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Macrolide-Resistant Mycoplasma pneumoniae in Children: Emphasis on the United States
1Department of Pediatrics, Divisions of Pediatric Hospital Medicine and Pediatric Infectious Diseases, Altru Health System, Grand Forks, ND, USA.
Abstract:
Several studies regarding infections caused by macrolide-resistant Mycoplasma pneumoniae have been reported in the last years in the United States, where the prevalence is approximately 10% but may range from 3% to even 80%. Macrolide-resistant M. pneumoniae may be associated with prolonged fever, hospital stay, and complications. Suspicion should be raised by non-response to macrolides, and detection can be achieved through routine reflexive testing of M. pneumoniae-positive specimens with a polymerase-chain reaction assay that rapidly predicts macrolide resistance. After timely initiation of an alternative antibiotic, prompt resolution of the disease is likely in most cases. This review summarizes current US data, offers some suggestions, and identifies knowledge gaps on this infection.
Insights
Macrolide-resistant Mycoplasma pneumoniae infections are increasing in the US. Early detection via PCR and alternative antibiotics can improve patient outcomes.
Area of Science:
- Infectious Diseases
- Microbiology
- Antimicrobial Resistance
Background:
- Macrolide-resistant *Mycoplasma pneumoniae* (MRMP) infections are a growing concern in the United States.
- Prevalence of MRMP varies significantly, ranging from 3% to 80% in reported studies.
- MRMP infections are linked to adverse clinical outcomes, including prolonged fever, extended hospital stays, and complications.
Purpose of the Study:
- To review current data on MRMP infections in the US.
- To provide suggestions for clinical management and identify knowledge gaps.
Main Methods:
- Literature review of studies on macrolide-resistant *Mycoplasma pneumoniae* in the United States.
- Analysis of prevalence data and clinical associations.
- Discussion of diagnostic approaches, including polymerase-chain reaction (PCR) for resistance detection.
Main Results:
- Macrolide resistance in *M. pneumoniae* is a significant issue in the US, with variable prevalence.
- Non-response to macrolide antibiotics is a key indicator for suspecting resistance.
- PCR-based assays can rapidly detect macrolide resistance.
Conclusions:
- Prompt recognition of MRMP infections through clinical suspicion and rapid diagnostic testing is crucial.
- Timely initiation of alternative antibiotic therapy can lead to disease resolution.
- Further research is needed to address identified knowledge gaps regarding MRMP infections.
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