Macrolide resistance of Mycoplasma pneumoniae in several regions of China from 2013 to 2019

Abstract

This paper retrospectively analysed the prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) in some parts of China. Between January 2013 and December 2019, we collected 4,145 respiratory samples, including pharyngeal swabs and alveolar lavage fluid. The highest PCR-positive rate of M. pneumoniae was 74.5% in Beijing, the highest resistance rate was 100% in Shanghai, and Gansu was the lowest with 20%. The highest PCR-positive rate of M. pneumoniae was 74.5% in 2013, and the highest MRMP was 97.4% in 2019; the PCR-positive rate of M. pneumoniae for adults in Beijing was 17.9% and the MRMP was 10.48%. Among the children diagnosed with community-acquired pneumonia (CAP), the PCR-positive and macrolide-resistant rates of M. pneumoniae were both higher in the severe ones. A2063G in domain V of 23S rRNA was the major macrolide-resistant mutation, accounting for more than 90%. The MIC values of all MRMP to erythromycin and azithromycin were ≥ 64 μg/ml, and the MICs of tetracycline and levofloxacin were ≤ 0.5 μg/ml and ≤ 1 μg/ml, respectively. The macrolide resistance varied in different regions and years. Among inpatients, the macrolide-resistant rate was higher in severe pneumonia. A2063G was the common mutation, and we found no resistance to tetracycline and levofloxacin.

Keywords: Mycoplasma pneumoniae; clinical features; drug-resistant; epidemic; macrolide.

Figure 1.

PCR positive and macrolide-resistance of M. pneumoniae from 2013-2019.

Figure 2.

Comparison of sequencing results. Note: (A: Combination of M. pneumoniae with 2063 A→G point mutation, with or without 2064 point mutation; B: Combination of M. pneumoniae with or without 2063 A→G point mutation; C: M. pneumoniae with 2063 A→G point mutation; position 28 is 2063 point and position 29 is 2064 point from domain V of 23S rRNA.).