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For: Wolff BJ, Thacker WL, Schwartz SB, Winchell JM. Detection of macrolide resistance in Mycoplasma pneumoniae by real-time PCR and high-resolution melt analysis. Antimicrob Agents Chemother 2008;52:3542-9. [PMID: 18644962 DOI: 10.1128/AAC.00582-08] [Citation(s) in RCA: 126] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open

For:	Wolff BJ, Thacker WL, Schwartz SB, Winchell JM. Detection of macrolide resistance in Mycoplasma pneumoniae by real-time PCR and high-resolution melt analysis. Antimicrob Agents Chemother 2008;52:3542-9. [PMID: 18644962 DOI: 10.1128/AAC.00582-08] [Citation(s) in RCA: 126] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open

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Cited by Other Article(s)

Chen J, Wang Y, Cheng J, Ma Y, Zhang X, Bai X, Rehati P, Cui H, Wu F, Pan Q, Huang J. Synergistic impact of macrolide resistance and H3N2 infection on M. pneumoniae outbreak in children. Microbiol Spectr 2025;13:e0184424. [PMID: 39998323 PMCID: PMC11960130 DOI: 10.1128/spectrum.01844-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Accepted: 01/02/2025] [Indexed: 02/26/2025] Open

Abstract

In November 2023, there was a substantial increase in the incidence of Mycoplasma pneumoniae infections in China following waves of SARS-CoV-2 Omicron variant and influenza outbreaks. This study aimed to elucidate the epidemiological features and clinical implications of M. pneumoniae infections in children and explore the potential influence of SARS-CoV-2 Omicron variants and influenza A infections on the M. pneumoniae outbreak. Among 38,668 children with lower respiratory tract infections from January to December 2023, 11,919 tested positive for M. pneumoniae, predominantly between October and December. The majority of the children with M. pneumoniae were aged 5-10 years, with type 1 strains and macrolide-resistant M. pneumoniae strains having the highest prevalence rates. Statistical analysis revealed elevated C-reactive protein, neutrophil, and monocyte levels and decreased lymphocyte, basophil, and eosinophil counts in M. pneumoniae-positive children. M. pneumoniae-positive children also presented significantly increased neutralizing antibody levels against preceding influenza A (H3N2) but not against SARS-CoV-2 Omicron variants. A parallel trend was observed between M. pneumoniae and H3N2 prevalence from June to December 2023. The emergence of macrolide-resistant strains and prior influenza A (H3N2) epidemics notably contributed to the M. pneumoniae outbreak. These findings suggested that H3N2 infection facilitates M. pneumoniae infection through various mechanisms. This study underscores the complex interactions between respiratory pathogens and highlights the need for comprehensive surveillance and response strategies.IMPORTANCEThis study identified key factors contributing to an outbreak of Mycoplasma pneumoniae that affected 11,919 children. The influencing factors included a high prevalence of macrolide-resistant epidemic strains (94.2%) and significantly higher H3N2 neutralizing antibody levels (P < 0.0001) stimulated by the preceding H3N2 influenza epidemic. These findings highlight the complex relationship between the prevalence of M. pneumoniae and H3N2 infection in children, indicating that it is necessary to consider pathogen interactions in respiratory disease management by continuously monitoring respiratory pathogens. The emergence of macrolide-resistant strains in China and the previous H3N2 influenza epidemic significantly exacerbated the severity of the M. pneumoniae outbreak. H3N2 infection potentially amplifies Mycoplasma transmission. This study elucidates the epidemiological and clinical aspects of M. pneumoniae infections in children, yields insights regarding the cause of the outbreak, and provides guidance for improving respiratory infection management.

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Affiliation(s)

Jiali Chen Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microorganisms and Infection, School of Basic Medical Sciences, Fudan University, Shanghai, China
Yingdan Wang Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microorganisms and Infection, School of Basic Medical Sciences, Fudan University, Shanghai, China
Juan Cheng Clinical Laboratory, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Yunping Ma Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microorganisms and Infection, School of Basic Medical Sciences, Fudan University, Shanghai, China Shanghai Immune Therapy Institute, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
Xin Zhang Clinical Laboratory, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Xuezhou Bai Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microorganisms and Infection, School of Basic Medical Sciences, Fudan University, Shanghai, China
Palizhati Rehati Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microorganisms and Infection, School of Basic Medical Sciences, Fudan University, Shanghai, China
Huashun Cui Department of Acupuncture and Moxibustion, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
Fan Wu Shanghai Immune Therapy Institute, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
Qiuhui Pan Clinical Laboratory, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China Faculty of Medical Laboratory Science, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China Shanghai Key Laboratory of Clinical Molecular Diagnostics for Pediatrics, Shanghai, China
Jinghe Huang Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microorganisms and Infection, School of Basic Medical Sciences, Fudan University, Shanghai, China

