1. J Thorac Dis. 2017 Oct;9(10):3774-3781. doi: 10.21037/jtd.2017.09.75.
Macrolide-resistant Mycoplasma pneumoniae prevalence and clinical aspects in adult patients with community-acquired pneumonia in China: a prospective multicenter surveillance study.
Yin YD(1), Wang R(2), Zhuo C(3), Wang H(4), Wang MG(5), Xie CM(6), She DY(7), Yuan X(8), Wang RT(7), Cao B(9), Liu YN(7).
Author information: (1)Department of Infectious Diseases and Clinical Microbiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China. (2)Department of Clinical Pharmacology, PLA General Hospital, Beijing 100853, China. (3)State Key Laboratory of Respiratory Diseases, the First Affiliated Hospital of Guangzhou Medical College, Guangzhou 510000, China. (4)Department of Laboratory Medicine, Peking University People's Hospital, Beijing 100044, China. (5)Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai 200040, China. (6)Department of Respiratory Medicine, the First Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-sen University, Guangzhou 510080, China. (7)Department of Respiratory Diseases, PLA General Hospital, Beijing 100853, China. (8)Department of Respiratory and Critical Care Medicine, the Affiliated Hospital of the Academy of Military Medical Science, Beijing 100071, China. (9)Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China.
Background: Drug resistant Mycoplasma pneumoniae (MP) is a rising issue in the management of community-acquired pneumonia (CAP). Epidemiological monitoring is essential for identifying resistant patterns of MP isolates against various antibiotics in adult CAP patients.
Methods: This is a prospectively designed multicenter study conducted on adult patients with CAP visiting six teaching hospitals in the cities of Beijing, Shanghai and Guangzhou between September 2010 and June 2012.
Results: A total of 520 adult patients (mean age: 45.7±26.2 years) with CAP visiting teaching hospitals in the cities of Beijing, Shanghai and Guangzhou were included. Of the 520 patients, only 75 (14.42%) were confirmed MP positive by means of culture and real-time PCR methods. Quinolones were the most common initially prescribed antimicrobial, followed by β-lactams and β-lactams plus quinolones. Macrolide resistance was as high as 80% and 72% against erythromycin (ERY) and azithromycin (AZM) respectively, which were associated with the A2063G transition mutation in domain V of the 23S ribosomal RNA (rRNA) gene. Six strains with mild to moderate ERY-resistant level were still susceptible to AZM. Tetracycline (TET), minocycline (MIN) and quinolones [moxifloxacin (MOX) and fluoroquinolones] had no signs of resistance.
Conclusions: High resistance was observed with macrolides, whereas, none of the MP strains were resistant to fluoroquinolones and TET. Hence, macrolide resistant MP (MRMP)_infections could be well treated with fluoroquinolones. However, few isolated strains had minimal inhibitory concentration (MIC) values on the edge of resistance to quinolones, alarming a quinolone-resistant MP in the near future.
DOI: 10.21037/jtd.2017.09.75
PMCID: PMC5723809
PMID: 29268385
Conflict of interest statement: Conflicts of Interest: The authors have no conflicts of interest to declare.
