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Mycoplasma pneumoniae in children: carriage, pathogenesis, and antibiotic resistance

Patrick M Meyer Sauteur1, Annemarie M C van Rossum, Cornelis Vink

  • 1aLaboratory of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus MC - Sophia Children's Hospital, University Medical Center bErasmus University College, Erasmus University, Rotterdam, The Netherlands.

Current Opinion in Infectious Diseases
|April 23, 2014
PubMed
Abstract

Insights

Mycoplasma pneumoniae diagnosis is challenged by asymptomatic carriage and rising macrolide resistance. New methods are needed to distinguish infection from carriage and guide antibiotic choices for pediatric respiratory illness.

Area of Science:

  • Pediatric infectious diseases
  • Microbiology
  • Respiratory medicine

Background:

  • Mycoplasma pneumoniae infections pose diagnostic and treatment challenges in children.
  • High prevalence in asymptomatic children complicates accurate diagnosis.
  • Increasing macrolide resistance in M. pneumoniae (MRMP) globally impacts treatment efficacy.

Purpose of the Study:

  • To review the scientific and clinical implications of asymptomatic carriage and macrolide resistance in pediatric M. pneumoniae infections.
  • To highlight the limitations of current diagnostic methods.
  • To discuss strategies for addressing the rise of MRMP.

Main Methods:

  • Review of recent scientific literature.
  • Analysis of diagnostic capabilities for M. pneumoniae.
  • Evaluation of the impact of macrolide resistance.

Main Results:

  • M. pneumoniae prevalence is similar in asymptomatic and symptomatic children.
  • Current diagnostics cannot differentiate bacterial carriage from active infection.
  • Worldwide emergence of macrolide-resistant M. pneumoniae (MRMP) is a significant concern.

Conclusions:

  • Diagnostic procedures must be modified to reliably detect symptomatic M. pneumoniae infections.
  • Methods for detecting macrolide resistance are essential.
  • Restrictive policies for macrolide use are necessary to combat MRMP spread.

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