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Emergence of macrolide-resistant strains during an outbreak of Mycoplasma pneumoniae infections in children.
J Antimicrob Chemother. 2011 Apr; 66(4):734-7.JA

Abstract

OBJECTIVES

Mycoplasma pneumoniae is a frequent cause of human lower respiratory tract infections (LRTIs) for which macrolides are the treatment of choice. The aim of this study was to determine the rate of macrolide resistance and to subtype M. pneumoniae strains in Italy.

PATIENTS AND METHODS

During an outbreak of M. pneumoniae infections in southern Italy in 2010, 48 clinical specimens from 43 paediatric patients hospitalized for LRTIs were analysed for macrolide resistance. The mutations associated with resistance (A2063G and A2064G) and M. pneumoniae subtypes were detected by sequencing the targeted domain V region of the 23S rRNA gene and a region in the MPN528a gene, respectively.

RESULTS

Macrolide resistance genotypes were detected in 11 (26%) of the 43 M. pneumoniae-positive children. The A2063G mutation was identified in seven patients and the A2064G mutation was identified in the remaining four. Upon admission, the isolates from three patients showed a susceptible genotype but subsequently acquired the A2063G mutation. Genotyping revealed M. pneumoniae subtype 1 in 33 of 40 sequenced strains and subtype 2 in the remaining 7. There was no association between macrolide resistance or susceptibility and the M. pneumoniae subtypes.

CONCLUSIONS

This is the first report of macrolide resistance among M. pneumoniae strains in Italy. Our findings indicate an unexpected high prevalence of macrolide resistance genotypes in children, and so macrolide resistance should be carefully considered in patients who do not respond appropriately to antibiotic treatment. The epidemiological monitoring of macrolide resistance has become necessary in Italy and in the rest of Europe.

Authors+Show Affiliations

Department of Biomedical Sciences and Human Oncology-Hygiene Section, University of Bari, and Department of Pulmonology, Giovanni XXIII Pediatric Hospital, Piazza G. Cesare 11, 70124 Bari, Italy. m.chironna@igiene.uniba.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21393214

Citation

Chironna, M, et al. "Emergence of Macrolide-resistant Strains During an Outbreak of Mycoplasma Pneumoniae Infections in Children." The Journal of Antimicrobial Chemotherapy, vol. 66, no. 4, 2011, pp. 734-7.
Chironna M, Sallustio A, Esposito S, et al. Emergence of macrolide-resistant strains during an outbreak of Mycoplasma pneumoniae infections in children. J Antimicrob Chemother. 2011;66(4):734-7.
Chironna, M., Sallustio, A., Esposito, S., Perulli, M., Chinellato, I., Di Bari, C., Quarto, M., & Cardinale, F. (2011). Emergence of macrolide-resistant strains during an outbreak of Mycoplasma pneumoniae infections in children. The Journal of Antimicrobial Chemotherapy, 66(4), 734-7. https://doi.org/10.1093/jac/dkr003
Chironna M, et al. Emergence of Macrolide-resistant Strains During an Outbreak of Mycoplasma Pneumoniae Infections in Children. J Antimicrob Chemother. 2011;66(4):734-7. PubMed PMID: 21393214.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Emergence of macrolide-resistant strains during an outbreak of Mycoplasma pneumoniae infections in children. AU - Chironna,M, AU - Sallustio,A, AU - Esposito,S, AU - Perulli,M, AU - Chinellato,I, AU - Di Bari,C, AU - Quarto,M, AU - Cardinale,F, Y1 - 2011/01/31/ PY - 2011/3/12/entrez PY - 2011/3/12/pubmed PY - 2011/7/16/medline SP - 734 EP - 7 JF - The Journal of antimicrobial chemotherapy JO - J Antimicrob Chemother VL - 66 IS - 4 N2 - OBJECTIVES: Mycoplasma pneumoniae is a frequent cause of human lower respiratory tract infections (LRTIs) for which macrolides are the treatment of choice. The aim of this study was to determine the rate of macrolide resistance and to subtype M. pneumoniae strains in Italy. PATIENTS AND METHODS: During an outbreak of M. pneumoniae infections in southern Italy in 2010, 48 clinical specimens from 43 paediatric patients hospitalized for LRTIs were analysed for macrolide resistance. The mutations associated with resistance (A2063G and A2064G) and M. pneumoniae subtypes were detected by sequencing the targeted domain V region of the 23S rRNA gene and a region in the MPN528a gene, respectively. RESULTS: Macrolide resistance genotypes were detected in 11 (26%) of the 43 M. pneumoniae-positive children. The A2063G mutation was identified in seven patients and the A2064G mutation was identified in the remaining four. Upon admission, the isolates from three patients showed a susceptible genotype but subsequently acquired the A2063G mutation. Genotyping revealed M. pneumoniae subtype 1 in 33 of 40 sequenced strains and subtype 2 in the remaining 7. There was no association between macrolide resistance or susceptibility and the M. pneumoniae subtypes. CONCLUSIONS: This is the first report of macrolide resistance among M. pneumoniae strains in Italy. Our findings indicate an unexpected high prevalence of macrolide resistance genotypes in children, and so macrolide resistance should be carefully considered in patients who do not respond appropriately to antibiotic treatment. The epidemiological monitoring of macrolide resistance has become necessary in Italy and in the rest of Europe. SN - 1460-2091 UR - https://www.unboundmedicine.com/medline/citation/21393214/Emergence_of_macrolide_resistant_strains_during_an_outbreak_of_Mycoplasma_pneumoniae_infections_in_children_ L2 - https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dkr003 DB - PRIME DP - Unbound Medicine ER -