Macrolide-resistant<i>Mycoplasma pneumoniae</i>in paediatric pneumonia: Table 1–

Cardinale, Fabio; Chironna, Maria; Dumke, Roger; Binetti, A; Daleno, Cristina; Sallustio, Anna; Valzano, Antonia; Esposito, Susanna

doi:10.1183/09031936.00172510

Cited by 39 publications

(30 citation statements)

References 11 publications

(8 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One explanation for this result is the possible acquisition of resistance to macrolides during treatment. In fact, several recent in vitro and in vivo studies have demonstrated that M. pneumoniae acquires macrolide resistance within a few days of administration of macrolide antibiotics 262728. However, we could not confirm this due to a lack of samples which were collected at different time points during the treatment course.…”

Section: Discussionmentioning

confidence: 63%

Macrolide Resistance and Its Impacts onM. PneumoniaePneumonia in Children: Comparison of Two Recent Epidemics in Korea

Kim

Yoo³

et al. 2017

Allergy Asthma Immunol Res

View full text Add to dashboard Cite

PurposeThe aim of this study was to investigate the change in macrolide resistance rate in pediatric Mycoplasma pneumoniae pneumonia and to evaluate the influence of macrolide-resistant M. pneumoniae (MRMP) on the clinical course of disease, by comparing 2 recent, consecutive epidemics in Korea.MethodsA total of 250 patients with M. pneumoniae pneumonia admitted to a single tertiary hospital were enrolled in this study. Detection of MRMP was based on specific point mutations in domain V of the 23S rRNA gene. The medical records of enrolled patients were reviewed retrospectively, and the clinical courses and laboratory data were compared.ResultsThe macrolide resistance rate of M. pneumoniae was 51.1% (48/94) in the 2011 epidemic, and 87.2% (136/156) in the 2015 epidemic. All MRMP isolates had the A2063G point mutation. In comparison of 2 epidemics, the mean age of patients with M. pneumoniae pneumonia was increased, and the total febrile days and febrile days after initiation of macrolides were prolonged in the 2015 epidemic. Overall severity of MRMP or macrolide-susceptible M. pneumoniae (MSMP) pneumonia over 2 epidemics was not significantly changed. However, the proportion of patients who had a fever lasting more than 72 hours after initiation of macrolides and who received corticosteroid treatment were higher in MRMP pneumonia during 2 epidemics.ConclusionsThe macrolide resistance rate of M. pneumoniae has risen rapidly over 2 recent, consecutive epidemics, and this has been associated with a prolonged clinical course and increased use of corticosteroids to treat pediatric M. pneumoniae pneumonia.

show abstract

Section: Discussionmentioning

confidence: 63%

Macrolide Resistance and Its Impacts onM. PneumoniaePneumonia in Children: Comparison of Two Recent Epidemics in Korea

Kim

Yoo³

et al. 2017

Allergy Asthma Immunol Res

View full text Add to dashboard Cite

show abstract

“…However, point mutations within the 23SrRNA gene in clinical specimens and isolates, including the A2058G mutation, have previously been shown to confer resistance [16]. Acquisition of resistance has been documented in patients receiving macrolides and resistance may develop as a consequence of antibiotic selective pressure [22]. This is supported by the highest macrolide resistance rates being reported in countries with extensive macrolide use [15].…”

Section: Discussionmentioning

confidence: 99%

Detection of macrolide resistant Mycoplasma pneumoniae in England, September 2014 to September 2015

