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Published on: February 24, 2023
Increased Macrolide-Resistant Mycoplasma pneumoniae Infections and Response to Doxycycline in Midwest United States
Miltiadis Douvoyiannis1,2, Tanner E Rothstein3, Robin Patel3,4
1Departments of Pediatrics and Pediatric Infectious Diseases, Altru Health System, Grand Forks, ND, USA.
Abstract:
37 cases of Mycoplasma pneumoniae pneumonia were diagnosed in children in North Dakota, over 3.5 months (35 by PCR); 44% harbored macrolide-resistance. Children with macrolide-resistant M. pneumoniae had a longer period of coughing prior to diagnosis (+ 3.9 days, p=0.048), a longer duration of illness (+ 5.4 days, p=0.011) and earlier resolution of fever after initiation of doxycycline (- 0.92 days, p=0.025) compared to those without macrolide resistant M. pneumoniae.
Insights
Macrolide-resistant Mycoplasma pneumoniae pneumonia in children prolongs illness and coughing duration. Early fever resolution with doxycycline was observed in resistant cases, suggesting altered treatment response.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in children.
- Macrolide resistance in M. pneumoniae is an emerging global health concern.
- Understanding the clinical impact of macrolide-resistant M. pneumoniae is crucial for effective treatment.
Purpose of the Study:
- To investigate the prevalence of macrolide-resistant Mycoplasma pneumoniae pneumonia in children.
- To compare the clinical characteristics and treatment outcomes of children infected with macrolide-resistant versus susceptible M. pneumoniae.
Main Methods:
- Retrospective analysis of 37 pediatric pneumonia cases diagnosed over 3.5 months in North Dakota.
- Polymerase chain reaction (PCR) used for M. pneumoniae detection and macrolide resistance genotyping.
- Comparison of clinical data, including duration of illness, coughing, and fever resolution, between resistant and susceptible groups.
Main Results:
- 37 pediatric pneumonia cases were identified; 35 were confirmed by PCR.
- 44% of M. pneumoniae isolates exhibited macrolide resistance.
- Children with macrolide-resistant M. pneumoniae experienced significantly longer coughing periods and overall illness duration.
- Fever resolution after doxycycline initiation was faster in children with macrolide-resistant infections.
Conclusions:
- Macrolide-resistant M. pneumoniae is prevalent in pediatric pneumonia cases.
- Infection with macrolide-resistant M. pneumoniae is associated with prolonged clinical illness.
- The findings highlight the need for monitoring macrolide resistance and considering alternative treatment strategies.
