Allergy Asthma Immunol Res.  2017 Jul;9(4):340-346. 10.4168/aair.2017.9.4.340.

Macrolide Resistance and Its Impacts on M. Pneumoniae Pneumonia in Children: Comparison of Two Recent Epidemics in Korea

• Kim JH
• Kim JY
• Yoo CH
• Seo WH
• Yoo Y
• Song DJ
• Choung JT

• KMID: 2378197
• DOI: http://doi.org/10.4168/aair.2017.9.4.340

Abstract

PURPOSE
The aim of this study was to investigate the change in macrolide resistance rate in pediatric Mycoplasma pneumoniae pneumonia and to evaluate the influence of macrolide-resistant M. pneumoniae (MRMP) on the clinical course of disease, by comparing 2 recent, consecutive epidemics in Korea.
METHODS
A total of 250 patients with M. pneumoniae pneumonia admitted to a single tertiary hospital were enrolled in this study. Detection of MRMP was based on specific point mutations in domain V of the 23S rRNA gene. The medical records of enrolled patients were reviewed retrospectively, and the clinical courses and laboratory data were compared.
RESULTS
The macrolide resistance rate of M. pneumoniae was 51.1% (48/94) in the 2011 epidemic, and 87.2% (136/156) in the 2015 epidemic. All MRMP isolates had the A2063G point mutation. In comparison of 2 epidemics, the mean age of patients with M. pneumoniae pneumonia was increased, and the total febrile days and febrile days after initiation of macrolides were prolonged in the 2015 epidemic. Overall severity of MRMP or macrolide-susceptible M. pneumoniae (MSMP) pneumonia over 2 epidemics was not significantly changed. However, the proportion of patients who had a fever lasting more than 72 hours after initiation of macrolides and who received corticosteroid treatment were higher in MRMP pneumonia during 2 epidemics.
CONCLUSIONS
The macrolide resistance rate of M. pneumoniae has risen rapidly over 2 recent, consecutive epidemics, and this has been associated with a prolonged clinical course and increased use of corticosteroids to treat pediatric M. pneumoniae pneumonia.

Keyword

Drug resistance; macrolides; Mycoplasma pneumoniae

MeSH Terms

Adrenal Cortex Hormones
Child*
Drug Resistance
Fever
Genes, rRNA
Humans
Korea*
Macrolides
Medical Records
Mycoplasma pneumoniae
Pneumonia*
Pneumonia, Mycoplasma
Point Mutation
Retrospective Studies
Tertiary Care Centers
Adrenal Cortex Hormones
Macrolides

Figure

• 

  Figure Study population. MRMP, macrolide-resistant M. pneumoniae; MSMP, macrolide-susceptible M. pneumoniae; PCR, polymerase chain reaction.

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