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Wang G, Wu P, Tang R, Zhang W. Global prevalence of resistance to macrolides in Mycoplasma pneumoniae: a systematic review and meta-analysis. J Antimicrob Chemother 2022; 77:2353-2363. [PMID: 35678262 DOI: 10.1093/jac/dkac170] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 05/03/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To determine the prevalence of resistance to macrolides in Mycoplasma pneumoniae worldwide. METHODS Prior to 12 December 2020, PubMed, Web of Science, Scopus and Embase databases were searched for epidemiological studies of M. pneumoniae resistance. Two reviewers independently extracted data from included studies. The extracted data include sampling population, total sampling number, the number of resistant strains and the molecular subtype of resistant strains. The estimate of resistance prevalence was calculated using the random-effects model. RESULTS A total of 17 873 strains were obtained from five continents and reported in 98 investigations between 2000 and 2020, with 8836 strains characterized as macrolide resistant. In summary, macrolide-resistant M. pneumoniae was most common in Asia (63% [95% CI 56, 69]). In Europe, North America, South America and Oceania, the prevalence was 3% [2, 7], 8.6% [6, 11], 0% and 3.3%, respectively. Over the last 20 years, the prevalence of macrolide-resistant M. pneumoniae has remained high in China (81% [73, 87]), with a significant increasing trend in South Korea (4% [1, 9] to 78% [49, 93], P < 0.0001). Furthermore, a point mutation at 2063 from A to G was mostly related to M. pneumoniae macrolide resistance. In terms of clinical outcomes, longer cough (mean difference [MD]: 2.93 [0.26, 5.60]) and febrile days (MD: 1.52 [1.12, 1.92]), and prolonged hospital stays (MD: 0.76 [0.05, 1.46]) might be induced by macrolide-resistant M. pneumoniae pneumonia. CONCLUSIONS The incidence of macrolide-resistant M. pneumoniae varies globally, with eastern Asia having a greater degree of resistance. However, attention is also required in other areas, and antibiotic alternatives should be considered for treatment in high-prevalence countries.
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Affiliation(s)
- Guotuan Wang
- Department of pharmacy, Karamay central hospital of Xinjiang, Karamay, Xinjiang, China
| | - Peng Wu
- Department of emergency, Karamay central hospital of Xinjiang, Karamay, Xinjiang, China
| | - Rui Tang
- Department of pharmacy, West China hospital, Sichuan university, Chengdu, Sichuan, China
| | - Weidong Zhang
- Department of pharmacy, Karamay central hospital of Xinjiang, Karamay, Xinjiang, China
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Han MY, Chung HL, Ahn YM, Shim JY. Literature review and future strategies of childhood respiratory diseases in Korea. ALLERGY ASTHMA & RESPIRATORY DISEASE 2018. [DOI: 10.4168/aard.2018.6.s1.s66] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Man Yong Han
- Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea
| | - Hai Lee Chung
- Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Young Min Ahn
- Department of Pediatrics, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Choi SY, Seo JH, Lee K, Choi Q. Clinical analysis of risk factors in refractory mycoplasma pneumonia in children. ALLERGY ASTHMA & RESPIRATORY DISEASE 2018. [DOI: 10.4168/aard.2018.6.1.62] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Seo Yeol Choi
- Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea
| | - Ju-Hee Seo
- Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea
| | - Kunsong Lee
- Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea
| | - Qute Choi
- Department of Laboratory Medicine, Dankook University College of Medicine, Cheonan, Korea
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4
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Kim YJ, Shin KS, Lee KH, Kim YR, Choi JH. Clinical Characteristics of Macrolide-Resistant Mycoplasma pneumoniae from Children in Jeju. J Korean Med Sci 2017; 32:1642-1646. [PMID: 28875608 PMCID: PMC5592178 DOI: 10.3346/jkms.2017.32.10.1642] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 07/09/2017] [Indexed: 11/23/2022] Open
Abstract
Mycoplasma pneumoniae is the major pathogen of community-acquired pneumonia in children. The prevalence of macrolide-resistant M. pneumoniae (MRMP) is important owing to the limited alternative therapies for children. We analyzed 111 M. pneumoniae obtained from 107 children admitted for lower respiratory tract infection at Jeju National University Hospital between 2010 and 2015. Macrolide resistance of M. pneumoniae was searched for using polymerase chain reaction (PCR) and sequencing. Of 107 clinical M. pneumoniae, 11 (10.3%) carried macrolide resistance mutations in the 23S rRNA gene. All macrolide resistance mutations were A2063G transitions. We found an acquired A2063G mutation of M. pneumoniae from a patient during macrolide treatment. Patients' characteristics and clinical severity did not differ between those with MRMP and macrolide-sensitive M. pneumoniae, with the exception of frequent pleural effusion in the MRMP group. The prevalence of MRMP (10.3%) in Jeju Island was relatively lower than those of surrounding countries in East Asia. Previous antimicrobial usage and timing of diagnostic test should be considered when determining of macrolide resistance of M. pneumoniae.