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Yang S, Liu X, Han Y, Wang H, Mei Y, Wang H, Zhang N, Peng Y, Li X. Clinical characteristics and associated factors of macrolide-resistant mycoplasma pneumoniae pneumonia in children: a systematic review and meta-analysis. Eur J Clin Microbiol Infect Dis 2025:10.1007/s10096-025-05101-z. [PMID: 40106136 DOI: 10.1007/s10096-025-05101-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2025] [Accepted: 03/06/2025] [Indexed: 03/22/2025]

Abstract

In recent years, the incidence of macrolide-resistant Mycoplasma pneumoniae (MRMP) pneumonia has markedly increased across East Asia, especially in China, Japan, and South Korea, presenting considerable challenges for clinical management. We systematically reviewed and conducted a meta-analysis on the resistance rate, clinical characteristics, and associated factors of MRMP, thereby establishing a foundation for early clinical identification and optimization of treatment strategies. In accordance with the PRISMA 2020 reporting guidelines, six databases including PubMed, Embase, Web of Science, CNKI, VIP, and Wanfang Data were systematically searched for relevant literature up to October 31, 2024. Studies explicitly reporting the clinical characteristics of both MRMP and macrolide-sensitive Mycoplasma pneumoniae (MSMP) pneumonia patients were included, with the population restricted to children. Pooled odds ratio (OR) and mean difference (MD), along with 95% confidence intervals, were calculated using inverse-variance weighting. A significance threshold was set at p < 0.05, and meta-analysis was performed using software such as RevMan, Stata, and R Studio. A total of 65 studies encompassing 20,141 patients were included in this analysis. The meta-analysis revealed that MRMP showed high resistance in East Asia compared to lower resistance in other regions. The overall resistance rate was 61% (95% CI: 54%, 68%), exhibiting notable regional variation. Elevated resistance rates were noted in East Asian countries, specifically China, Japan, and South Korea, reported at 68% (95% CI: 63%, 73%), 61% (95% CI: 43%, 80%), and 63% (95% CI: 42%, 85%), respectively. MRMP resistance was significantly associated with prolonged fever duration (MD: 1.97, 95% CI: 1.10, 2.84), extended hospitalization (MD: 1.96, 95% CI: 1.39, 2.54), elevated log MP-DNA levels (MD: 2.79, 95% CI: 1.54, 4.04), increased proportions of severe (OR: 2.45, 95% CI: 1.75, 3.44) cases and refractory (OR: 3.25, 95% CI: 1.47, 7.17) cases, and the occurrence of complications, particularly intrapulmonary manifestations including pulmonary consolidations (OR: 1.43, 95% CI: 1.14, 1.78), pleural effusions (OR: 2.11, 95% CI: 1.28, 3.49), lobar lesions (OR: 2.03, 95% CI: 1.03, 4.00), mucus plugs (OR: 4.63, 95% CI: 1.66, 12.94), and necrotizing pneumonia (OR: 2.49, 95% CI: 1.19, 5.24), alongside extrapulmonary involvement (OR: 3.08, 95% CI: 2.49, 3.82). No significant differences were observed in peak body temperature (MD: 0.05, 95% CI: -0.11, 0.20) or inflammatory markers including white blood cell count (WBC, MD: 0.28, 95% CI: -0.38, 0.94), C-reactive protein (CRP, MD: 0.71, 95% CI: -2.16, 3.58), Procalcitonin (PCT, MD: -0.11, 95% CI: -0.27, 0.05) and lactate dehydrogenase (LDH, MD: 3.80, 95% CI: -22.92, 30.52). The high resistance rate may be associated with environmental pressure stemming from the widespread use of macrolide antibiotics and increased genetic mutations due to the extensive spread of MP. The observed increase in severe cases, refractory cases, and complications associated with MRMP may be attributed to prolonged colonization resulting from ineffective anti-Mycoplasma pneumoniae treatment, rather than to enhanced virulence or a more severe cytokine storm. PROSPERO registration number CRD42024550871.

