scholarly journals Macrolide resistance and molecular typing of Mycoplasma pneumoniae infections during a 4 year period in Spain

2020 ◽  
Vol 75 (10) ◽  
pp. 2752-2759 ◽  
Author(s):  
Belén Rivaya ◽  
Elena Jordana-Lluch ◽  
Gema Fernández-Rivas ◽  
Sònia Molinos ◽  
Roi Campos ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Variable Number Tandem Repeat ◽  
Respiratory Viruses ◽  
Variable Number ◽  
Community Acquired Pneumonia ◽  
Macrolide Resistance ◽  
23S Rrna ◽  
Resistance Pattern ◽  
Molecular Tools ◽  
Resistance Detection

Abstract Background Mycoplasma pneumoniae (MP) causes community-acquired pneumonia affecting mainly children, and tends to produce cyclic outbreaks. The widespread use of macrolides is increasing resistance rates to these antibiotics. Molecular tools can help in diagnosis, typing and resistance detection, leading to better patient management. Objectives To assess the MP genotypes and resistance pattern circulating in our area while comparing serological and molecular diagnosis of MP. Methods Molecular and serological diagnosis of MP was performed in 821 samples collected in Badalona (Barcelona, Spain) from 2013 to 2017. Multiple locus variable number tandem repeat analysis (MLVA) and macrolide resistance detection by pyrosequencing were performed in those cases positive by PCR. Presence of respiratory viruses and relevant clinical data were also recorded. Results MP was detected in 16.8% of cases by PCR, with an overall agreement with serology of 76%. Eleven different MLVA types were identified, with 4-5-7-2 (50.1%) and 3-5-6-2 (29.2%) being the most abundant, with the latter showing a seasonal increase during the study. A total of 8% of the strains harboured a point substitution associated with macrolide resistance, corresponding mainly to an A2063G 23S rRNA mutation and directly related to previous macrolide therapy. Analysis of respiratory viruses showed viral coinfections in most cases. Conclusions Serological and molecular tools combined could improve MP diagnosis and the analysis of its infection patterns. Macrolide resistance is associated with previous therapy. Given that MP pneumonia usually resolves spontaneously, it should be reconsidered whether antibiotic treatment is suitable for all cases.

scholarly journals First Description of Macrolide-Resistant Mycoplasma pneumoniae in Adults with Community-Acquired Pneumonia in Italy

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Daniela Loconsole ◽  
Anna Lisa De Robertis ◽  
Rosanna Mallamaci ◽  
Anna Sallustio ◽  
Anna Morea ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Variable Number Tandem Repeat ◽  
Point Mutations ◽  
Cross Sectional Study ◽  
Variable Number ◽  
Community Acquired Pneumonia ◽  
23S Rrna ◽  
Cross Sectional ◽  
South Italy ◽  
Multiple Loci

Background. Mycoplasma pneumoniae is a common cause of community-acquired pneumonia (CAP). This cross-sectional study aimed to determine the prevalence of macrolide-resistant M. pneumoniae strains in a convenience series of 234 adult hospitalised and nonhospitalised subjects with a diagnosis of CAP in January 2013 to April 2015 in South Italy. Methods. Respiratory samples were subjected to real-time PCR. In M. pneumoniae-positive samples, domain V of 23S rRNA was sequenced to detect resistance-conferring point mutations. P1 major adhesion protein typing and multiple loci variable-number tandem repeat analysis (MLVA) were also performed. Results. Of the 234 samples, 15 (6.4%) were positive for M. pneumoniae. Three of these had a macrolide-resistant genotype: two and one had A2063G and A2064G mutations, respectively. Fourteen of the 15 strains were subtyped: half had subtype 1 and half had subtype 2. Eight strains underwent MLVA profiling: one each had the J, A, and Z type. The remainder was unclassifiable. Conclusions. This novel discovery of macrolide-resistant M. pneumoniae strains in adults with CAP in Italy suggests that there may be increasing circulation of these strains in the population. To facilitate rapid optimization of the antibiotic strategy in Italy, macrolide resistance should be monitored by a surveillance system that is based on molecular methods.

scholarly journals A study of community-acquired Mycoplasma pneumoniae in Yantai, China

2018 ◽  
Vol 49 (2) ◽  
pp. 160-163
Author(s):  
Hong-Xia Yu ◽  
Mao-Mao Zhao ◽  
Zeng-Hui Pu ◽  
Yuan-Rong Ju ◽  
Yan Liu
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Community Acquired Pneumonia ◽  
Macrolide Resistance ◽  
23S Rrna ◽  
Diagnostic Tools ◽  
Rrna Gene ◽  
Resistance Mutations ◽  
First Line ◽  
Tract Infections

Introduction: Community-acquired pneumonia (CAP) is a global disease responsible for a large number of deaths, with significant economic impact. As diagnostic tools have increased in sensitivity, understanding of the etiology of CAP has begun to change. Mycoplasma pneumoniae is one of the major pathogens causing CAP. Macrolides and related antibiotics are first-line treatments for M. pneumoniae. Macrolide resistance has been spreading for 15 years and now occurs in worldwide. We undertook the first study on macrolide resistance of M. pneumoniae in Yantai. This may be helpful to determine the appropriate therapy for CAP in this population. Objective: To investigate the rate and mechanism of macrolide resistance in Yantai. Methods: Pharyngeal swab samples were collected from adult CAP patients. Samples were assayed by polymerase chain reaction (PCR) and cultivated to test for M. pneumoniae. Nested PCR was used to specifically amplify M. pneumoniae 23S rRNA gene fragments containing mutations, and amplicons were analyzed by CE-SSCP for macrolide resistance mutations. Results were confirmed by sequencing. Twenty-seven strains of M. pneumoniae were isolated and the activities of nine antibiotics against M. pneumoniae were tested in vitro. Results: Out of 128 samples tested, 27 were positive for M. pneumoniae. Mycoplasma 100% macrolides resistance to Mycoplasma pneumoniae. The mechanism of macrolides resistance was A2063G point mutation in the sequence directly binding to macrolides in the 23S rRNA V domain in vitro. The mean pyretolytic time for the fluoroquinolone group was 4.7 ±2.9 d, which was significantly shorter than 8.2 ±4.1 d for the azithromycin group. Conclusions: Macrolides are not the first-line treatment for M. pneumoniae respiratory tract infections in Yantai.

scholarly journals Emergence of Macrolide-Resistant Mycoplasma pneumoniae during an Outbreak in a Primary School: Clinical Characterization of Hospitalized Children

Pathogens ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 328
Author(s):  
Daniel Hubert ◽  
Roger Dumke ◽  
Stefan Weichert ◽  
Sybille Welker ◽  
Tobias Tenenbaum ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Case Series ◽  
Community Acquired Pneumonia ◽  
Hospitalized Patients ◽  
Macrolide Resistance ◽  
23S Rrna ◽  
Hospitalized Children ◽  
First Case ◽  
Potential Link

Mycoplasma pneumoniae (M. pneumoniae) is a common causative pathogen of community-acquired pneumonia. Here, we report the development of macrolide resistance during a school outbreak of severe M. pneumoniae infections in southwest Germany. We conducted a case series to assess the clinical and laboratory characteristics of hospitalized children with M. pneumonia infection and the prevalence of macrolide-resistant M. pneumoniae (MRMP) in this patient group. We retrospectively analyzed 23 children with serologically (19 patients) and/or PCR (eight patients) confirmed M. pneumoniae infection between October 2019 and December 2019. Most of the 15 hospitalized patients had lower respiratory tract infection (n = 10) and required oxygen therapy (83%). The median length of hospitalization was 7 days (range 3–10 days). In 8/15 patients (53.3%) azithromycin and in 4/15 (26.6%) clarithromycin treatment was applied. However, among the five patients for which extended molecular characterization was performed, sequencing of 23S rRNA revealed no mutation only in the first case, but development of macrolide resistance A2058G in four subsequent cases. Hence, we identified a cluster of hospitalized patients with emerging MRMP. Further studies are warranted to confirm a potential link between macrolide resistance and disease severity.

scholarly journals Increased incidence of Mycoplasma pneumoniae infection in England and Wales in 2010: multiocus variable number tandem repeat analysis typing and macrolide susceptibility

2011 ◽  
Vol 16 (19) ◽  
Author(s):  
V J Chalker ◽  
T Stocki ◽  
M Mentasti ◽  
D Fleming ◽  
T G Harrison
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Tandem Repeat ◽  
Variable Number Tandem Repeat ◽  
Variable Number ◽  
Macrolide Resistance ◽  
Similar Increase ◽  
England And Wales ◽  
Repeat Analysis ◽  
Resistance Markers ◽  
Mycoplasma Pneumoniae Infection