et al. 2015

View full text Add to dashboard Cite

Mycoplasma pneumoniae infection can cause pneumonia, particularly in children. Global increase in macrolide-resistant M. pneumoniae is of concern due to limited therapeutic options. We describe the detection of macrolide resistance-conferring mutations in 9.3% of 43 clinical specimens where M. pneumoniae was detected in England and Wales from September 2014-September 2015. This study aims to impact by highlighting the presence of macrolide resistance in M. pneumoniae positive patients, promoting increased clinical vigilance. Macrolide resistance determinationThe Bacteriology Reference Department, Public Health England (PHE), London, receives specimens from England and Wales for M. pneumoniae testing and confirmatory testing. Here we detected M. pneumoniae by qPCR in 60 clinical specimens from 60 patients (Cambridge, Leeds, London, Manchester, Nottingham and Oxford) that were submitted to PHE between 1 September 2014 and 1 September 2015. DNA extractions from specimens, where M. pneumoniae was detected, were screened for point mutations known to confer macrolide resistance. Mutations in domain V of the 23S rRNA were detected by a modified version of the method described by Li et al., 2009 [3], wherein the entire region of interest is amplified and sequenced as one product. Primers used were as follows: forward primer 5'-ATCTCTTGACTGTCTCGGC-3' and reverse primer 5'-TACAACTGGAGCATAAGAGGTG-3'.Of the 60 specimens, 17 (28.3%; 95% confidence interval (CI): 18.4--40.8) contained insufficient DNA to determine macrolide resistance-conferring mutations. Of the remaining 43 specimens mutations in the 23S rRNA known to confer macrolide resistance were found in four (9.3%; 95% CI: 3.1-22.2). Of these 43 specimens, 32 were from a single city in England, Leeds, and a single specimen among these was positive for the mutation, 3.1% (95% CI: 0.01-17.1). The cases identified with point mutations known to confer macrolide-resistant M. pneumoniae were in two women and two men, respectively, aged > 15 to <65 years old. Three were hospitalised with pneumonia (Table) with no known connection between patients.Interestingly, two of the macrolide-resistant cases were patients that had recently arrived from the United States (exact timeline unknown); of which one had received clarithromycin whilst undergoing treatment in the UK. The origins of the infecting M. pneumoniae strains in these two cases may have been external to England and Wales. The other two cases were from separate cities in England. All macrolide resistanceconferring mutations were A2058G (Escherichia coli numbering) point mutation in the 23S rRNA.

show abstract

“…Antibiotic resistance is mainly due to point mutations at nucleotide positions A2063, A2064, or C2617 of domain V of 23S rRNA, or the ribosomal target of macrolides. Mutations at positions A2063 or A2064 confer a high level of resistance to macrolides, whereas mutations at positions A2067 and C2617 are related to a lower level of resistance12). A2063G is the most common mutation, followed by A2064G, but C2617A and mutations in the ribosomal proteins L4 and L22 have been reported rarely.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of C-reactive protein in response to macrolides in children with macrolide-resistantMycoplasma pneumoniaepneumonia

et al. 2014

View full text Add to dashboard Cite

PurposeThe prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) has increased worldwide. The aim of this study was to estimate the proportion of MRMP in a tertiary hospital in Korea, and to find potential laboratory markers that could be used to predict the efficacy of macrolides in children with MRMP pneumonia.MethodsA total of 95 patients with M. pneumoniae pneumonia were enrolled in this study. Detection of MRMP was based on the results of specific point mutations in domain V of the 23S rRNA gene. The medical records of these patients were reviewed retrospectively and the clinical course and laboratory data were compared.ResultsThe proportion of patients with MRMP was 51.6% and all MRMP isolates had the A2063G point mutation. The MRMP group had longer hospital stay and febrile period after initiation of macrolides. The levels of serum C-reactive protein (CRP) and interleukin-18 in nasopharyngeal aspirate were significantly higher in patients who did not respond to macrolide treatment. CRP was the only significant factor in predicting the efficacy of macrolides in patients with MRMP pneumonia. The area under the curve for CRP was 0.69 in receiver operating characteristic curve analysis, indicating reasonable discriminative power, and the optimal cutoff value was 40.7 mg/L.ConclusionThe proportion of patients with MRMP was high, suggesting that the prevalence of MRMP is rising rapidly in Korea. Serum CRP could be a useful marker for predicting the efficacy of macrolides and helping clinicians make better clinical decisions in children with MRMP pneumonia.

show abstract

Macrolide-resistantMycoplasma pneumoniaein paediatric pneumonia: Table 1–

Cited by 39 publications

References 11 publications

Macrolide Resistance and Its Impacts onM. PneumoniaePneumonia in Children: Comparison of Two Recent Epidemics in Korea

Macrolide Resistance and Its Impacts onM. PneumoniaePneumonia in Children: Comparison of Two Recent Epidemics in Korea

Detection of macrolide resistant Mycoplasma pneumoniae in England, September 2014 to September 2015

Predictive value of C-reactive protein in response to macrolides in children with macrolide-resistantMycoplasma pneumoniaepneumonia

Contact Info

Product

Resources

About