In Vitro Activities of 11 Antimicrobial Agents against Macrolide-Resistant Mycoplasma pneumoniae Isolates from Pediatric Patients: Results from a Multicenter Surveillance Study

Akaike, Hiroto; Miyashita, Naoyuki; Kubo, Mika; Kawai, Yasuhiro; Tanaka, Takaaki; Ogita, Satoko; Kawasaki, Kozo; Nakano, Takashi; Terada, Kihei; Ouchi, Kazunobu

doi:10.7883/yoken.65.535

Cited by 25 publications

(19 citation statements)

References 16 publications

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“…In East Asia, macrolide-resistant Mp rapidly increased and became the cause of the majority of clinically-proven Mp in both children and adults. The prevalence of macrolide-resistant Mp varies among countries and age groups (Averbuch et al, 2011; Akaike et al, 2012; Miyashita et al, 2012; Spuesens et al, 2012; Uldum et al, 2012; Yamada et al, 2012; Yoo et al, 2012; Dumke et al, 2013; Eshaghi et al, 2013; Pereyre et al, 2013; Wu et al, 2013; Zhao et al, 2013) (Table 2). For example, over 90% of isolated Mp in China was macrolide resistant, while no macrolide-resistant Mp was found in the Netherlands.…”

Section: Epidemiologymentioning

confidence: 99%

Novel aspects on the pathogenesis of Mycoplasma pneumoniae pneumonia and therapeutic implications

et al. 2014

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Mycoplasma pneumoniae (Mp) is a leading cause of community acquired pneumonia. Knowledge regarding Mp pneumonia obtained from animal models or human subjects has been discussed in many different reports. Accumulated expertise concerning this critical issue has been hard to apply clinically, and potential problems may remain undiscovered. Therefore, our multidisciplinary team extensively reviewed the literature regarding Mp pneumonia, and compared findings from animal models with those from human subjects. In human beings, the characteristic pathological features of Mp pneumonia have been reported as alveolar infiltration with neutrophils and lymphocytes and lymphocyte/plasma cell infiltrates in the peri-bronchovascular area. Herein, we demonstrated the novel aspects of Mp pneumonia that the severity of the Mp pneumonia seemed to depend on the host innate immunity to the Mp, which might be accelerated by antecedent Mp exposure (re-exposure or latent respiratory infection) through up-regulation of Toll-like receptor 2 expression on bronchial epithelial cells and alveolar macrophages. The macrolides therapy might be beneficial for the patients with macrolide-resistant Mp pneumonia via not bacteriological but immunomodulative effects. This exhaustive review focuses on pathogenesis and extends to some therapeutic implications such as clarithromycin, and discusses the various diverse aspects of Mp pneumonia. It is our hope that this might lead to new insights into this common respiratory disease.

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Section: Epidemiologymentioning

confidence: 99%

Novel aspects on the pathogenesis of Mycoplasma pneumoniae pneumonia and therapeutic implications

et al. 2014

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“…Macrolide‐resistant MP is widespread in Asia, and is spreading to Europe and North America . PCR assays have been developed to detect three major mutations in domain V of 23S rRNA that confer high‐level macrolide resistance in isolates of MP or directly in clinical specimens .…”

Section: Discussionmentioning

confidence: 99%

“…Among these, only macrolides can safely be used regardless of age. The prevalence of macrolide‐resistant MP isolates has recently increased sharply in eastern Asia . In 2011, 89.5% of MP strains in Japanese pediatric patients had high resistance to macrolides .…”

mentioning

confidence: 99%

Genetic point‐of‐care diagnosis of Mycoplasma pneumoniae infection using LAMP assay

Kakuya¹,

Kinebuchi²,

Fujiyasu³

et al. 2014

Pediatrics International

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“…Although the A2063G mutation was related to an intermediate level of resistance to 16-membered macrolides, the A2067G transition conferred a high level of resistance to these antibiotics in a mutant selected in vitro (Fig. 1)212223).…”

Section: Mechanisms Of Resistance Acquisition and Detection Of Macrolmentioning

confidence: 99%

Mechanism of resistance acquisition and treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children

2017

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Mycoplasma pneumoniae pneumonia (MPP) is one of the most common forms of community-acquired pneumonia in children and adolescents. Outbreaks of MPP occur in 3- to 7-year cycles worldwide; recent epidemics in Korea occurred in 2006–2007, 2011, and 2015–2016. Although MPP is known to be a mild, self-limiting disease with a good response to macrolides, it can also progress into a severe and fulminant disease. Notably, since 2000, the prevalence of macrolide-resistant MPP has rapidly increased, especially in Asian countries, recently reaching up to 80%–90%. Macrolide-resistant Mycoplasma pneumoniae (MRMP) harbors a point mutation in domain V of 23S rRNA with substitutions mainly detected at positions 2063 and 2064 of the sequence. The excessive use of macrolides may contribute to these mutations. MRMP can lead to clinically refractory pneumonia, showing no clinical or radiological response to macrolides, and can progress to severe and complicated pneumonia. Refractory MPP is characterized by an excessive immune response against the pathogen as well as direct injury caused by an increasing bacterial load. A change of antibiotics is recommended to reduce the bacterial load. Tetracyclines or quinolones can be alternatives for treating MRMP. Otherwise, corticosteroid or intravenous immunoglobulin can be added to the treatment regimen as immunomodulators to down-regulate an excessive host immune reaction and alleviate immune-mediated pulmonary injury. However, the exact starting time point, dose, or duration of immunomodulators has not been established. This review focuses on the mechanism of resistance acquisition and treatment options for MRMP pneumonia.

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In Vitro Activities of 11 Antimicrobial Agents against Macrolide-Resistant Mycoplasma pneumoniae Isolates from Pediatric Patients: Results from a Multicenter Surveillance Study

Cited by 25 publications

References 16 publications

Novel aspects on the pathogenesis of Mycoplasma pneumoniae pneumonia and therapeutic implications

Novel aspects on the pathogenesis of Mycoplasma pneumoniae pneumonia and therapeutic implications

Genetic point‐of‐care diagnosis of Mycoplasma pneumoniae infection using LAMP assay

Mechanism of resistance acquisition and treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children

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