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MESH Headings
- Anti-Bacterial Agents/therapeutic use
- Child
- Child, Preschool
- Drug Resistance, Bacterial/genetics
- Female
- Humans
- Macrolides/therapeutic use
- Male
- Mutation
- Mycoplasma pneumoniae/genetics
- Mycoplasma pneumoniae/isolation & purification
- Nasopharynx/microbiology
- Pneumonia, Mycoplasma/diagnosis
- Pneumonia, Mycoplasma/drug therapy
- Pneumonia, Mycoplasma/microbiology
- Pneumonia, Mycoplasma/pathology
- Polymerase Chain Reaction
- Prevalence
- RNA, Ribosomal, 23S/genetics
- RNA, Ribosomal, 23S/metabolism
- Republic of Korea/epidemiology
- Respiratory Tract Infections/diagnosis
- Respiratory Tract Infections/drug therapy
- Respiratory Tract Infections/microbiology
- Respiratory Tract Infections/pathology
- Severity of Illness Index
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Affiliation(s)
- Yoon Joo Kim
- Department of Pediatrics, Jeju National University Hospital, Jeju, Korea
| | - Kyung Sue Shin
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Keun Hwa Lee
- Department of Microbiology and Immunology, Jeju National University School of Medicine, Jeju, Korea
| | - Young Ree Kim
- Department of Laboratory Medicine, Jeju National University Hospital, Jeju, Korea
| | - Jae Hong Choi
- Department of Pediatrics, Jeju National University Hospital, Jeju, Korea.
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5
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Lee E, Cho HJ, Hong SJ, Lee J, Sung H, Yu J. Prevalence and clinical manifestations of macrolide resistant Mycoplasma pneumoniae pneumonia in Korean children. KOREAN JOURNAL OF PEDIATRICS 2017; 60:151-157. [PMID: 28592978 PMCID: PMC5461279 DOI: 10.3345/kjp.2017.60.5.151] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 12/01/2016] [Accepted: 12/21/2016] [Indexed: 11/27/2022]
Abstract
Purpose Macrolide resistance rate of Mycoplasma pneumoniae has rapidly increased in children. Studies on the clinical features between macrolide susceptible-M. pneumoniae (MSMP) and macrolide resistant-M. pneumoniae (MRMP) are lacking. The aim of this study was to identify the macrolide resistance rate of M. pneumoniae in Korean children with M. pneumoniae penupmonia in 2015 and compare manifestations between MSMP and MRMP. Methods Among 122 children (0–18 years old) diagnosed with M. pneumoniae pneumonia, 95 children with the results of macrolide sensitivity test were included in this study. Clinical manifestations were acquired using retrospective medical records. Results The macrolide resistant rate of M. pneumoniae was 87.2% (82 of 94 patients) in children with M. pneumoniae pneumonia. One patient showed a mixed type of wild type and A2063G mutation in 23S rRNA of M. pneumoniae. There were no significant differences in clinical, laboratory, and radiologic findings between the MSMP and MRMP groups at the first visit to our hospital. The time interval between initiation of macrolide and defervescence was significantly longer in the MRMP group (4.9±3.3 vs. 2.8±3.1 days, P=0.039). Conclusion The macrolide resistant rate of M. pneumoniae is very high in children with M. pneumoniae pneumonia in Korea. The clinical manifestations of MRMP are similar to MSMP except for the defervescence period after administration of macrolide. Continuous monitoring of the occurrence and antimicrobial susceptibility of MRMP is required to control its spread and establish strategies for treating second-line antibiotic resistant M. pneumoniae infection.
