scholarly journals Increased Macrolide Resistance of Mycoplasma pneumoniae in Pediatric Patients with Community-Acquired Pneumonia

2007 ◽  
Vol 52 (1) ◽  
pp. 348-350 ◽  
Author(s):  
Miyuki Morozumi ◽  
Satoshi Iwata ◽  
Keiko Hasegawa ◽  
Naoko Chiba ◽  
Reiko Takayanagi ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Pediatric Patients ◽  
Community Acquired Pneumonia ◽  
Macrolide Resistance ◽  
23S Rrna ◽  
Resistant Strains ◽  
Domain V

ABSTRACT Among 380 Mycoplasma pneumoniae isolates from 3,678 pediatric patients with community-acquired pneumonia, 50 macrolide-resistant strains had an A2063G transition in domain V of the 23S rRNA, whereas 5 had an A2064G transition. These resistant strains increased rapidly from April 2002 to December 2006.

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 Mutations in domain V of Mycoplasma pneumoniae 23S rRNA are not associated with clinical characteristics of M. pneumoniae pneumonia in children: a case control study

2020 ◽  
Author(s):  
Huan Deng ◽  
Yifan Zhu ◽  
Jiamin Zhang ◽  
Qiangquan Rong ◽  
Yao Quan ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Lymphocyte Count ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Laboratory Data ◽  
Point Mutations ◽  
Community Acquired Pneumonia ◽  
Pulmonary Complications ◽  
23S Rrna ◽  
Domain V

Abstract Background Mycoplasma pneumoniae (MP) is a common agent of community-acquired pneumonia in children and young adults that can lead to refractory or persistent Mycoplasma pneumoniae pneumonia (MPP). Macrolide-resistant MP harbors point mutations in domain V of 23S ribosomal Ribonucleic Acid (rRNA) with substitutions detected at positions 2063, 2064, 2067 and 2617. This study’s purpose is to investigate the prevalence and clinical characteristics of mutations in domain V of MP 23S rRNA. Methods We sequenced the 23S rRNA domain V of MP strains collected from children with MPP. Clinical and laboratory data were also obtained, including gender, age, duration of fever, duration of fever after the start of macrolide therapy, MP-Deoxyribonucleic Acid (DNA) load at enrollment, leukocyte count, neutrophil count, and lymphocyte count, immunomodulators treatment and pulmonary complications.Results Of 276 strains, 255 (92.39 %) harbored A to G transition at the position 2063 (A2063G), and 21 (7.61 %) were not mutated. There were no significant differences in gender, age, duration of fever, duration of fever after the start of macrolide therapy, MP-DNA load at enrollment, hospitalization days, lymphocyte count and pulmonary complications when patients were stratified based on the presence or absence of domain V mutations. We also found that children with refractory MPP experienced higher MP-DNA load than the non-refractory MPP, but the prevalence of domain V mutations was comparable.Conclusions We found that clinical MP strains harbored very high mutation rate in 23S rRNA domain V, especially A2063G mutation. However, these mutations were not associated with clinical symptoms, laboratory results, pulmonary complications and development of refractory pneumonia. Instead, MP-DNA load was significantly different between refractory and non-refractory MPP.

scholarly journals Mutation in 23S rRNA Associated with Macrolide Resistance in Neisseria gonorrhoeae

2002 ◽  
Vol 46 (9) ◽  
pp. 3020-3025 ◽  
Author(s):  
Lai-King Ng ◽  
Irene Martin ◽  
Gary Liu ◽  
Louis Bryden
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Promoter Region ◽  
Efflux Pump ◽  
Macrolide Resistance ◽  
23S Rrna ◽  
Cross Resistance ◽  
E Coli ◽  
Single Base Pair ◽  
Resistant Strains ◽  
Domain V

