Macrolide-Resistant Mycoplasma pneumoniae in the United States as Determined from a National Surveillance Program
| Autor: | Steven D. Dallas, Emily Mixon, Thomas Prescott Atkinson, Karen B. Fowler, Edward G. Brooks, Yi-Wei Tang, Lynn B. Duffy, Xiaotian Zheng, M. Prichard, Rangaraj Selvarangan, Li Xiao, Donna M. Crabb, Tao Hong, J. Dien Bard, Xuan Qin, Ken B. Waites, Amy E. Ratliff |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Adult Male medicine.medical_specialty Mycoplasma pneumoniae Adolescent Epidemiology 030106 microbiology Microbial Sensitivity Tests medicine.disease_cause 03 medical and health sciences Young Adult 0302 clinical medicine Antibiotic resistance 23S ribosomal RNA Internal medicine Drug Resistance Bacterial Pneumonia Mycoplasma Prevalence Medicine Humans Clinical significance 030212 general & internal medicine Child Immunodeficiency Aged Aged 80 and over business.industry Incidence (epidemiology) Macrolide resistant Infant Middle Aged medicine.disease United States Anti-Bacterial Agents RNA Ribosomal 23S Macrolide resistance Child Preschool Epidemiological Monitoring Mutation Female Macrolides business |
| Zdroj: | Journal of clinical microbiology. 57(11) |
| ISSN: | 1098-660X |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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