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Affiliation(s)
- Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Gwangju, Korea
| | - Hyun-Ju Cho
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jina Lee
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Heungsup Sung
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jinho Yu
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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6
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Seo YH, Kim JS, Seo SC, Seo WH, Yoo Y, Song DJ, Choung JT. Predictive value of C-reactive protein in response to macrolides in children with macrolide-resistant Mycoplasma pneumoniae pneumonia. KOREAN JOURNAL OF PEDIATRICS 2014; 57:186-92. [PMID: 24868216 PMCID: PMC4030120 DOI: 10.3345/kjp.2014.57.4.186] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 09/24/2013] [Accepted: 11/18/2013] [Indexed: 11/27/2022]
Abstract
Purpose The 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. Methods A 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. Results The 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. Conclusion The 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.
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Affiliation(s)
- Young Ho Seo
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Jang Su Kim
- Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sung Chul Seo
- Environmental Health Center for Childhood Asthma, Korea University Anam Hospital, Seoul, Korea
| | - Won Hee Seo
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Young Yoo
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea. ; Environmental Health Center for Childhood Asthma, Korea University Anam Hospital, Seoul, Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea. ; Environmental Health Center for Childhood Asthma, Korea University Anam Hospital, Seoul, Korea
| | - Ji Tae Choung
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea. ; Environmental Health Center for Childhood Asthma, Korea University Anam Hospital, Seoul, Korea
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7
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Ji M, Lee NS, Oh JM, Jo JY, Choi EH, Yoo SJ, Kim HB, Hwang SH, Choi SH, Lee SO, Kim MN, Sung H. Single-nucleotide polymorphism PCR for the detection of Mycoplasma pneumoniae and determination of macrolide resistance in respiratory samples. J Microbiol Methods 2014; 102:32-6. [PMID: 24780151 DOI: 10.1016/j.mimet.2014.04.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 03/04/2014] [Accepted: 04/18/2014] [Indexed: 11/18/2022]
Abstract
The aim of this study was to develop a single-nucleotide polymorphism (SNP) PCR assay to be performed directly on respiratory samples for the simultaneous detection of Mycoplasma pneumoniae and its 23S rRNA gene mutations, which are responsible for macrolide resistance. For multiplex SNP PCR, two outer primers for amplification of the 23S rRNA gene and two mutant-specific primers for the discrimination of single base changes were designed. A total of 73M. pneumoniae-positive samples and 100M. pneumoniae-negative samples were analyzed using this assay. By SNP PCR, we detected two mutations conferring high-level macrolide resistance in 22 samples (A2063G from 20 and A2064G from 2 samples); these results are identical to those produced by the 23S rRNA gene sequencing of M. pneumoniae-positive samples. Thus, this assay can be used as a practical method for the simultaneous detection of M. pneumoniae and mutations associated with macrolide resistance directly from respiratory samples.