ABSTRACT Fifty-six azithromycin-resistant (MICs, 2.0 to 4.0 μg/ml) Neisseria gonorrhoeae strains with cross-resistance to erythromycin (MICs, 2.0 to 64.0 μg/ml), isolated in Canada between 1997 and 1999, were characterized, and their mechanisms of azithromycin resistance were determined. Most (58.9%) of them belonged to auxotype-serotype class NR/IB-03, with a 2.6-mDa plasmid. Based on resistance to crystal violet (MICs ≥ 1 μg/ml), 96.4% of these macrolide-resistant strains appeared to have increased efflux. Nine of the eleven strains selected for further characterization were found to have a promoter region mtrR mutation, a single-base-pair (A) deletion in the 13-bp inverted repeat, which is believed to cause overexpression of the mtrCDE-encoded efflux pump. The two remaining macrolide-resistant strains (erythromycin MIC, 64.0 μg/ml; azithromycin MIC, 4.0 μg/ml), which did not have the mutation in the mtrR promoter region, were found to have a C2611T mutation (Escherichia coli numbering) in the peptidyltransferase loop in domain V of the 23S rRNA alleles. Although mutations in domain V of 23S rRNA alleles had been reported in other bacteria, including E. coli, Streptococcus pneumoniae, and Helicobacter pylori, this is the first observation of these mutations associated with macrolide resistance in N. gonorrhoeae.

scholarly journals Mutations in domain V of Mycoplasma pneumoniae 23S rRNA are not associated with clinical characteristics of M. pneumoniae pneumonia in children: a case control study

2020 ◽  
Author(s):  
Huan Deng ◽  
Yifan Zhu ◽  
Jiamin Zhang ◽  
Qiangquan Rong ◽  
Yao Quan ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Lymphocyte Count ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Laboratory Data ◽  
Point Mutations ◽  
Community Acquired Pneumonia ◽  
Pulmonary Complications ◽  
23S Rrna ◽  
Domain V

Abstract Background Mycoplasma pneumoniae (MP) is a common agent of community-acquired pneumonia in children and young adults that can lead to refractory or persistent Mycoplasma pneumoniae pneumonia (MPP). Macrolide-resistant MP harbors point mutations in domain V of 23S ribosomal Ribonucleic Acid (rRNA) with substitutions detected at positions 2063, 2064, 2067 and 2617. This study aims to investigate the prevalence and clinical characteristics of mutations in domain V of MP 23S rRNA. Methods We sequenced the 23S rRNA domain V of MP strains collected from children with MPP. Clinical and laboratory data were also obtained, including gender, age, duration of fever, duration of fever after the start of macrolide therapy, MP-Deoxyribonucleic Acid (DNA) load at enrollment, leukocyte count, neutrophil, and lymphocyte count, immunomodulators treatment and pulmonary complications. Results Of 276 strains, 255 (92.39 %) harbored A to G transition at the position 2063 (A2063G), and 21 (7.61 %) were not mutated. There were no significant differences in gender, age, duration of fever, duration of fever after the start of macrolide therapy, MP-DNA load at enrollment, hospitalization days, lymphocyte count and pulmonary complications when patients were stratified based on the presence or absence of domain V mutations. We also found that children with refractory MPP experienced higher MP-DNA load than the non-refractory MPP, but the prevalence of domain V mutations was no statistical difference. Conclusions We found that clinical MP strains harbored very high mutation rate in 23S rRNA domain V, especially A2063G mutation. However, these mutations were not associated with clinical symptoms, laboratory results, pulmonary complications and development of refractory MPP. Instead, MP-DNA load was significantly different between refractory and non-refractory MPP.

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 Therapeutic Efficacy of Macrolides, Minocycline, and Tosufloxacin against Macrolide-Resistant Mycoplasma pneumoniae Pneumonia in Pediatric Patients

2013 ◽  
Vol 57 (5) ◽  
pp. 2252-2258 ◽  
Author(s):  
Yasuhiro Kawai ◽  
Naoyuki Miyashita ◽  
Mika Kubo ◽  
Hiroto Akaike ◽  
Atsushi Kato ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Mycoplasma Pneumoniae ◽  
Pediatric Patients ◽  
Definitive Treatment ◽  
23S Rrna ◽  
Content Type ◽  
The Past ◽  
First Choice ◽  
Domain V ◽  
Mycoplasma Pneumoniae Pneumonia