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Affiliation(s)

Shuo Yang First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China
Xinying Liu First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China
Yaowei Han First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China
Huizhe Wang First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China
Yunzheng Mei First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China
Haokai Wang First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China
Na Zhang First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China
Yingying Peng Binhai New Area Hospital of TCM Tianjin, Fourth Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300451, China
Xinmin Li First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China. National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China.

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Butpech T, Tovichien P. Mycoplasma pneumoniae pneumonia in children. World J Clin Cases 2025;13:99149. [PMID: 39959768 PMCID: PMC11606359 DOI: 10.12998/wjcc.v13.i5.99149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 10/11/2024] [Accepted: 11/04/2024] [Indexed: 11/18/2024] Open

Wijesooriya LI, Chalker V, Perera P, Sunil-Chandra NP. A study on viruses and bacteria with particular interest on Mycoplasma pneumoniae in children with exacerbation of asthma from a tertiary care hospital in Sri Lanka. Access Microbiol 2024;6:000778.v5. [PMID: 39081780 PMCID: PMC11288328 DOI: 10.1099/acmi.0.000778.v5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/11/2024] [Indexed: 08/02/2024] Open

Abstract

Asthma is a significant public health concern, particularly in children with severe symptoms. Exacerbation of asthma (EOA) is life-threatening, and respiratory infections (RIs) play a crucial role. Though viruses play a significant role in EOA, patients are empirically treated with antibiotics, contributing to antibiotic resistance development. Although there are widely reported associations of EOA with viral or Mycoplasma pneumoniae infections, there are no published data for Sri Lanka. The present study aimed to identify the association of common respiratory viruses, typical respiratory bacterial pathogens and M. pneumoniae in children with EOA and relate them with the compatibility of antimicrobial use. A case-control study was conducted in the paediatric unit of North Colombo Teaching Hospital, Sri Lanka, involving two groups of children between 5 and 15 years of age. Group 1 is children with EOA and Group 2 is children with stable asthma (SA). Each group consisted of 100 children. Sputum/throat swabs were tested for common respiratory viruses using virus-specific fluorescein isothiocyanate-labelled monoclonal antibodies (MAbs), bacteria by routine culture, and M. pneumoniae by real-time polymerase chain reaction. Macrolide resistance in M. pneumoniae was detected using conventional PCR and sequencing specific genetic mutations in the 23S rRNA gene. M. pneumoniae was genotyped using nested multilocus sequence typing, which targeted eight housekeeping genes (ppa, pgm, gyrB, gmk, glyA, atpA, arcC and adk). There was no significant difference in age, gender, demographic or geographical location between the two groups. In children with EOA, antibiotics were used in 66 % (66/100) and macrolides in 42 % (42/100). Samples comprised 78 % (78/100) sputum and 22 % (22/100) throat swabs. Adenovirus was the most common virus identified, and it was significantly higher in children with EOA compared to those with SA. Still, the two groups had no significant difference in typical bacteria findings. M. pneumoniae was detected in one patient with EOA, but none was detected in the SA group. The M. pneumoniae was macrolide-sensitive and ST14 by multilocus sequence typing. This study showed that the empiric use of antibiotics in children with asthma might be better targeted with prior pathogen screening to inform appropriate treatment to minimize antibiotic resistance.

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Liu L, Xiang C, Zhang Y, He L, Meng F, Gong J, Liu J, Zhao F. A Novel Detection Procedure for Mutations in the 23S rRNA Gene of Macrolide-Resistant Mycoplasma pneumoniae with Two Non-Overlapping Probes Amplification Assay. Microorganisms 2023;12:62. [PMID: 38257888 PMCID: PMC10820694 DOI: 10.3390/microorganisms12010062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open

Affiliation(s)

Liyong Liu National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (L.L.); (C.X.); (Y.Z.); (L.H.); (F.M.); (J.G.); (J.L.)
Caixin Xiang National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (L.L.); (C.X.); (Y.Z.); (L.H.); (F.M.); (J.G.); (J.L.) School of Public Health, China Medical University, Shenyang 110122, China
Yiwei Zhang National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (L.L.); (C.X.); (Y.Z.); (L.H.); (F.M.); (J.G.); (J.L.)
Lihua He National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (L.L.); (C.X.); (Y.Z.); (L.H.); (F.M.); (J.G.); (J.L.)
Fanliang Meng National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (L.L.); (C.X.); (Y.Z.); (L.H.); (F.M.); (J.G.); (J.L.)
Jie Gong National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (L.L.); (C.X.); (Y.Z.); (L.H.); (F.M.); (J.G.); (J.L.)
Jie Liu National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (L.L.); (C.X.); (Y.Z.); (L.H.); (F.M.); (J.G.); (J.L.) School of Public Health, China Medical University, Shenyang 110122, China
Fei Zhao National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (L.L.); (C.X.); (Y.Z.); (L.H.); (F.M.); (J.G.); (J.L.)

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Blakiston MR, Vesty A, Basu I. Macrolide resistant Mycoplasma pneumoniae in Auckland, New Zealand. Pathology 2023;55:399-400. [PMID: 36085087 DOI: 10.1016/j.pathol.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/05/2022] [Accepted: 06/14/2022] [Indexed: 11/26/2022]

Duan Y, Zhang X, Li Y, Zhao X, Zhao X, Chen L, Shi C, Ma C, Wang X. Amino-modified silica membrane capable of DNA extraction and enrichment for facilitated isothermal amplification detection of Mycoplasma pneumoniae. J Pharm Biomed Anal 2023;224:115190. [PMID: 36463769 DOI: 10.1016/j.jpba.2022.115190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 11/29/2022]

Affiliation(s)

Yake Duan Shandong Provincial Key Laboratory of Biochemical Engineering, Qingdao Nucleic Acid Rapid Detection Engineering Research Center, College of Marine Science and Biological Engineering, Qingdao University of Science and Technology, Qingdao 266042, PR China
Xin Zhang Shandong Provincial Key Laboratory of Biochemical Engineering, Qingdao Nucleic Acid Rapid Detection Engineering Research Center, College of Marine Science and Biological Engineering, Qingdao University of Science and Technology, Qingdao 266042, PR China
Yong Li Shandong Provincial Key Laboratory of Biochemical Engineering, Qingdao Nucleic Acid Rapid Detection Engineering Research Center, College of Marine Science and Biological Engineering, Qingdao University of Science and Technology, Qingdao 266042, PR China
Xiaoli Zhao Shandong Provincial Key Laboratory of Biochemical Engineering, Qingdao Nucleic Acid Rapid Detection Engineering Research Center, College of Marine Science and Biological Engineering, Qingdao University of Science and Technology, Qingdao 266042, PR China
Xiaowen Zhao Core Laboratory, The Affiliated Qingdao Central Hospital of Qingdao University, Qingdao 266042, PR China
Lei Chen Department of Laboratory Medicine, The Second People's Hospital of Weifang, Weifang 261041, PR China
Chao Shi Qingdao Nucleic Acid Rapid Testing International Science and Technology Cooperation Base, College of Life Sciences, Department of Pathogenic Biology, School of Basic Medicine, and Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao 266071, PR China
Cuiping Ma Shandong Provincial Key Laboratory of Biochemical Engineering, Qingdao Nucleic Acid Rapid Detection Engineering Research Center, College of Marine Science and Biological Engineering, Qingdao University of Science and Technology, Qingdao 266042, PR China
Xiujuan Wang Shandong Provincial Key Laboratory of Biochemical Engineering, Qingdao Nucleic Acid Rapid Detection Engineering Research Center, College of Marine Science and Biological Engineering, Qingdao University of Science and Technology, Qingdao 266042, PR China.

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Li L, Ma J, Guo P, Song X, Li M, Yu Z, Yu Z, Cheng P, Sun H, Zhang W. Molecular beacon based real-time PCR p1 gene genotyping, macrolide resistance mutation detection and clinical characteristics analysis of Mycoplasma pneumoniae infections in children. BMC Infect Dis 2022;22:724. [PMID: 36068499 PMCID: PMC9447981 DOI: 10.1186/s12879-022-07715-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/29/2022] [Indexed: 11/10/2022] Open

Abstract

Background

Mycoplasma pneumoniae can be divided into different subtypes on the basis of the sequence differences of adhesive protein P1, but the relationship between different subtypes, macrolide resistance and clinical manifestations are still unclear. In the present study, we established a molecular beacon based real-time polymerase chain reaction (real-time PCR) p1 gene genotyping method, analyzed the macrolide resistance gene mutations and the relationship of clinical characteristics with the genotypes.

