Macrolide-Resistant <i>Mycoplasma pneumoniae</i> Infection, Japan, 2008–2015

Tanaka, Takaaki; Oishi, Tomohiro; Miyata, Ippei; Wakabayashi, Shoko; Kono, Mina; Ono, Sahoko; Kato, Atsushi; Fukuda, Yoko; Saito, Aki; Kondo, Eisuke; Teranishi, Hideto; Tanaka, Yuki; Wakabayashi, Tokio; Akaike, Hiroto; Ogita, Satoko; Ohno, Naoki; Nakano, Takashi; Terada, Kihei; Ouchi, Kazunobu

doi:10.3201/eid2310.170106

Cited by 78 publications

(62 citation statements)

References 14 publications

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“…After collection, each swab was placed into 3 mL of Universal Viral Transport Medium (Becton, Dickinson and Company) for DNA extracts. Mycoplasma pneumonia DNA was detected by real‐time PCR targeting a conserved part of the gene encoding the P1 adhesin …”

Section: Participants and Methodsmentioning

confidence: 99%

Multi‐season analyses of causative pathogens in children hospitalized with asthma exacerbation

Abe

Yasudo

Fukano

et al. 2019

Pediatric Allergy Immunology

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Background Respiratory viral and mycoplasma infections are associated with childhood asthma exacerbations. Here, we explored epidemiologic profile of causative pathogens and possible factors for exacerbation in a single center over a three‐year period. Methods Hospitalized asthmatic children with attack aged 6 months‐17 years were recruited between 2012 and 2015 (n = 216). Nasopharyngeal mucosa cell samples were collected from the participants and examined by reverse transcription‐polymerase chain reaction to detect rhinovirus (RV), respiratory syncytial virus (RSV), enterovirus (EV), parainfluenza virus (PIV), Mycoplasma pneumoniae, and others. Clinical features, laboratory data, asthma exacerbation intensity, and asthma severity were compared among participants. Epidemiologic profile of causative pathogens and possible factors for exacerbation were explored. Results Viruses and/or Mycoplasma pneumoniae were detected in 75% of the participants. Rhinovirus (48%) was the most commonly detected virus in the participants with single infection, followed by RSV (6%). The median age at admission in the RV group was significantly higher than that in the RSV group. Insufficient asthma control and allergen sensitization were significantly related to RV‐associated asthma exacerbation. There was no seasonality of pathogen types associated with asthma exacerbation although a sporadic prevalence of EV‐D68 was observehinovirud. Rhinovirus were repeatedly detected in multiple admission cases. Conclusion Our three‐year analysis revealed that patients with RV infection were significantly prone to repeated RV infection in the subsequent exacerbation and good asthma control could prevent RV‐associated asthma development and exacerbation. Multiple‐year monitoring allowed us to comprehend the profile of virus‐ and/or mycoplasma‐induced asthma exacerbation.

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Section: Participants and Methodsmentioning

confidence: 99%

Multi‐season analyses of causative pathogens in children hospitalized with asthma exacerbation

Abe

Yasudo

Fukano

et al. 2019

Pediatric Allergy Immunology

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“…Although her symptoms got better with levofloxacin, we should have administered corticosteroid as a cellular immune suppressor with antibiotic treatment. We did not use macrolide first because the prevalence of macrolide‐resistant M. pneumoniae remains high in Japan . One study reported the prevalence of macrolide‐resistant M. pneumoniae in adult patients with CAP was 100%.…”

Section: Discussionmentioning

confidence: 99%

“…We did not use macrolide first because the prevalence of macrolide-resistant M. pneumoniae remains high in Japan. 10 One study reported the prevalence of macrolideresistant M. pneumoniae in adult patients with CAP was 100%. The prevalence of azithromycin-resistant M. pneumoniae was reported 72%, and tuberculosis test was negative in this patient; thus, we chose levofloxacin instead of macrolide antibiotics.…”

Section: Discussionmentioning

confidence: 99%

An atypical case of atypical pneumonia

Ota

Iida

Ota

et al. 2018

J of Gen and Family Med

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Atypical pneumonia has been thought to account for 7%‐20% of community‐acquired pneumonia (CAP). The treatment for the pathogens that cause atypical pneumonia is different from that of other bacterial pneumonia. Therefore, identification of the causative pathogen in a primary care situation is crucial for adequate treatment of CAP. Mycoplasma infection is prevalent in the general population, but Mycoplasma pneumoniae with extrapulmonary symptoms is relatively rare. Herein, we report a case of CAP because of M. pneumoniae that presented with a wide variety of extrapulmonary diseases. Delayed administration of appropriate antibiotics may contribute to development of extrapulmonary manifestations.

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“…Tanaka et al15 reported a year‐by‐year variation in the prevalence of macrolide‐resistant M. pneumoniae in Japan, demonstrating an increase from 55.6% to 81.6% between 2008 and 2012, with a gradual decrease thereafter, reaching 43.6% by 2015. Despite this decrease, the macrolide resistance rate of M. pneumoniae remains high in Japan, and its clinical importance is unaltered.…”

Section: Introductionmentioning

confidence: 99%

“…13,14 The prevalence of macrolide-resistant M. pneumoniae is 23.3%-100% in East Asian regions, 3.5%-13.2% in North America, and below 10% in European countries, except Italy, which has a higher rate of 26%. 11 Tanaka et al 15…”

Section: Introductionmentioning

confidence: 99%

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

Akashi

Hayashi

Suzuki

et al. 2018

J of Gen and Family Med

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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.

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Macrolide-Resistant Mycoplasma pneumoniae Infection, Japan, 2008–2015

Cited by 78 publications

References 14 publications

Multi‐season analyses of causative pathogens in children hospitalized with asthma exacerbation

Multi‐season analyses of causative pathogens in children hospitalized with asthma exacerbation

An atypical case of atypical pneumonia

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

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