ABSTRACTThe importance of macrolide-resistant (MR)Mycoplasma pneumoniaehas become much more apparent in the past decade. We investigated differences in the therapeutic efficacies of macrolides, minocycline, and tosufloxacin against MRM. pneumoniae. A total of 188 children withM. pneumoniaepneumonia confirmed by culture and PCR were analyzed. Of these, 150 patients had a strain with an MR gene and 134 had one with an A-to-G mutation at position 2063 ofM. pneumoniae23S rRNA domain V. Azithromycin (n= 27), clarithromycin (n= 23), tosufloxacin (n= 62), or minocycline (n= 38) was used for definitive treatment of patients with MRM. pneumoniae. Defervescence within 48 h after the initiation of antibiotic therapy was observed in 41% of the patients in the azithromycin group, 48% of those in the clarithromycin group, 69% of those in the tosufloxacin group, and 87% of those in the minocycline group. The average number of days of fever after the administration of antibiotic treatment was lower in the minocycline and tosufloxacin groups than in the macrolide groups. The decrease in theM. pneumoniaeburden, as estimated by the number of DNA copies, after 48 to 96 h of treatment was more rapid in patients receiving minocycline (P= 0.016) than in those receiving tosufloxacin (P= 0.049), azithromycin (P= 0.273), or clarithromycin (P= 0.107). We found that the clinical and bacteriological efficacies of macrolides against MRM. pneumoniaepneumonia was low. Our results indicated that minocycline rather than tosufloxacin can be considered the first-choice drug for the treatment ofM. pneumoniaepneumonia in children aged ≥8 years.

scholarly journals Macrolide-Resistant Mycoplasma pneumoniae in Adults in Zhejiang, China

2014 ◽  
Vol 59 (2) ◽  
pp. 1048-1051 ◽  
Author(s):  
Zibo Zhou ◽  
Xiangzhi Li ◽  
Xiaojian Chen ◽  
Fangjun Luo ◽  
Changwang Pan ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Rflp Analysis ◽  
Zhejiang Province ◽  
23S Rrna ◽  
Rrna Gene ◽  
Type I ◽  
Content Type ◽  
23S Rrna Gene ◽  
Resistant Strains ◽  
Domain V

ABSTRACTMycoplasma pneumoniaeis a major pathogen causing community-acquired pneumoniae (CAP), which is generally treated with macrolides. In recent years, however, although macrolide-resistantM. pneumoniaehas been reported frequently, particularly in China, very little is known about the prevalence of macrolide-resistantM. pneumoniaeinfection in adults. In this study, we survey the macrolide-resistantM. pneumoniaein adults in Zhejiang province and characterize the mechanisms of resistance to macrolide. Six hundred fifty throat swab samples were collected from adult patients with CAP from January 2012 to August 2014. These samples were assayed by nested PCR and then cultivated forM. pneumoniae. All isolates were sequenced to determine the mutation in domain V of the 23S rRNA gene. The activities of 10 antibiotics against macrolide-resistantM. pneumoniaeisolates were also investigatedin vitro. Moreover, restriction fragment length polymorphism (RFLP) analysis of the amplified P1 gene was used to type 50 resistant strains. One hundred percent (71/71) ofM. pneumoniaestrains isolated from adults with CAP were resistant to erythromycin (MIC = 128 to >256 μg/ml), clarithromycin (MIC = 128 to >256 μg/ml), and azithromycin (MIC = 32 to >64 μg/ml). Furthermore, all macrolide-resistantM. pneumoniaestrains identified had an A2063G mutation in domain V of the 23S rRNA gene. Forty-six resistant strains (92.0%) were classified into type I strain on the basis of P1 gene PCR-RFLP analysis. According to these findings, it is suggested that macrolide-resistantM. pneumoniaeinfection is very prevalence among adults in Zhejiang province. Thus, there is necessary to perform the epidemiological monitoring of macrolide-resistantM. pneumoniaein the future.