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Affiliation(s)
- Misuk Ji
- Department of Laboratory Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | - Ji-Min Oh
- SolGent Co., Ltd., Daejeon, Republic of Korea
| | - Ji Yoon Jo
- SolGent Co., Ltd., Daejeon, Republic of Korea
| | - Eun Hwa Choi
- Department of Pediatrics, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soo Jin Yoo
- Department of Laboratory Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
| | - Hyo-Bin Kim
- Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
| | - Sang-Hyun Hwang
- Department of Laboratory Medicine and Hematologic Malignancy Branch, Research Institute and Hospital, National Cancer Center, Goyang-si, Republic of Korea
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Oh Lee
- Department of Infectious Diseases, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Mi-Na Kim
- Department of Laboratory Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Heungsup Sung
- Department of Laboratory Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Republic of Korea.
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8
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You SY, Jwa HJ, Yang EA, Kil HR, Lee JH. Effects of Methylprednisolone Pulse Therapy on Refractory Mycoplasma pneumoniae Pneumonia in Children. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2013; 6:22-6. [PMID: 24404389 PMCID: PMC3881395 DOI: 10.4168/aair.2014.6.1.22] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 04/30/2013] [Accepted: 05/03/2013] [Indexed: 11/29/2022]
Abstract
Purpose Mycoplasma pneumoniae (M. pneumoniae) is one of the most common causes of community-acquired pneumonia in children. The clinical course is typically self-limited and benign; however, rare cases of severe pneumonia can develop despite appropriate antibiotic therapy. We studied the effects of methylprednisolone pulse therapy on severe refractory M. pneumoniae pneumonia in children. Methods The clinical effects of methylprednisolone therapy were evaluated retrospectively in 12 children with severe refractory M. pneumoniae pneumonia, which was diagnosed serologically. All patients developed respiratory distress, high fever, and initial lobar pneumonic consolidation based on radiological findings. All clinical symptoms deteriorated despite appropriate antibiotic therapy. Thus, children were treated with intravenous methylprednisolone pulse therapy in addition to antibiotics. Results The average febrile period before admission was 4.9±1.7 days, and fever persisted in all children until steroid administration. Methylprednisolone pulse therapy (30 mg/kg) was given 5.4±2.5 days after admission. After methylprednisolone pulse therapy, clinical symptoms improved in all patients without adverse events. The fever subsided 0-2 h after initiation of corticosteroid therapy. The abnormal radiological findings resolved within 2.6±1.3 days, and the high C-reactive protein levels (6.7±5.9 mg/dL) on admission decreased to 1.3±1.7 mg/dL within 3.0±1.1 days after starting corticosteroid therapy. Conclusions Three-day methylprednisolone pulse therapy could be applied to treatment of refractory M. pneumoniae pneumonia despite appropriate antibiotic therapy and appeared to be efficacious and well-tolerated.
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Affiliation(s)
- Sun Young You
- Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hye Jeong Jwa
- Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea
| | - Eun Ae Yang
- Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea
| | - Hong Ryang Kil
- Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jae Ho Lee
- Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea
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Uh Y, Hong JH, Oh KJ, Cho HM, Park SD, Kim J, Yoon KJ. Macrolide resistance of Mycoplasma pneumoniae and its detection rate by real-time PCR in primary and tertiary care hospitals. Ann Lab Med 2013; 33:410-4. [PMID: 24205489 PMCID: PMC3819439 DOI: 10.3343/alm.2013.33.6.410] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 05/03/2013] [Accepted: 07/15/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the prevalence of Mycoplasma pneumoniae in primary and tertiary care hospitals and its macrolide resistance rate. METHODS Nasopharyngeal swabs were collected from 195 pediatric patients in primary and tertiary care hospitals from October to November 2010. The AccuPower MP real-time PCR kit (Bioneer, Korea) was used for the detection of M. pneumoniae. Direct amplicon sequencing was performed to detect point mutations conferring resistance to macrolides in the 23S rRNA gene. RESULTS Among the 195 specimens, 17 (8.7%) were M. pneumoniae positive, and 3 of the strains (17.6%) obtained from these 17 specimens displayed the A2063G mutation in 23S rRNA. Three macrolide-resistant M. pneumoniae isolates were isolated from patients hospitalized at the primary care hospital. The positive rates of M. pneumoniae for the primary and tertiary care hospitals were 12.1% (15/124) and 2.8% (2/71), respectively (P=0.033). CONCLUSIONS The positive rate of M. pneumoniae in the primary care hospital was higher than that in the tertiary care hospital. Simultaneous detection of M. pneumoniae and macrolide-resistant mutation genes in the 23S rRNA by real-time PCR is needed for rapid diagnosis and therapy of M. pneumoniae infections.