An epidemic of Mycoplasma pneumoniae infection began in Denmark in late 2010. A similar increase in M. pneumoniae infections was noted in England and Wales in the same period, with a decline in early 2011. Multiocus variable number tandem repeat analysis typing and analysis of macrolide resistance markers indicate that at least nine known and two novel strain types were circulating in England and Wales during October 2010 to January 2011. There was no evidence of macrolide resistance.

scholarly journals Increased Macrolide Resistance Rate of M3562 Mycoplasma pneumoniae Correlated With Macrolide Usage and Genotype Shifting

2021 ◽  
Vol 11 ◽  
Author(s):  
Yacui Wang ◽  
Baoping Xu ◽  
Xirong Wu ◽  
Qingqin Yin ◽  
Yi Wang ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Tandem Repeat ◽  
Variable Number Tandem Repeat ◽  
Clonal Expansion ◽  
Variable Number ◽  
Resistance Rate ◽  
Macrolide Resistance ◽  
Repeat Analysis ◽  
Time Period ◽  
Predominant Type

To characterize Mycoplasma pneumoniae (MP) strains and to clarify the continuous high rates of macrolide resistance, 1,524 oropharyngeal swabs collected from children in Beijing Children’s Hospital infected with MP during 2016-2019 were analyzed. Among the 1,524 samples, 1,386 harbored mutations associated with macrolide resistance; 1,049 samples were successfully classified into 11 genotypes using multiple locus variable-number tandem-repeat analysis (MLVA). The proportion of the predominant type, M4572, decreased from 84.49 to 70.77% over the time period examined, while that of M3562 increased from 11.63 to 24.67%. Notably, we also found that the frequency of macrolide resistance in M3562 drastically increased, from 60% in 2016 to 93.48% in 2019. Clinical data suggested that the frequency of resistant M3562 was higher in the macrolide usage group than in the nondrug usage group (90.73 vs 53.57%, P<0.0001), while the resistance rate of M4572 was not substantially affected by previous macrolide exposure. These findings validated that antimicrobial application and clonal expansion of resistant MP strains play important roles in the high rates of macrolide resistance.

scholarly journals Molecular Characterization of Mycoplasma pneumoniae Infections in Two Rural Populations of Thailand from 2009 to 2012

2017 ◽  
Vol 55 (7) ◽  
pp. 2222-2233 ◽  
Author(s):  
Toni Whistler ◽  
Pongpun Sawatwong ◽  
Maureen H. Diaz ◽  
Alvaro J. Benitez ◽  
Bernard J. Wolff ◽  
...  
Keyword(s):  
Molecular Characterization ◽  
Mycoplasma Pneumoniae ◽  
Variable Number Tandem Repeat ◽  
Population Based ◽  
Variable Number ◽  
23S Rrna ◽  
Nasopharyngeal Swab ◽  
Urban Centers ◽  
Content Type ◽  
Adhesion Protein

ABSTRACTStudies onMycoplasma pneumoniaein Thailand have focused on urban centers and have not included molecular characterization. In an attempt to provide a more comprehensive understanding of this organism, we conducted a systematic random sampling to identify 3,000 nasopharyngeal swab specimens collected from January 2009 through July 2012 during population-based surveillance for influenza-like illness in two rural provinces.M. pneumoniaewas detected by real-time PCR in 175 (5.8%) specimens. Genotyping was performed using the major adhesion protein (P1) and multilocus variable-number tandem-repeat analysis (MLVA). Of the 157 specimens typed, 97 were P1 type 1 and 60 were P1 type 2. Six different MLVA profiles were identified in 149 specimens, with 4/5/7/2 (40%) and 3/5/6/2 (26%) predominating. There was no discrete seasonality toM. pneumoniaeinfections. Examination of the 23S rRNA sequence for known polymorphisms conferring macrolide resistance revealed that all 141 tested to possess the genotype associated with macrolide susceptibility.

scholarly journals 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

2012 ◽  
Vol 56 (12) ◽  
pp. 6393-6396 ◽  
Author(s):  
Soo Jin Yoo ◽  
Hyo-Bin Kim ◽  
Sang-Ho Choi ◽  
Sang-Oh Lee ◽  
Sung-Han Kim ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Pediatric Patients ◽  
Gene Mutations ◽  
Community Acquired Pneumonia ◽  
Clinical Impact ◽  
Macrolide Resistance ◽  
23S Rrna ◽  
Rrna Gene ◽  
Content Type ◽  
23S Rrna Gene

ABSTRACTWe investigated the frequency and clinical significance of macrolide resistance in adult and pediatric patients with community-acquired pneumonia from aMycoplasma pneumoniaeinfection. 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-resistantM. pneumoniaeinfections showed a longer duration of fever (P= 0.021) and required a longer duration of antibiotic treatment (P= 0.007).

