Macrolide-Resistant Mycoplasma pneumoniae in the United States as Determined from a National Surveillance Program.

Autor:	Waites KB; Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA kwaites@uabmc.edu., Ratliff A; Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA., Crabb DM; Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA., Xiao L; Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA., Qin X; Department of Laboratory Medicine and Pathology, Seattle Children's Hospital, Seattle, Washington, USA., Selvarangan R; Children's Mercy Hospital, Kansas City, Missouri, USA., Tang YW; Memorial Sloan Kettering Cancer Center, Weill Medical College of Cornell University, New York, New York, USA., Zheng X; Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA., Dien Bard J; Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA., Hong T; Department of Pathology, Hackensack University Medical Center, Hackensack, New Jersey, USA., Prichard M; Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA., Brooks E; Department of Pediatrics, University of Texas Health Science Center, San Antonio, Texas, USA., Dallas S; Department of Pathology, University of Texas Health Science Center, San Antonio, Texas, USA., Duffy L; Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA., Mixon E; Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA., Fowler KB; Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA., Atkinson TP; Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Jazyk:	angličtina
Zdroj:	Journal of clinical microbiology [J Clin Microbiol] 2019 Oct 23; Vol. 57 (11). Date of Electronic Publication: 2019 Oct 23 (Print Publication: 2019).
DOI:	10.1128/JCM.00968-19
Abstrakt:	There are sparse data to indicate the extent that macrolide-resistant Mycoplasma pneumoniae (MRMp) occurs in the United States or its clinical significance. Between 2015 and 2018, hospitals in 8 states collected and stored respiratory specimens that tested positive for M. pneumoniae and sent them to the University of Alabama at Birmingham, where real-time PCR was performed for detection of 23S rRNA mutations known to confer macrolide resistance. MRMp was detected in 27 of 360 specimens (7.5%). MRMp prevalence was significantly higher in the South and East (18.3%) than in the West (2.1%). A2063G was the predominant 23S rRNA mutation detected. MICs for macrolide-susceptible M. pneumoniae (MSMp) were ≤0.008 μg/ml, whereas MICs for MRMp were 16 to 32 μg/ml. Patients with MRMp infection were more likely to have a history of immunodeficiency or malignancy. Otherwise, there were no other significant differences in the clinical features between patients infected with MRMp and those infected with MSMp, nor were there any differences in radiographic findings, hospitalization rates, viral coinfections, the mean duration of antimicrobial treatment, or clinical outcomes. There was no significant change in MRMp incidence over time or according to age, sex, race/ethnicity, or status as an inpatient or an outpatient. Patients with MRMp were more likely to have received a macrolide prior to presentation, and their treatment was more likely to have been changed to a fluoroquinolone after presentation. This is the first national surveillance program for M. pneumoniae in the United States. Additional surveillance is needed to assess the clinical significance of MRMp and to monitor changes in MRMp prevalence. (Copyright © 2019 American Society for Microbiology.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu