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Epidemiology of macrolide-resistant Mycoplasma pneumoniae by age distribution in Japan

Naoki Kawakami1, Ho Namkoong2, Fumitake Saito3

  • 1Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, 9-1 Akashicho, Chuo City, Tokyo, 104-8560, Japan.

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
|September 2, 2020
PubMed
Abstract

Insights

Macrolide-resistant Mycoplasma pneumoniae infections show similar prevalence and clinical features across all age groups. Previous macrolide treatment significantly increases the risk of developing drug-resistant M. pneumoniae.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Public Health

Background:

  • Mycoplasma pneumoniae is a primary cause of community-acquired pneumonia in all age demographics.
  • Macrolide resistance in M. pneumoniae is a growing global health concern, necessitating comprehensive age-stratified studies.
  • Limited research exists on the simultaneous evaluation of macrolide-resistant M. pneumoniae across diverse age groups.

Purpose of the Study:

  • To determine the prevalence and clinical characteristics of macrolide-resistant Mycoplasma pneumoniae infections.
  • To analyze the age distribution of macrolide-resistant M. pneumoniae infections.
  • To investigate the association between previous macrolide treatment and drug resistance.

Main Methods:

  • A study involving 292 patients in Tokyo, Japan, from 2015-2016.
  • Real-time PCR was used to detect M. pneumoniae DNA in patients.
  • PCR-positive patients were categorized by age: preschool (≤5 years), school-aged (6-15 years), adolescents (16-19 years), and adults (≥20 years).
  • Analysis included clinical characteristics, macrolide resistance prevalence, and 23S rRNA domain V resistance-associated mutations.

Main Results:

  • No significant differences were observed in the prevalence of macrolide-resistant M. pneumoniae or clinical characteristics across age groups.
  • A statistically significant higher prevalence of macrolide resistance-associated mutations was found in patients with a history of macrolide treatment (63.8%) compared to those without (11.1%).
  • The prevalence of macrolide-resistant M. pneumoniae infection and resistance-associated mutation status showed no significant variation among the studied age groups.

Conclusions:

  • Clinical characteristics and prevalence of macrolide-resistant M. pneumoniae infections are consistent across all age groups.
  • Prior macrolide treatment is a contributing factor to the development of drug resistance in M. pneumoniae infections.
  • Further research may be warranted to explore other factors influencing macrolide resistance in M. pneumoniae.
Keywords:
23S rRNAM. pneumoniaeMacrolide-resistancePCRPneumonia

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