Clinical relevance of macrolide-resistant Mycoplasma pneumoniae in respiratory tract infection
Keywords:
Mycoplasma pneumoniae, Macrolide-resistant, Respiratory tract infection, Gene mutationAbstract
OBJECTIVE
To assess the differences in clinical consequences between patients infected with macrolide-resistant Mycoplasma pneumoniae (MRMP) and macrolide-susceptible Mycoplasma pneumoniae (MSMP).
METHODS
One hundred and sixteen M. pneumoniae strains had been isolated from 1,100 patients with respiratory tract infection by real-time polymerase chain reaction (rt-PCR) assay from February 2012 to April 2015. We performed gene sequencing analysis to detect point mutations in 23S rRNA conferring resistant genotypes. Clinical characteristics and treatment outcomes of patients with MRMP and MSMP groups were compared.
RESULTS
There were 116 clinical isolates in which 31 of them were resistant to macrolide (26.7%). Most of MRMP strains harbored an A-to-G transition mutation at position 2063 in 23S rRNA genes, and only one of them harbored an A-to-G transition mutation at position 2064. Clinical data were completely available for 104 patients. There were 25 of them who had infected with MRMP (24.0%). Demographic data, clinical symptoms, leukocyte counts, and chest film findings of MRMP and MSMP groups were similar. The percentage of infected patients in the MRMP group, who had antibiotic exposure prior to 3 months, was higher than that of MSMP group (80% vs. 34.2%; P=0.001). The rate of changes from initially prescribed antibiotic therapy to levofloxacin was significantly higher in the MRMP group (40% vs. 0%; P=0.003). Moreover, the duration of symptom resolution after initiation of antibiotic therapy was also significantly longer in the MRMP group (6 days vs. 3 days; P=0.01).
CONCLUSION
History of antibiotic exposure was more common in patients infected with MRMP. The time of symptom resolution in MRMP patients was significantly longer.
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