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Community outbreak of macrolide-resistant Mycoplasma pneumoniae in Yamagata, Japan in 2009.
Pediatr Infect Dis J. 2013 Mar; 32(3):237-40.PI

Abstract

BACKGROUND

We detected a community outbreak of macrolide-resistant Mycoplasma pneumoniae infection that occurred predominantly among students at 2 schools in Yamagata, Japan.

METHODS

Throat swab specimens were collected from patients who were clinically suspected to have M. pneumoniae infection after testing negative for influenza virus by a nasopharyngeal swab rapid antigen test. We performed cultures for M. pneumoniae, and all isolates were sequenced for the presence of a mutation of the 23S rRNA gene.

RESULTS

Of 96 specimens collected between July 2009 and January 2010, 83 were from students attending junior high school A and primary schools B, C and D. A total of 47 M. pneumoniae isolates were obtained; among them, 25, 15 and 4 were isolated from students attending schools A, B and D, respectively, and M. pneumoniae could not be isolated from students who attended school C. An A2063T mutation in domain V of the 23S rRNA gene, which is associated with macrolide resistance, was identified in 39 (83.0%) isolates. The rates of macrolide resistance at schools A, B and D were 96.0%, 86.7% and 0%, respectively. The minimum inhibitory concentrations for isolates with an A2063T transversion showed high resistance to clarithromycin (minimum inhibitory concentration, 16-64 mg/L), and clarithromycin prescribed initially was clinically ineffective.

CONCLUSIONS

This school-based cluster of macrolide-resistant M. pneumoniae infections, which was identified in 2 geographically close schools, indicates that the transmission principally occurred by close contact between students at school. Monitoring the spread of macrolide-resistant M. pneumoniae and clinical guidelines for the appropriate medication against such infections would be needed to control outbreaks of M. pneumoniae.

Authors+Show Affiliations

Department of Microbiology, Yamagata Prefectural Institute of Public Health, Yamagata, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23114374

Citation

Suzuki, Yu, et al. "Community Outbreak of Macrolide-resistant Mycoplasma Pneumoniae in Yamagata, Japan in 2009." The Pediatric Infectious Disease Journal, vol. 32, no. 3, 2013, pp. 237-40.
Suzuki Y, Itagaki T, Seto J, et al. Community outbreak of macrolide-resistant Mycoplasma pneumoniae in Yamagata, Japan in 2009. Pediatr Infect Dis J. 2013;32(3):237-40.
Suzuki, Y., Itagaki, T., Seto, J., Kaneko, A., Abiko, C., Mizuta, K., & Matsuzaki, Y. (2013). Community outbreak of macrolide-resistant Mycoplasma pneumoniae in Yamagata, Japan in 2009. The Pediatric Infectious Disease Journal, 32(3), 237-40. https://doi.org/10.1097/INF.0b013e31827aa7bd
Suzuki Y, et al. Community Outbreak of Macrolide-resistant Mycoplasma Pneumoniae in Yamagata, Japan in 2009. Pediatr Infect Dis J. 2013;32(3):237-40. PubMed PMID: 23114374.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Community outbreak of macrolide-resistant Mycoplasma pneumoniae in Yamagata, Japan in 2009. AU - Suzuki,Yu, AU - Itagaki,Tsutomu, AU - Seto,Junji, AU - Kaneko,Akiko, AU - Abiko,Chieko, AU - Mizuta,Katsumi, AU - Matsuzaki,Yoko, PY - 2012/11/2/entrez PY - 2012/11/2/pubmed PY - 2013/9/21/medline SP - 237 EP - 40 JF - The Pediatric infectious disease journal JO - Pediatr Infect Dis J VL - 32 IS - 3 N2 - BACKGROUND: We detected a community outbreak of macrolide-resistant Mycoplasma pneumoniae infection that occurred predominantly among students at 2 schools in Yamagata, Japan. METHODS: Throat swab specimens were collected from patients who were clinically suspected to have M. pneumoniae infection after testing negative for influenza virus by a nasopharyngeal swab rapid antigen test. We performed cultures for M. pneumoniae, and all isolates were sequenced for the presence of a mutation of the 23S rRNA gene. RESULTS: Of 96 specimens collected between July 2009 and January 2010, 83 were from students attending junior high school A and primary schools B, C and D. A total of 47 M. pneumoniae isolates were obtained; among them, 25, 15 and 4 were isolated from students attending schools A, B and D, respectively, and M. pneumoniae could not be isolated from students who attended school C. An A2063T mutation in domain V of the 23S rRNA gene, which is associated with macrolide resistance, was identified in 39 (83.0%) isolates. The rates of macrolide resistance at schools A, B and D were 96.0%, 86.7% and 0%, respectively. The minimum inhibitory concentrations for isolates with an A2063T transversion showed high resistance to clarithromycin (minimum inhibitory concentration, 16-64 mg/L), and clarithromycin prescribed initially was clinically ineffective. CONCLUSIONS: This school-based cluster of macrolide-resistant M. pneumoniae infections, which was identified in 2 geographically close schools, indicates that the transmission principally occurred by close contact between students at school. Monitoring the spread of macrolide-resistant M. pneumoniae and clinical guidelines for the appropriate medication against such infections would be needed to control outbreaks of M. pneumoniae. SN - 1532-0987 UR - https://www.unboundmedicine.com/medline/citation/23114374/Community_outbreak_of_macrolide_resistant_Mycoplasma_pneumoniae_in_Yamagata_Japan_in_2009_ L2 - https://doi.org/10.1097/INF.0b013e31827aa7bd DB - PRIME DP - Unbound Medicine ER -