Methods

A molecular beacon based real-time PCR p1 gene genotyping method was established, the mutation sites of macrolide resistance genes were analyzed by PCR and sequenced, and the relationship of clinical characteristics with the genotypes was analyzed.

Results

The detection limit was 1–100 copies/reaction. No cross-reactivity was observed in the two subtypes. In total, samples from 100 patients with positive M. pneumoniae detection results in 2019 and 2021 were genotyped using the beacon based real-time PCR method and P1-1 M. pneumoniae accounted for 69.0%. All the patients had the A2063G mutation in the macrolide resistance related 23S rRNA gene. Novel mutations were also found, which were C2622T, C2150A, C2202G and C2443A mutations. The relationship between p1 gene genotyping and the clinical characteristics were not statistically related.

Conclusion

A rapid and easy clinical application molecular beacon based real-time PCR genotyping method targeting the p1 gene was established. A shift from type 1 to type 2 was found and 100.0% macrolide resistance was detected. Our study provided an efficient method for genotyping M. pneumoniae, valuable epidemiological monitoring information and clinical treatment guidance to control high macrolide resistance.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-022-07715-6.

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Affiliation(s)

Lifeng Li Henan International Joint Laboratory of Children's Infectious Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China.,Department of Neonatology, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
Jiayue Ma Henan International Joint Laboratory of Children's Infectious Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
Pengbo Guo Henan International Joint Laboratory of Children's Infectious Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
Xiaorui Song Henan International Joint Laboratory of Children's Infectious Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
Mingchao Li Department of Neonatology, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
Zengyuan Yu Department of Neonatology, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
Zhidan Yu Henan International Joint Laboratory of Children's Infectious Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
Ping Cheng Department of Neonatology, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
Huiqing Sun Department of Neonatology, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China.
Wancun Zhang Henan International Joint Laboratory of Children's Infectious Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China.

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Lang JE, Hornik CP, Elliott C, Silverstein A, Hornik C, Al-Uzri A, Bosheva M, Bradley JS, Borja-Tabora CFC, John DD, Echevarria AM, Ericson JE, Friedel D, Gonczi F, Isidro MGD, James LP, Kalocsai K, Koutroulis I, Laki I, Ong-Lim ALT, Nad M, Simon G, Syed S, Szabo E, Benjamin DK, Cohen-Wolkowiez M. Solithromycin in Children and Adolescents With Community-acquired Bacterial Pneumonia. Pediatr Infect Dis J 2022;41:556-562. [PMID: 35675525 PMCID: PMC9199591 DOI: 10.1097/inf.0000000000003559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]

Abstract

BACKGROUND

Solithromycin is a new macrolide-ketolide antibiotic with potential effectiveness in pediatric community-acquired bacterial pneumonia (CABP). Our objective was to evaluate its safety and effectiveness in children with CABP.

METHODS

This phase 2/3, randomized, open-label, active-control, multicenter study randomly assigned solithromycin (capsules, suspension or intravenous) or an appropriate comparator antibiotic in a 3:1 ratio (planned n = 400) to children 2 months to 17 years of age with CABP. Primary safety endpoints included treatment-emergent adverse events (AEs) and AE-related drug discontinuations. Secondary effectiveness endpoints included clinical improvement following treatment without additional antimicrobial therapy.

RESULTS

Unrelated to safety, the sponsor stopped the trial prior to completion. Before discontinuation, 97 participants were randomly assigned to solithromycin (n = 73) or comparator (n = 24). There were 24 participants (34%, 95% CI, 23%-47%) with a treatment-emergent AE in the solithromycin group and 7 (29%, 95% CI, 13%-51%) in the comparator group. Infusion site pain and elevated liver enzymes were the most common related AEs with solithromycin. Study drug was discontinued due to AEs in 3 subjects (4.3%) in the solithromycin group and 1 (4.2%) in the comparator group. Forty participants (65%, 95% CI, 51%-76%) in the solithromycin group achieved clinical improvement on the last day of treatment versus 17 (81%, 95% CI, 58%-95%) in the comparator group. The proportion achieving clinical cure was 60% (95% CI, 47%-72%) and 68% (95% CI, 43%-87%) for the solithromycin and comparator groups, respectively.