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Affiliation(s)
- Young Uh
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Differences in the frequency of 23S rRNA gene mutations in Mycoplasma pneumoniae between children and adults with community-acquired pneumonia: clinical impact of mutations conferring macrolide resistance. Antimicrob Agents Chemother 2012; 56:6393-6. [PMID: 23006753 DOI: 10.1128/aac.01421-12] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We investigated the frequency and clinical significance of macrolide resistance in adult and pediatric patients with community-acquired pneumonia from a Mycoplasma pneumoniae infection. The frequency of the A2063G mutation in the 23S rRNA gene was significantly higher in children than in adults (61.3% [19/31] and 13.3% [8/60], respectively; P < 0.001). Patients with macrolide-resistant M. pneumoniae infections showed a longer duration of fever (P = 0.021) and required a longer duration of antibiotic treatment (P = 0.007).
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11
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Youn YS, Lee KY. Mycoplasma pneumoniae pneumonia in children. KOREAN JOURNAL OF PEDIATRICS 2012; 55:42-7. [PMID: 22375148 PMCID: PMC3286761 DOI: 10.3345/kjp.2012.55.2.42] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 01/11/2012] [Indexed: 12/20/2022]
Abstract
Mycoplasma pneumoniae (MP), the smallest self-replicating biological system, is a common cause of upper and lower respiratory tract infections, leading to a wide range of pulmonary and extra-pulmonary manifestations. MP pneumonia has been reported in 10 to 40% of cases of community-acquired pneumonia and shows an even higher proportion during epidemics. MP infection is endemic in larger communities of the world with cyclic epidemics every 3 to 7 years. In Korea, 3 to 4-year cycles have been observed from the mid-1980s to present. Although a variety of serologic assays and polymerase chain reaction (PCR) techniques are available for the diagnosis of MP infections, early diagnosis of MP pneumonia is limited by the lack of immunoglobulin (Ig) M antibodies and variable PCR results in the early stages of the infection. Thus, short-term paired IgM serologic tests may be mandatory for an early and definitive diagnosis. MP infection is usually a mild and self-limiting disease without specific treatment, and if needed, macrolides are generally used as a first-choice drug for children. Recently, macrolide-resistant MP strains have been reported worldwide. However, there are few reports of apparent treatment failure, such as progression of pneumonia to acute respiratory distress syndrome despite macrolide treatment. The immunopathogenesis of MP pneumonia is believed to be a hyperimmune reaction of the host to the insults from MP infection, including cytokine overproduction and immune cell activation (T cells). In this context, immunomodulatory treatment (corticosteroids or/and intravenous Ig), in addition to antibiotic treatment, might be considered for patients with severe infection.
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Affiliation(s)
- You-Sook Youn
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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12
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Seo YB, Yang TU, Kim IS, Hong KW, Song JY, Cheong HJ, Kim WJ. Clinical and Epidemiologic Characteristics ofMycoplasma pneumoniaePneumonia in Adults During 2011 Epidemic. Infect Chemother 2012. [DOI: 10.3947/ic.2012.44.5.367] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Yu Bin Seo
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Tea Un Yang
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - In Seon Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung-Wook Hong
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Joon Young Song
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hee Jin Cheong
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Woo Joo Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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