Abstract
In recent years, the increased prevalence of macrolide-resistant Mycoplasma pneumoniae (MR-M. pneumoniae) has become a significant issue in Japan. We isolated 94 strains of M. pneumoniae, and determined the minimum inhibitory concentrations (MICs) of macrolides and other antimicrobial agents for these strains. We also performed a comparative clinical evaluation of macrolide efficacy for cases of MR-M. pneumoniae infections and cases of macrolide-sensitive Mycoplasma pneumoniae infections (MS-M. pneumoniae). Of the 94 isolates of M. pneumoniae, 64 (68.1%) were classified as MS-M. pneumoniae and 30 (31.9%) as MR-M. pneumoniae strains. The clinical study included an assessment of 47 pediatric cases of MS-M. pneumoniae and 22 pediatric cases of MR-M. pneumoniae. The patient demographics, such as sex, age, the period from the onset of the infection to the first examination, laboratory findings, diagnosis, and the severity of symptoms, showed no significant difference between the two study groups. However, the efficacy of macrolide treatment was 91.5% for MS-M. pneumoniae and 22.7% for MR-M. pneumoniae, a statistically significant difference (P < 0.01). Although M. pneumoniae infection is generally considered a treatable condition, the increasing prevalence of macrolide-resistant strains of M. pneumoniae has become a significant clinical issue in pediatric patients, and it is therefore necessary to give careful consideration to the appropriate antimicrobial therapy for MR-M. pneumoniae infection.
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References
Lucier TS, Heitzman K, Liu SK, Hu PC. Transition mutations in the 23S rRNA of erythromycin-resistant isolates of Mycoplasma pneumoniae. Antimicrob Agents Chemother 1995;39:2770–2773.
Okazaki N, Narita M, Yamada S, Izumikawa K, Umetsu M, Kenri T, et al. Characteristics of macrolide-resistant Mycoplasma pneumoniae strains isolated from patients and induced with erythromycin in vitro. Microbiol Immunol 2001;45:617–620.
Morozumi M, Hasegawa K, Kobayashi R, Inoue N, Iwata S, Ubukata K, et al. Emergence of macrolide-resistant Mycoplasma pneumoniae with a 23S rRNA gene mutation. Antimicrob Agents Chemother 2005;49:2302–2306.
Morozumi M, Iwata S, Hasegawa K, Chiba N, Takayanagi R, Matsubara K, et al. Increased Macrolide Resistance of Mycoplasma pneumoniae in Pediatric Patients with Community-Acquired Pneumonia. Antimicrob Agents Chemother 2008;52:348–350.
Matsuoka M, Narita M, Okazaki N, Ohya H, Yamazaki T, Ouchi K, et al. Characterization and molecular analysis of macrolide-resistant Mycoplasma pneumoniae clinical isolates obtained in Japan. Antimicrob Agents Chemother 2004;48:4624–4630.
Fujii R, Kobayashi Y, Nishimura T, Sunakawa K, Iwata S, Meguro H, et al. Committee for the Preparation of Evaluation Criteria. Criteria for the clinical evaluation of antimicrobial drugs in pediatrics. Jpn J Antibiotic 1998;51:709–719.
Uehara S, Sunakawa K, Eguchi H, Ouchi K, Okada K, Kurosaki T, et al. Guidelines for the management of respiratory infectious diseases in children in Japan 2007. Tokyo: Japanese Society of Pediatric Infectious Diseases and Japanese Society of Pediatric Respiratory Infectious Diseases; 2007. p 56–57.
Hamano-Hasegawa K, Morozumi M, Nakayama E, Chiba N, Murayama SY, Takayanagi R, et al. Comprehensive detection of causative pathogens using real-time PCR to diagnose pediatric community-acquired pneumonia. J Infect Chemother 2008;14:424–432.
Ikejima H, Yamamoto H, Ishida K, Kaku M, Shimada J. Evaluation of in-vitro activity of new quinolones, macrolides, and minocycline against Mycoplasma pneumoniae. J Infect Chemother 2000;6:148–150.
Suzuki S, Yamazaki T, Narita M, Okazaki N, Suzuki I, Andoh T, et al. Clinical evaluation of macrolide-resistant Mycoplasma pneumoniae. Antimicrob Agents Chemother 2006;50:709–712.
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Matsubara, K., Morozumi, M., Okada, T. et al. A comparative clinical study of macrolide-sensitive and macrolide-resistant Mycoplasma pneumoniae infections in pediatric patients. J Infect Chemother 15, 380–383 (2009). https://doi.org/10.1007/s10156-009-0715-7
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DOI: https://doi.org/10.1007/s10156-009-0715-7