CONCLUSIONS

Intravenous and oral solithromycin were generally well-tolerated and associated with clinical improvement in the majority of participants treated for CABP.

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Affiliation(s)

Jason E. Lang Department of Pediatrics, Duke University Medical Center, Durham, NC, USA Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
Christoph P. Hornik Department of Pediatrics, Duke University Medical Center, Durham, NC, USA Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
Carrie Elliott Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
Adam Silverstein Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
Chi Hornik Department of Pediatrics, Duke University Medical Center, Durham, NC, USA Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
Amira Al-Uzri Oregon Health and Science University, Portland, OR, USA
Miroslava Bosheva Medical University, Plovdiv, Bulgaria
John S. Bradley Rady Children’s Hospital and the University of California San Diego, San Diego, CA, USA
Charissa Fay Corazon Borja-Tabora Research Institute for Tropical Medicine, Manila, Philippines
David Di John Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, USA
Ana Mendez Echevarria Pediatric Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Madrid, Spain
Jessica E. Ericson Penn State College of Medicine, Hershey, PA, USA
David Friedel Virginia Commonwealth University Medical Center, Richmond, VA, USA
Ferenc Gonczi University of Debrecen Clinical Center Infectology Clinic, Debrecen, Hungary
Marie Grace Dawn Isidro West Visayas State University Medical Center, Iloilo City, Philippines
Laura P. James Arkansas Children’s Hospital Research Institute, Little Rock, AR, USA
Krisztina Kalocsai Dél-pesti Centrumkórház Országos Hematológiai és Infektológiai Intézet, Budapest, Hungary
Ioannis Koutroulis Children's National Hospital, Washington, DC, USA
Istvan Laki Pulmonary Hospital, Törökbálint, Hungary
Anna Lisa T. Ong-Lim Philippine General Hospital, University of the Philippines Manila, Philippines
Marta Nad Kanizsai Dorottya Hospital, Nagykanizsa, Hungary
Gabor Simon Fejér County Szent György University Teaching Hospital, Székesfehérvár, Hungary
Salma Syed East Carolina University, Brody School of Medicine, Greenville, NC, USA
Eva Szabo Csolnoky Ferenc Hospital, Veszprém, Hungary
Daniel K. Benjamin Department of Pediatrics, Duke University Medical Center, Durham, NC, USA Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
Michael Cohen-Wolkowiez Department of Pediatrics, Duke University Medical Center, Durham, NC, USA Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA

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Wang G, Wu P, Tang R, Zhang W. Global prevalence of resistance to macrolides in Mycoplasma pneumoniae: a systematic review and meta-analysis. J Antimicrob Chemother 2022;77:2353-2363. [PMID: 35678262 DOI: 10.1093/jac/dkac170] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 05/03/2022] [Indexed: 02/05/2023] Open

Jiang FC, Wang RF, Chen P, Dong LY, Wang X, Song Q, Wan YQ, Song QQ, Song J, Wang YH, Xia ZQ, Xia D, Han J. Genotype and mutation patterns of macrolide resistance genes of Mycoplasma pneumoniae from children with pneumonia in Qingdao, China, in 2019. J Glob Antimicrob Resist 2021;27:273-278. [PMID: 34687926 DOI: 10.1016/j.jgar.2021.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 08/16/2021] [Accepted: 10/03/2021] [Indexed: 11/17/2022] Open

Affiliation(s)

Fa-Chun Jiang Municipal Centre of Disease Control and Prevention of Qingdao, Qingdao Institute of Prevention Medicine, Qingdao 266033, Shandong, China
Rui-Fang Wang State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Ping Chen State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; Bengbu Medical College, Bengbu 233030, Anhui, China
Li-Yan Dong Municipal Centre of Disease Control and Prevention of Qingdao, Qingdao Institute of Prevention Medicine, Qingdao 266033, Shandong, China
Xia Wang District Center of Disease Control and Prevention of Shibei, Qingdao 266000, Shandong, China
Qin Song District Center of Disease Control and Prevention of Chengyang, Qingdao 266041, Shandong, China
Yi-Qiu Wan State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; Medical College of Anhui University of Science and Technology, Huainan 232001, Anhui, China
Qin-Qin Song State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Juan Song State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Yan-Hai Wang State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Zhi-Qiang Xia State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Dong Xia State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Jun Han State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

