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Published on: February 24, 2023

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Characteristics of hospitalized children infected with macrolide-resistant Mycoplasma pneumoniae

Haruki Komatsu1, Tomoyuki Tsunoda2, Ayano Inui2

  • 1Department of Pediatrics, Toho University Sakura Medical Center, Japan; Division of Hepatology and Gastroenterology, Department of Pediatrics, Eastern Yokohama Hospital, Japan.

The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases
|January 7, 2014
PubMed
Abstract

Insights

Macrolide-resistant Mycoplasma pneumoniae infections are common in hospitalized children, often affecting preschoolers previously treated with macrolides. Minocycline may be a necessary second-line treatment for children under eight when macrolides fail.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Respiratory tract infections (RTIs) in children can be caused by Mycoplasma pneumoniae.
  • Macrolide resistance in M. pneumoniae is an emerging concern globally.
  • Understanding the characteristics of children with macrolide-resistant M. pneumoniae (MR-MP) is crucial for effective treatment.

Purpose of the Study:

  • To retrospectively analyze the clinical features of children hospitalized with RTIs caused by MR-MP.
  • To identify risk factors and treatment patterns associated with MR-MP infections in pediatric patients.

Main Methods:

  • Retrospective cohort study of children hospitalized for M. pneumoniae RTIs.
  • Diagnosis confirmed by polymerase chain reaction (PCR).
  • Macrolide resistance mutations (A2063G, A2064G) identified via sequence analysis.

Main Results:

  • 33 children hospitalized with M. pneumoniae; 31 (94%) had MR-MP.
  • The majority of MR-MP cases were in children aged five years.
  • Prior macrolide antibiotic use was reported in 68% of MR-MP cases; minocycline was used in 52% during hospitalization.

Conclusions:

  • Preschool-aged children are frequently hospitalized with MR-MP, often after macrolide treatment.
  • Minocycline administration is a viable second-line option for children under eight with persistent symptoms.
  • Widespread macrolide resistance necessitates alternative therapeutic strategies in Japan.
Keywords:
AntibioticsMinocyclineMutationYoung children

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