A study of community-acquired Mycoplasma pneumoniae in Yantai, China.
Introduction
Community-acquired pneumonia (CAP) is a global disease responsible for a large number of deaths, with significant economic impact. As diagnostic tools have increased in sensitivity, understanding of the etiology of CAP has begun to change. Mycoplasma pneumoniae is one of the major pathogens causing CAP. Macrolides and related antibiotics are first-line treatments for M. pneumoniae. Macrolide resistance has been spreading for 15 years and now occurs in worldwide. We undertook the first study on macrolide resistance of M. pneumoniae in Yantai. This may be helpful to determine the appropriate therapy for CAP in this population.


Objective
To investigate the rate and mechanism of macrolide resistance in Yantai.


Methods
Pharyngeal swab samples were collected from adult CAP patients. Samples were assayed by polymerase chain reaction (PCR) and cultivated to test for M. pneumoniae. Nested PCR was used to specifically amplify M. pneumoniae 23S rRNA gene fragments containing mutations, and amplicons were analyzed by CE-SSCP for macrolide resistance mutations. Results were confirmed by sequencing. Twenty-seven strains of M. pneumoniae were isolated and the activities of nine antibiotics against M. pneumoniae were tested in vitro.


Results
Out of 128 samples tested, 27 were positive for M. pneumoniae. Mycoplasma 100% macrolides resistance to Mycoplasma pneumoniae. The mechanism of macrolides resistance was A2063G point mutation in the sequence directly binding to macrolides in the 23S rRNA V domain in vitro. The mean pyretolytic time for the fluoroquinolone group was 4.7 ±2.9 d, which was significantly shorter than 8.2 ±4.1 d for the azithromycin group.


Conclusions
Macrolides are not the first-line treatment for M. pneumoniae respiratory tract infections in Yantai.
['Yu|Hong-Xia|HX|', 'Zhao|Mao-Mao|MM|', 'Pu|Zeng-Hui|ZH|', 'Ju|Yuan-Rong|YR|', 'Liu|Yan|Y|']
D000293:Adolescent D000328:Adult D000368:Aged D000900:Anti-Bacterial Agents D002681:China D017714:Community-Acquired Infections D024881:Drug Resistance, Bacterial D005260:Female D006801:Humans D018942:Macrolides D008297:Male D008875:Middle Aged D009177:Mycoplasma pneumoniae D011019:Pneumonia, Mycoplasma D017354:Point Mutation D016133:Polymerase Chain Reaction D055815:Young Adult
Mycoplasma pneumoniae community-acquired pneumonia therapy adult drug resistance