The clinical significance of and the factors associated with macrolide resistance and poor macrolide response in pediatric Mycoplasma pneumoniae infection: A retrospective study

Yen, Meng-Hsiu; Yan, Dah-Chin; Tsao, Kuo‐Chien; Huang, Yi‐Chuan; Cheng, Sheue-yann; Chiu, Cheng-Hsun; Huang, Yayu; Lin, Tsan-Shiun

doi:10.1016/j.jmii.2023.01.010

Cited by 13 publications

(2 citation statements)

References 25 publications

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“…Recent studies indicated that drug resistance did not affect the clinical features or the presence of pulmonary consolidation in MPP. MRMP infections only prolonged the fever duration and the hospital stay by 1–2 days [ 20 ]. Perhaps because of the immunomodulatory effects of macrolide antibiotics [ 15 , 21 ], children who did not change their antibiotic regimen had favorable responses.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the clinical characteristics in parents and their children in a series of family clustered Mycoplasma pneumoniae infections

Liu,

Zhang,

Chen

et al. 2024

BMC Pulm Med

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Background Mycoplasma pneumoniae infections have increased in China recently, causing some evidence of familial clustering. The purpose of this study was to compare the clinical features of parents and children in cases of familial clustering of Mycoplasma pneumoniae infection. Methods A retrospective analysis was performed on the cases of familial clustering of Mycoplasma pneumoniae infection, and the clinical characteristics of parents and children were compared. Results We identified 63 families, of these, 57 (65.5%) adults and 65 (94.2%) children required hospitalization. Fifty-seven adults (mean age 35.1 ± 4.6 years, 80.7% female) and 55 children (mean age 6.3 ± 3.9 years, 54.5% female) were included in the analysis. The incidence of mycoplasma infection in adults had increased gradually over the past year, while the rate in children had spiked sharply since June 2023. The clinical symptoms were similar in the two groups, mainly fever and cough. The peak temperature of children was higher than that of adults (39.1 ± 0.7℃ vs 38.6 ± 0.7℃, p = 0.004). Elevated lactate dehydrogenase was more common in children than in adults (77.8% vs 11.3%, p < 0.001). Bronchial pneumonia and bilateral involvement were more common in children, while adults usually had unilateral involvement. Three (60%) adults and 21 (52.5%) children were macrolide-resistant Mycoplasma pneumoniae infected. Children were more likely to be co-infected (65.5% vs 22.8%, p < .001). Macrolides were used in most children and quinolones were used in most adults. Ten (18.2%) children were diagnosed with severe Mycoplasma pneumoniae pneumonia, whereas all adults had mild disease. Children had a significantly longer fever duration than adults ((5.6 ± 2.2) days vs (4.1 ± 2.2) days, p = 0.002). No patient required mechanical ventilation or died. Conclusions Mycoplasma pneumoniae infection shows a familial clustering epidemic trend at the turn of summer and autumn, with different clinical characteristics between parents and children.

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Section: Discussionmentioning

confidence: 99%

Comparison of the clinical characteristics in parents and their children in a series of family clustered Mycoplasma pneumoniae infections

Liu,

Zhang,

Chen

et al. 2024

BMC Pulm Med

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“…Tol oxacin has been approved for pediatric use in Japan since 2010, and macrolide resistance rates decreased by 59.3% and 43.6% in 2014 and 2015, respectively [11,12]. In addition, limitations exist regarding testing and statistical methods, with a few methods differentiating based on a child's response to macrolide therapy, a method that lacks accuracy [13]. The traditional method involves MP culture, which requires substantial training, is time-consuming, and is not conducive to early diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and logistic regression analysis of 227 cases of children with macrolide-resistant Mycoplasma pneumoniae pneumonia

Yan,

Tao,

et al. 2024

Preprint

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Purpose To investigate macrolide-resistant Mycobacterium pneumoniae (MRMP) pneumonia in children and construct a logistic regression model for mutations in the Mycoplasma pneumoniae drug-resistant gene. Methods Clinical data of 281 children were analyzed. Sequencing confirmed a mutation at the A2063G locus of the 23S rRNA gene in 227 children (A2063G group); 54 children showed no mutations (non-MRMP [NMRMP] group). We compared clinical features, laboratory tests, imaging, and bronchoscopy results and constructed a multifactorial logistic regression model to analyze risk and protective factors. Results The A2063G group had longer durations of fever and hospitalization before admission, a higher proportion of glucocorticosteroid treatment, longer time to discontinue hormones, and higher probability of combined infections. Monocyte percentage was significantly higher in the A2063G group. Imaging suggested a higher incidence of infections in the right lung compared to both lungs. Univariate analysis revealed fever duration before admission, hormone dose and duration, monocyte percentage, and mixed infections as risk factors for Mycoplasma pneumoniae infection with the A2063G mutation. The logistic regression model showed that mixed infections were an independent risk factor for the A2063G locus mutation, whereas hormone dose was a protective factor. Conclusion Detection rate was high; all children showed the A2063G mutation in the bacterial drug-resistant gene, longer fever duration and hospitalization before admission, a significantly higher percentage of monocytes, higher glucocorticoid use, and longer to cease medication. The presence of other respiratory infections was an independent risk factor for the emergence of resistant genes, while hormone dose use was a protective factor.

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Clinical characteristics and logistic regression analysis of macrolide-resistant Mycoplasma pneumoniae pneumonia in children

Yan,

Tao,

et al. 2024

Eur J Clin Microbiol Infect Dis

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The clinical significance of and the factors associated with macrolide resistance and poor macrolide response in pediatric Mycoplasma pneumoniae infection: A retrospective study

Cited by 13 publications

References 25 publications

Comparison of the clinical characteristics in parents and their children in a series of family clustered Mycoplasma pneumoniae infections

Comparison of the clinical characteristics in parents and their children in a series of family clustered Mycoplasma pneumoniae infections

Clinical characteristics and logistic regression analysis of 227 cases of children with macrolide-resistant Mycoplasma pneumoniae pneumonia

Clinical characteristics and logistic regression analysis of macrolide-resistant Mycoplasma pneumoniae pneumonia in children

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