scholarly journals Macrolide Susceptibility and Molecular Characteristics of Bordetella Pertussis

2021 ◽  
Author(s):  
juansheng zhang ◽  
diqiang zhang ◽  
xiaoqiang wang ◽  
xiaoguang wei ◽  
hao li ◽  
...  
Keyword(s):  
Bordetella Pertussis ◽  
Variable Number Tandem Repeat ◽  
Resistance Mutation ◽  
Drug Resistance Mutation ◽  
Genetic Mutation ◽  
Variable Number ◽  
Macrolide Resistance ◽  
Rrna Genes ◽  
23S Rrna ◽  
Molecular Characteristics

Abstract ObjectiveTo compare the macrolide resistance and molecular characteristics of clinical isolated Bordetella pertussis, and explore the relationship between the macrolide-resistance and genotypes. MethodsErythromycin、azithromycin and clarithromycin susceptibility of clinical isolates during 2018-2020 was determined by E-test. The A2047G of the 23S rRNA genes was sequenced for drug-resistance mutation. Multilocus antigen sequence typing (MAST)、Multiple Locus Variable-number tandem repeat Analysis (MLVA) and Pulsed field gel electrophoresis (PFGE) methods were employed to do molecular typing for the strains. Results58 strains were isolated in this study, 46 of them were macrolide-resistant and 12 sensitive. All macrolide-resistant strains carried a genetic mutation at the A2047G site, genotype was prn1/ptxP1/ptxA1/fim3-1/fim2-1, the MLVA types were identified as MT195、MT55 and MT104, PFGE profiles were classified into BPSR23 and BpFINR9 types. However, no mutations were found in all macrolide-sensitive strains whose genotypes were (prn9 or prn2)/ptxP1/ptxA1/fim3-1/fim2-1 and MT27, and PFGE classified other profiles. ConclusionsThe clinical isolated Bordetella pertussis has serious resistance to erythromycin and began to spread to other macrolides. There were differences between macrolide-resistant and -sensitive Bordetella pertussis in genotypes. The acquisition of macrolide resistance may be associated with change of specific molecular types.

scholarly journals Molecular Detection and Characterization of Mycoplasma pneumoniae Among Patients Hospitalized With Community-Acquired Pneumonia in the United States

2015 ◽  
Vol 2 (3) ◽  
Author(s):  
Maureen H. Diaz ◽  
Alvaro J. Benitez ◽  
Kristen E. Cross ◽  
Lauri A. Hicks ◽  
Preeta Kutty ◽  
...  
Keyword(s):  
United States ◽  
Mycoplasma Pneumoniae ◽  
Variable Number Tandem Repeat ◽  
The United States ◽  
Variable Number ◽  
Community Acquired Pneumonia ◽  
Molecular Characteristics

Abstract Background.  Mycoplasma pneumoniae is a common cause of community-acquired pneumonia (CAP). The molecular characteristics of M pneumoniae detected in patients hospitalized with CAP in the United States are poorly described. Methods.  We performed molecular characterization of M pneumoniae in nasopharyngeal/oropharyngeal swabs from children and adults hospitalized with CAP in the Centers for Disease Control and Prevention Etiology of Pneumonia in the Community (EPIC) study, including P1 typing, multilocus variable-number tandem-repeat analysis (MLVA), and macrolide susceptibility genotyping. Results.  Of 216 M pneumoniae polymerase chain reaction-positive specimens, 40 (18.5%) were obtained from adults and 176 (81.5%) from children. P1 type distribution differed between adults (64% type 1 and 36% type 2) and children (84% type 1, 13% type 2, and 3% variant) (P &lt; .05) and among sites (P &lt; .01). Significant differences in the proportions of MLVA types 4/5/7/2 and 3/5/6/2 were also observed by age group (P &lt; .01) and site (P &lt; .01). A macrolide-resistant genotype was ide.jpegied in 7 (3.5%) specimens, 5 of which were from patients who had recently received macrolide therapy. No significant differences in clinical characteristics were ide.jpegied among patients with various strain types or between macrolide-resistant and -sensitive M pneumoniae infections. Conclusions.  The P1 type 1 genotype and MLVA type 4/5/7/2 predominated, but there were differences between children and adults and among sites. Macrolide resistance was rare. Differences in strain types did not appear to be associated with differences in clinical outcomes. Whole genome sequencing of M pneumoniae may help ide.jpegy better ways to characterize strains.

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