scholarly journals Macrolide-resistant Mycoplasma pneumoniae in South Korea: a strong association with M. pneumoniae type 1

2019 ◽  
Vol 147 ◽  
Author(s):  
Hye-Young Lee ◽  
Sang-Ho Choi ◽  
Jeonghyun Chang ◽  
Mi-Na Kim ◽  
Jinho Yu ◽  
...  
Keyword(s):  
South Korea ◽  
Mycoplasma Pneumoniae ◽  
Strong Association ◽  
Community Acquired Pneumonia ◽  
Macrolide Resistance ◽  
Limited Data ◽  
Children And Young Adults ◽  
Domain V ◽  
23S Ribosomal Rna

Abstract Mycoplasma pneumoniae is a main pathogen causing community-acquired pneumonia in children and young adults. Since the emergence of macrolide-resistant M. pneumoniae in the early 2000s in Japan, it has been increasingly reported worldwide as a growing problem in treatment for children. With increasing macrolide-resistant M. pneumoniae and limited data regarding its characterization and molecular analysis, we investigated the dominant M. pneumoniae strains during the recent outbreak in South Korea, and evaluated if there was an association between a specific type and macrolide resistance. Between October 2014 and December 2016 in South Korea, 249 respiratory specimens obtained from patients with confirmed M. pneumoniae pneumonia were genotyped the P1 adhesin gene, and the mutations associated with resistance (A2063G and A2064G) were tested by sequencing the targeted domain V regions of the 23S ribosomal RNA gene. Results revealed that M. pneumoniae type 1 were predominant, which was strongly associated with macrolide-resistance during the whole study period. This is the first study assessing whether M. pneumoniae subtype is related to macrolide resistance during the outbreak of M. pneumoniae.

scholarly journals Detection of Macrolide Resistance in Mycoplasma pneumoniae by Real-Time PCR and High-Resolution Melt Analysis

2008 ◽  
Vol 52 (10) ◽  
pp. 3542-3549 ◽  
Author(s):  
Bernard J. Wolff ◽  
W. Lanier Thacker ◽  
Stephanie B. Schwartz ◽  
Jonas M. Winchell
Keyword(s):  
Real Time ◽  
Real Time Pcr ◽  
Macrolide Resistance ◽  
23S Rrna ◽  
Rrna Gene ◽  
High Resolution Melt ◽  
23S Rrna Gene ◽  
Resistant Strains ◽  
V Region ◽  
Domain V

ABSTRACT Mycoplasma pneumoniae is a significant cause of community-acquired pneumonia, which is often empirically treated with macrolides or azalides such as erythromycin or azithromycin. Recent studies have discovered the existence of macrolide-resistant strains within the population that have been mapped to mutations within the domain V region of the 23S rRNA gene. Currently, identification of these resistant strains relies on time-consuming and labor-intensive procedures such as restriction fragment length polymorphism, MIC studies, and sequence analysis. The current study reports two distinct real-time PCR assays that can detect the A2063G or A2064G base mutation (A2058G or A2059G by Escherichia coli numbering) conferring macrolide resistance. By subjecting the amplicon of the targeted domain V region of the 23S rRNA gene to a high-resolution melt curve analysis, macrolide-resistant strains can quickly be separated from susceptible strains. Utilizing this method, we screened 100 clinical isolates and found 5 strains to possess mutations conferring resistance. These findings were concordant with both sequencing and MIC data. This procedure was also used successfully to identify both susceptible and resistant genotypes in 23 patient specimens. These patient specimens tested positive for the presence of M. pneumoniae by a separate real-time PCR assay, although the bacteria could not be isolated by culture. This is the first report of a real-time PCR assay capable of detecting the dominant mutations that confer macrolide resistance on M. pneumoniae, and these assays may have utility in detecting resistant strains of other infectious agents. These assays may also allow for clinicians to select appropriate treatment options more rapidly and may provide a convenient method to conduct surveillance for genetic mutations conferring antibiotic resistance.

Sign in / Sign up

Export Citation Format

Share Document