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Macrolide-resistant Mycoplasma pneumoniae infection prevalence increases again in Osaka

Naoyuki Miyashita1, Makoto Ogata1, Naoki Fukuda1

  • 1First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan.

Respiratory Investigation
|April 23, 2025
PubMed
Abstract

Insights

Macrolide-resistant Mycoplasma pneumoniae (M. pneumoniae) is increasing in Osaka. Most resistant strains show a specific gene mutation linked to high-level macrolide resistance.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Molecular Biology

Background:

  • Mycoplasma pneumoniae is a common cause of respiratory infections.
  • Macrolide antibiotics are a primary treatment for M. pneumoniae infections.
  • Emergence of macrolide resistance in M. pneumoniae poses a significant public health challenge.

Purpose of the Study:

  • To determine the prevalence of macrolide-resistant M. pneumoniae strains.
  • To investigate the resistance mechanisms in M. pneumoniae.
  • To track trends in macrolide resistance from 2018 to 2024.

Main Methods:

  • Analysis of 367 patients with M. pneumoniae infection.
  • Utilized polymerase chain reaction (PCR) for strain identification.
  • Examined the M. pneumoniae 23S rRNA gene for resistance mutations.

Main Results:

  • Prevalence of macrolide-resistant M. pneumoniae significantly increased in 2024 (60.2%) compared to 2018-2020.
  • A notable rise in resistance was observed, particularly in 2024.
  • The A-to-G transition at position 2063 in the 23S rRNA gene was the predominant resistance mechanism, conferring high-level resistance.

Conclusions:

  • Macrolide-resistant M. pneumoniae prevalence is increasing in Osaka Prefecture.
  • The identified genetic mutation is strongly associated with macrolide resistance.
  • Continued surveillance of macrolide resistance in M. pneumoniae is crucial.
Keywords:
A2063GMacrolide resistantMycoplasma pneumoniaeType 1 and 2 lineagesp1 gene

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