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Updated: Sep 22, 2025
Antigen-Capture Enzyme-Linked Immunosorbent Assay for Specific Detection of Mycoplasma pneumoniae
Published on: February 24, 2023
Children with Mycoplasma pneumoniae infection in Taiwan: Changes in molecular characteristics and clinical outcomes
Jo-Ching Charlotte Hsiung1, Hsuan-Yin Ma2, Chun-Yi Lu3
1College of Medicine, National Taiwan University, Taipei, Taiwan.
Background:
Mycoplasma pneumoniae is a pathogen that causes respiratory diseases in children. Infections caused by M. pneumoniae are usually self-limited but occasionally can be severe. We observed emerging cases of severe mycoplasma infection requiring extracorporeal membrane oxygenation (ECMO). Thus, we investigated chronological changes in the molecular features of the M. pneumoniae and its clinical impacts among the pediatric population.
Methods:
From 2011 to 2019, respiratory samples were collected from patients younger than 18 years old with pneumonia in a tertiary children's hospital. Focused multiple-locus variable number of tandem repeats analysis (MLVA) typing was performed on samples positive for M. pneumoniae in 2016 and 2019. Clinical data from the patients' electronic medical records were collected. We described the annual trend of macrolide resistance and MLVA type and analyzed the associations between clinical manifestations and MLVA types.
Results:
The percentage of macrolide-resistant (MLR) M. pneumoniae gradually increased from 22% (27/122) in 2015 to 70% (82/117) in 2019. Among the MLRM. pneumoniae, the predominant strain shifted from type P (31% [13/42]) to type A (40% [19/46]). The demographics, initial presentations, and clinical courses of the subjects with MLRM. pneumoniae did not differ significantly between 2011 and 2019. However, in 2019, two fulminant cases requiring venovenous ECMO were observed, which indicates that more attention to the clinical severity of MLRM. pneumoniae infections is warranted.
Conclusion:
Obtaining accurate information on macrolide susceptibility is crucial for physicians to initiate appropriate antibiotic treatment in a timely fashion. Although we could not identify significant differences among mycoplasma pneumonias caused by different MLVAs over a span of 9 years, the emergence of severe mycoplasma infections requiring ECMO was clinically significant, and further monitoring was required.
Insights
Macrolide-resistant Mycoplasma pneumoniae infections increased significantly in children from 2015 to 2019. Severe cases requiring extracorporeal membrane oxygenation (ECMO) emerged, highlighting the need for careful monitoring and timely treatment.
Area of Science:
- Pediatric infectious diseases
- Molecular epidemiology of respiratory pathogens
- Antimicrobial resistance
Background:
- Mycoplasma pneumoniae causes pediatric respiratory illness, typically self-limiting but sometimes severe.
- Emerging severe cases requiring extracorporeal membrane oxygenation (ECMO) prompted investigation.
- Study focused on chronological changes in M. pneumoniae molecular features and clinical impact.
Purpose of the Study:
- Investigate chronological changes in molecular features of M. pneumoniae.
- Assess the clinical impact of M. pneumoniae infections in children.
- Analyze trends in macrolide resistance and specific MLVA types.
Main Methods:
- Respiratory samples from pediatric pneumonia patients (2011-2019) analyzed.
- Multiple-locus variable number of tandem repeats (MLVA) typing performed on M. pneumoniae isolates (2016, 2019).
- Clinical data collected to analyze macrolide resistance trends and MLVA type associations.
Main Results:
- Macrolide resistance in M. pneumoniae increased from 22% (2015) to 70% (2019).
- Predominant macrolide-resistant strain shifted from type P to type A.
- Fulminant cases requiring ECMO emerged in 2019, indicating increased clinical severity.
Conclusions:
- Accurate macrolide susceptibility data is crucial for timely antibiotic treatment.
- While MLVA types showed no significant clinical differences over 9 years, severe infections requiring ECMO are a significant concern.
- Further monitoring of severe M. pneumoniae infections is warranted.
