Nationwide Surveillance of Macrolide-Resistant Mycoplasma pneumoniae Infection in Pediatric Patients

Kawai, Yasuhiro; Miyashita, Naoyuki; Kubo, Mika; Akaike, Hiroto; Kato, Atsushi; Saito, Aki; Kondo, Eisuke; Teranishi, Hideto; Wakabayashi, Tokio; Ogita, Satoko; Tanaka, Takaaki; Kawasaki, Kozo; Nakano, Takashi; Terada, Kihei; Ouchi, Kazunobu

doi:10.1128/aac.00663-13

Cited by 92 publications

(76 citation statements)

References 21 publications

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“…Differences in the prevalence of MR M. pneumonia among prefectures in Japan have been reported previously (21). In the present report, we showed for the first time the differences in the prevalence of macrolide resistance among M. pneumoniae infections across cities in one prefecture of Japan.…”

Section: Discussionsupporting

confidence: 56%

“…Therefore, it is important to understand the regional prevalence of MR M. pneumoniae infections to predict the duration of fever caused by M. pneumoniae. Differences in the prevalence of MR M. pneumoniae among 7 surveillance areas throughout Japan were recently reported (21), but such differences among cities are not known. The purpose of this study was to determine the differences in prevalence of MR M. pneumonia among 4 cities in Hokkaido (83,457 km 2 ), the northernmost island of Japan.…”

Section: Introductionmentioning

confidence: 99%

“…Since approximately the year 2000, macrolide-resistant (MR) M. pneumoniae has been appearing in Asia, Europe, Canada, and the USA (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). The rate of macrolide resistance among M. pneumoniae infections ranges from 3 to 26z in Europe (9,15), from 63 to 97z in China (16)(17)(18)(19), and from 25 to 93z in Japan (20)(21)(22). The total number of febrile days and the number of febrile days during macrolide administration are greater in patients infected with MR M. pneumoniae than in patients infected with macrolide-sensitive (MS) M. pneumoniae (23).…”

Section: Introductionmentioning

confidence: 99%

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Regional Differences in Prevalence of Macrolide Resistance among Pediatric <i>Mycoplasma pneumoniae</i> Infections in Hokkaido, Japan

et al. 2016

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SUMMARY:Recently, macrolide-resistant (MR) Mycoplasma pneumonia appeared, and prevalence of macrolide resistance among M. pneumoniae infections varies by country. However, reports on regional differences in the prevalence of MR M. pneumonia within a country are scarce. In this study, 617 nasopharyngeal swab samples were collected from 617 pediatric patients, and DNA of M. pneumoniae was identified in 95 samples. In 51 of the 95 M. pneumonia positive samples, we detected the presence of mutation A2063G mutation (conferring macrolide resistance) in the 23S rRNA gene. The overall macrolide resistance rate was 53.7z, but there were regional differences: 0.0z in Muroran, 5.3z in Asahikawa, 55.3z in Sapporo, and 100.0z in Kushiro. Statistically significant pairwise differences in the prevalence of MR M. pneumoniae were observed among these cities except for the pair of Muroran and Asahikawa. After exclusion (in order to avoid the influence of macrolides) of patients who were prescribed macrolides before collection of nasopharyngeal swab samples, statistically significant differences persisted: 0.0z in Muroran, 5.6z in Asahikawa, 38.5z in Sapporo, and 100.0z in Kushiro.

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Regional Differences in Prevalence of Macrolide Resistance among Pediatric <i>Mycoplasma pneumoniae</i> Infections in Hokkaido, Japan

et al. 2016

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“…[18][19][20][21] Cell-mediated immunity of the host rather than direct microbial damage plays an important role in the progression of this illness. 22,23 Clinically and experimentally, steroids have a positive effect on refractory M. pneumoniae pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Lactate Dehydrogenase as a Biomarker for Prediction of RefractoryMycoplasma pneumoniaePneumonia in Children

et al. 2015

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BACKGROUND: Corticosteroids have been used for refractory Mycoplasma pneumoniae pneumonia and have beneficial effects. The aim of this study was to identify the biomarkers for predicting refractory M. pneumoniae pneumonia in a timely fashion to initiate steroid therapy. METHODS: This was a prospective cohort study of children with M. pneumoniae pneumonia admitted to the Children's Hospital of Fudan University from September 2012 to August 2013. Lactate dehydrogenase (LDH) and other laboratory tests, including complete blood counts, C-reactive protein, erythrocyte sedimentation rate (ESR), alanine aminotransferase, aspartate aminotransferase, ␣-hydroxybutyrate dehydrogenase (HBDH), creatine kinase, and creatine kinase MB, were performed on admission. Based on the definition of refractory M. pneumoniae pneumonia, subjects were divided into 2 groups: refractory M. pneumoniae pneumonia and usual M. pneumoniae pneumonia.The diagnostic values of laboratory findings were analyzed. RESULTS: In total, 653 subjects were enrolled, including 300 in the refractory pneumonia group and 353 in the usual pneumonia group. There was no significant difference in sex distribution between the 2 groups. The average age in the refractory M. pneumoniae pneumonia group was greater than that in the usual M. pneumoniae pneumonia group. Compared with the usual pneumonia group, the refractory pneumonia group showed significantly higher levels of C-reactive protein, serum LDH, serum HBDH, serum alanine aminotransferase, serum aspartate aminotransferase, and neutrophils and higher ESRs. Logistic regression showed that age, LDH, and ESR were the significant factors in predicting refractory M. pneumoniae pneumonia. In addition, LDH and HBDH were strongly correlated, and receiver operating characteristic curve analysis showed that the area under the curve of LDH was 0.718 with a cutoff of 379 IU/L, that of ESR was 0.683 with a cutoff of 32.5 IU/L, and that of HBDH was 0.691 with a cutoff of 259.5 IU/L. CONCLUSIONS: Serum LDH can be used as a biomarker to predict refractory M. pneumoniae pneumonia at the early stage of hospitalization.

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“…In Japan, the Infectious Disease Control Law mandates that the number of M. pneumoniae pneumonia cases diagnosed at designated sentinel sites be reported weekly, although these data do not include the prevalence trends of macrolide resistance. The rate of macrolide resistance was shown to vary from 50% to 93% across the seven districts of Japan,24 as well as among areas in the same prefecture ranging from 0 to 100% (Hokkaido) 23. In this study, we employed the GENECUBE system and GENECUBE Mycoplasma detection kit for point‐of‐care molecular examinations, which can determine the presence of M. pneumoniae and MRM within only 1 hour.…”

Section: Discussionmentioning

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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Nationwide Surveillance of Macrolide-Resistant Mycoplasma pneumoniae Infection in Pediatric Patients

Cited by 92 publications

References 21 publications

Regional Differences in Prevalence of Macrolide Resistance among Pediatric <i>Mycoplasma pneumoniae</i> Infections in Hokkaido, Japan

Regional Differences in Prevalence of Macrolide Resistance among Pediatric <i>Mycoplasma pneumoniae</i> Infections in Hokkaido, Japan

Lactate Dehydrogenase as a Biomarker for Prediction of RefractoryMycoplasma pneumoniaePneumonia in Children

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

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