The Prevalence of 23S rRNA Mutations in  ML-Resistant M. pneumoniae Isolates to Clarithromycin in Patients with  Respiratory Infections

Mohammadi, Hanieh Big; Pouladi, Iman; Zolfaghari, Mohammad Reza; Niakan, Mohammad

doi:10.29252/rbmb.9.2.156

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…Besides, in a study by Pourakbari et al in 2018, the rate of resistance to macrolides, including erythromycin, was 65% in Iran, which is consistent with our study (11). In another study by Big Mohammadi et al in 2020 in Iran, the rate of resistance to macrolides was high, and rational and limited prescriptions were considered necessary, as similarly described in our study (12).…”

Section: Discussionsupporting

confidence: 91%

“…Additionally, the amount of antibiotic use is high in Iran, and it is necessary to review and plan for the prescription of antibiotics (10). Due to the frequent use of antibiotics, the level of resistance to macrolides is high in Iran (11), and there is a need to limit their use (12). Some studies have reported a longer duration of disease, more severe pneumonia, and higher inflammatory markers in children with MRM.…”

Section: Introductionmentioning

confidence: 99%

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Macrolide-resistant Mycoplasma pneumoniae in an Iranian Pediatric Sample with Community-Acquired Pneumonia

Fahimzad,

Karimi,

Nadji

et al. 2023

Jundishapur J Microbiol

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Background: To the best of our knowledge, the prevalence of macrolide-resistant Mycoplasma pneumoniae (MRM) in Iranian children has not been investigated. Objectives: The present study aimed to evaluate the prevalence of MRM in Iranian children with community-acquired pneumonia (CAP). Methods: A total of 222 children with CAP, aged 3 - 15 years, who were hospitalized in 10 different children's hospitals, were enrolled in this study. Mycoplasmas were detected using the polymerase chain reaction (PCR) assay. The severity of CAP was evaluated according to the Infectious Diseases Society of America (IDSA) guidelines. The level of C-reactive protein (CRP) was also measured by the particle-enhanced turbidimetric immunoassay. Additionally, the chest X-rays of children with CAP were recorded and sent to a radiologist for further evaluation. Results: Twenty-one children (9.4%) diagnosed with CAP also had M. pneumoniae infection, 17 (77.27%) of whom were positive for A2063G transition and high-level macrolide resistance. The severity of CAP (P ≥ 0.99), CRP level (0.07), and chest X-ray changes (P = 0.08) were not significantly different between children with MRM pneumonia and those with macrolide-susceptible M. pneumoniae. Conclusions: The prevalence of high-level MRM pneumonia in children is high in Iran, similar to other Asian countries. However, this type of Mycoplasma infection was not associated with the severity of CAP and did not have significant effects on chest X-ray (CXR) changes or the CRP level in the patients.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Macrolide-resistant Mycoplasma pneumoniae in an Iranian Pediatric Sample with Community-Acquired Pneumonia

Fahimzad,

Karimi,

Nadji

et al. 2023

Jundishapur J Microbiol

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“…Macrolides are recommended for the treatment of M. pneumoniae which are usually considered as the first selective agent for the treatment of M. pneumoniae infection (24). With widespread use of these drugs, ML resistant isolates have been reported worldwide (24,25). In 1970, the first clinical case of erythromycin-resistant M. pneumoniae was reported in a girl (13(.…”

Section: Discussionmentioning

confidence: 99%

Molecular Detection and Evaluation of MLـ Resistance M. Pneumoniae Associated with Mutation in 23S RNA Gene among Iranian Patients with Respiratory Infections

et al. 2020

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Background: Mycoplasma pneumoniae is a common cause of community-acquired pneumonia. The global increased resistance of M. pneumoniae strains to macrolide (ML) has become a worrisome health problem. The widespread use of these medications has led to increased rate of reported ML-resistant M. pneumoniae (MRMP) throughout the world. This study was aimed to evaluate the resistance of M. pneumoniae against erythromycin due to mutations in the 23S rRNA gene of patients with respiratory infections in Iran. Methods: In this study, 100 samples of throat swab from a patient with respiratory problems were collected. After the cultured of all samples in M. pneumonia-specific PPLO medium, PCR technique was performed with specific primers. Afterwards, the broth micro-dilution MIC assay was employed. Finally, the PCR product of the 23S rRNA gene was sequenced to detect mutations of domain V in 23S rRNA gene of MRMP. Results: It was found that 17 cases (17%) were positive for mycoplasma genus and six cases (6%) positive for M. pneumoniae species. Also, analysis of the sequence of 23S rRNA gene, revealed that one of the samples had mutations at positions A2431G and G2491A. All positive samples M. pneumoniae with 23S rRNA gene were sensitive to erythromycin. Conclusions: These use of these antibiotics should be limited to prevent the emergence of MRMP in Iran.

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Global prevalence of resistance to macrolides inMycoplasma pneumoniae: a systematic review and meta-analysis

Wang

Tang

et al. 2022

Journal of Antimicrobial Chemotherapy

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Objectives To determine the prevalence of resistance to macrolides in Mycoplasma pneumoniae worldwide. Methods Prior to 12 December 2020, PubMed, Web of Science, Scopus and Embase databases were searched for epidemiological studies of M. pneumoniae resistance. Two reviewers independently extracted data from included studies. The extracted data include sampling population, total sampling number, the number of resistant strains and the molecular subtype of resistant strains. The estimate of resistance prevalence was calculated using the random-effects model. Results A total of 17 873 strains were obtained from five continents and reported in 98 investigations between 2000 and 2020, with 8836 strains characterized as macrolide resistant. In summary, macrolide-resistant M. pneumoniae was most common in Asia (63% [95% CI 56, 69]). In Europe, North America, South America and Oceania, the prevalence was 3% [2, 7], 8.6% [6, 11], 0% and 3.3%, respectively. Over the last 20 years, the prevalence of macrolide-resistant M. pneumoniae has remained high in China (81% [73, 87]), with a significant increasing trend in South Korea (4% [1, 9] to 78% [49, 93], P < 0.0001). Furthermore, a point mutation at 2063 from A to G was mostly related to M. pneumoniae macrolide resistance. In terms of clinical outcomes, longer cough (mean difference [MD]: 2.93 [0.26, 5.60]) and febrile days (MD: 1.52 [1.12, 1.92]), and prolonged hospital stays (MD: 0.76 [0.05, 1.46]) might be induced by macrolide-resistant M. pneumoniae pneumonia. Conclusions The incidence of macrolide-resistant M. pneumoniae varies globally, with eastern Asia having a greater degree of resistance. However, attention is also required in other areas, and antibiotic alternatives should be considered for treatment in high-prevalence countries.

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The Prevalence of 23S rRNA Mutations in ML-Resistant M. pneumoniae Isolates to Clarithromycin in Patients with Respiratory Infections

Cited by 3 publications

References 23 publications

Macrolide-resistant Mycoplasma pneumoniae in an Iranian Pediatric Sample with Community-Acquired Pneumonia

Macrolide-resistant Mycoplasma pneumoniae in an Iranian Pediatric Sample with Community-Acquired Pneumonia

Molecular Detection and Evaluation of MLـ Resistance M. Pneumoniae Associated with Mutation in 23S RNA Gene among Iranian Patients with Respiratory Infections

Global prevalence of resistance to macrolides inMycoplasma pneumoniae: a systematic review and meta-analysis

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