Epidemiology of macrolide-resistant Mycoplasma pneumoniae by age distribution in Japan. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Kawakami, Naoki; Namkoong, Ho; Saito, Fumitake; Ishizaki, Masami; Yamazaki, Masahiko; Mitamura, Keiko
• Is Part Of: Journal of infection and chemotherapy. Volume 27:Issue 1(2021)
• Page Start: 45
• Page End: 48
• Publication Date: 2021-01
• Subjects: M. pneumoniae -- Macrolide-resistance -- Pneumonia -- 23S rRNA -- PCR; Chemotherapy -- Periodicals; Infection -- Periodicals; Communicable diseases -- Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1016/j.jiac.2020.08.006
• Languages: English
• ISSNs: 1341-321X

Abstract

Abstract: Introduction: Mycoplasma pneumoniae ( M. pneumoniae ) is the major pathogen involved in community-acquired pneumonia in all age groups. Resistance to macrolides, the first-line treatment for M. pneumoniae infection, is a major global public health concern. However, studies evaluating macrolide-resistant M. pneumoniae infection simultaneously in all ages are limited. This study aimed to determine the prevalence and clinical characteristics of macrolide-resistant M. pneumoniae infection in terms of age distribution. Methods: We enrolled 292 patients in Tokyo, Japan, who visited Eiju General Hospital or Zama Children's Clinic in 2015–2016. Patients were tested using real-time PCR for M. pneumoniae DNA. PCR-positive patients (n = 151) were further selected and sequentially divided into preschool-aged children (≤5 years, n = 31), school-aged children (6–15 years, n = 101), adolescents (16–19 years, n = 5), and adults (≥20 years, n = 14). We then analyzed the M. pneumoniae infection clinical characteristics, prevalence of macrolide-resistant infection, and 23S rRNA domain V resistance-associated mutation status. Results: We found insignificant differences in the prevalence of macrolide-resistant M. pneumoniae infection among all groups, clinical characteristics, and resistance-associated mutation status in patients with macrolide-resistant M. pneumoniae infection. We also found statistically higher prevalence of mutation-positive (n = 85) M. pneumoniae in patients previously treated with macrolide compared to the mutation-negative group (n = 66); 63.8% vs 11.1% (p < 0.001), respectively. Conclusions: We found no significant differences in both clinical characteristics and prevalence of macrolide-resistant M. pneumoniae infection among all ages. Also, previous macrolide treatment contributes to drug-resistance.