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. 2017 Jul;9(4):340-346.
doi: 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

Jong Hyun Kim  1 , Jee Yong Kim  2 , Chang Hoon Yoo  3 , Won Hee Seo  1 , Young Yoo  1   4 , Dae Jin Song  1   5 , Ji Tae Choung  1   4
Affiliations

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

Jong Hyun Kim et al. Allergy Asthma Immunol Res. 2017 Jul.

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.

Keywords: Drug resistance; Mycoplasma pneumoniae; macrolides.

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Conflict of interest statement

There are no financial or other issues that might lead to conflict of interest.

Figures

Figure
Figure. Study population. MRMP, macrolide-resistant M. pneumoniae; MSMP, macrolide-susceptible M. pneumoniae; PCR, polymerase chain reaction.
See this image and copyright information in PMC

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