marked by point mutations in the 23S rRNA gene, poses a growing global concern since its initial detection in 2001. The prominence of the A2063G mutation during this emergence remains unexplained. This study aimed to clarify the possibility of detecting MRMP from recent clinical macrolide-susceptible M. pneumoniae through exposure to azithromycin (AZM), which has a long half-life and was launched immediately before the first MRMP detection. Six strains isolated from Japanese children in 2019 and reference strain (FH), all belonging to the recent dominant P1 genotype, two, or two subtype, were cultivated in a medium containing slightly higher concentrations than the originated minimum inhibitory concentration (MIC) of AZM and underwent sequencing if they grew. Four out of the seven strains grew after exposure to AZM, and C2617G and C2617A were detected, with no mutation in two strains. After another cultivation and sequencing, two of four strains grew, one was changed from C2617G to A2063G, and the other remained C2617A. The MIC of AZM in A2063G strains was 128 mg/mL; for C2617A, it was 0.0156 mg/mL. This is the first study to detect the strains with A2063G mutation from recent macrolide-susceptible M. pneumoniae using AZM exposure.

show abstract

Expert consensus on the diagnosis and treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children

Wang,

Zhou,

Bai

et al. 2024

World J Pediatr

View full text Add to dashboard Cite

Background Mycoplasma pneumoniae (M. pneumoniae) is a significant contributor to community-acquired pneumonia among children. Since 1968, when a strain of M. pneumoniae resistant to macrolide antibiotics was initially reported in Japan, macrolide-resistant M. pneumoniae (MRMP) has been documented in many countries worldwide, with varying incidence rates. MRMP infections lead to a poor response to macrolide antibiotics, frequently resulting in prolonged fever, extended antibiotic treatment, increased hospitalization, intensive care unit admissions, and a significantly higher proportion of patients receiving glucocorticoids or second-line antibiotics. Since 2000, the global incidence of MRMP has gradually increased, especially in East Asia, which has posed a serious challenge to the treatment of M. pneumoniae infections in children and attracted widespread attention from pediatricians. However, there is still no global consensus on the diagnosis and treatment of MRMP in children. Methods We organized 29 Chinese experts majoring in pediatric pulmonology and epidemiology to write the world’s first consensus on the diagnosis and treatment of pediatric MRMP pneumonia, based on evidence collection. The evidence searches and reviews were conducted using electronic databases, including PubMed, Embase, Web of Science, CNKI, Medline, and the Cochrane Library. We used variations in terms for “macrolide-resistant”, “Mycoplasma pneumoniae”, “MP”, “M. pneumoniae”, “pneumonia”, “MRMP”, “lower respiratory tract infection”, “Mycoplasma pneumoniae infection”, “children”, and “pediatric”. Results Epidemiology, pathogenesis, clinical manifestations, early identification, laboratory examination, principles of antibiotic use, application of glucocorticoids and intravenous immunoglobulin, and precautions for bronchoscopy are highlighted. Early and rapid identification of gene mutations associated with MRMP is now available by polymerase chain reaction and fluorescent probe techniques in respiratory specimens. Although the resistance rate to macrolide remains high, it is fortunate that M. pneumoniae still maintains good in vitro sensitivity to second-line antibiotics such as tetracyclines and quinolones, making them an effective treatment option for patients with initial treatment failure caused by macrolide antibiotics. Conclusions This consensus, based on international and national scientific evidence, provides scientific guidance for the diagnosis and treatment of MRMP in children. Further studies on tetracycline and quinolone drugs in children are urgently needed to evaluate their effects on the growth and development. Additionally, developing an antibiotic rotation treatment strategy is necessary to reduce the prevalence of MRMP strains.

show abstract

Guidelines for the Management of Respiratory Infectious Diseases in Children in Japan 2022

Cited by 5 publications

References 30 publications

Azithromycin Effectiveness in Children with Mutated Mycoplasma Pneumoniae Pneumonia

Azithromycin Effectiveness in Children with Mutated Mycoplasma Pneumoniae Pneumonia

Novel Knowledge of Macrolide Resistance in Mycoplasma pneumoniae by Azithromycin Exposure

Expert consensus on the diagnosis and treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children

Contact Info

Product

Resources

About