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Point-of-care molecular diagnosis of Mycoplasma pneumoniae including macrolide sensitivity using quenching probe polymerase chain reaction. PLoS One 2021;16:e0258694. [PMID: 34648603 PMCID: PMC8516298 DOI: 10.1371/journal.pone.0258694] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 10/02/2021] [Indexed: 12/22/2022] Open

Lanata MM, Wang H, Everhart K, Moore-Clingenpeel M, Ramilo O, Leber A. Macrolide-Resistant Mycoplasma pneumoniae Infections in Children, Ohio, USA. Emerg Infect Dis 2021;27:1588-1597. [PMID: 34013867 PMCID: PMC8153876 DOI: 10.3201/eid2706.203206] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open

Rivaya B, Jordana-Lluch E, Fernández-Rivas G, Molinos S, Campos R, Méndez-Hernández M, Matas L. Macrolide resistance and molecular typing of Mycoplasma pneumoniae infections during a 4 year period in Spain. J Antimicrob Chemother 2021;75:2752-2759. [PMID: 32653897 PMCID: PMC7678890 DOI: 10.1093/jac/dkaa256] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/21/2020] [Accepted: 05/12/2020] [Indexed: 02/05/2023] Open

Zhao F, Zhang J, Wang X, Liu L, Gong J, Zhai Z, He L, Meng F, Xiao D. A multisite SNP genotyping and macrolide susceptibility gene method for Mycoplasma pneumoniae based on MALDI-TOF MS. iScience 2021;24:102447. [PMID: 33997713 PMCID: PMC8105657 DOI: 10.1016/j.isci.2021.102447] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/20/2021] [Accepted: 04/14/2021] [Indexed: 11/06/2022] Open

Li S, Xue G, Zhao H, Feng Y, Yan C, Cui J, Xie X, Yuan J. Quantitative proteomics analysis of Mycoplasma pneumoniae identifies potential macrolide resistance determinants. AMB Express 2021;11:26. [PMID: 33580372 PMCID: PMC7881084 DOI: 10.1186/s13568-021-01187-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/04/2021] [Indexed: 11/16/2022] Open

Esposito S, Argentiero A, Gramegna A, Principi N. Mycoplasma pneumoniae: a pathogen with unsolved therapeutic problems. Expert Opin Pharmacother 2021;22:1193-1202. [PMID: 33544008 DOI: 10.1080/14656566.2021.1882420] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]

Efficiency of the novel quenching-probe PCR method to detect 23S rRNA mutations in children with Mycoplasma pneumoniae infection. J Microbiol Methods 2021;181:106135. [PMID: 33422523 DOI: 10.1016/j.mimet.2021.106135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 01/05/2021] [Accepted: 01/05/2021] [Indexed: 11/20/2022]

Morinaga Y, Suzuki H, Notake S, Mizusaka T, Uemura K, Otomo S, Oi Y, Ushiki A, Kawabata N, Kameyama K, Morishita E, Uekura Y, Sugiyama A, Kawashima Y, Yanagihara K. Evaluation of GENECUBE Mycoplasma for the detection of macrolide-resistant Mycoplasma pneumoniae. J Med Microbiol 2020;69:1346-1350. [PMID: 33141009 DOI: 10.1099/jmm.0.001264] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open

Abstract

Introduction. Resistance against macrolide antibiotics in Mycoplasma pneumoniae is becoming non-negligible in terms of both appropriate therapy and diagnostic stewardship. Molecular methods have attractive features for the identification of Mycoplasma pneumoniae as well as its resistance-associated mutations of 23S ribosomal RNA (rRNA).Hypothesis/Gap Statement. The automated molecular diagnostic sytem can identify macrolide-resistant M. pneumoniae.Aim. To assess the performance of an automated molecular diagnostic system, GENECUBE Mycoplasma, in the detection of macrolide resistance-associated mutations.Methodology. To evaluate whether the system can distinguish mutant from wild-type 23S rRNA, synthetic oligonucleotides mimicking known mutations (high-level macrolide resistance, mutation in positions 2063 and 2064; low-level macrolide resistance, mutation in position 2067) were assayed. To evaluate clinical oropharyngeal samples, purified nucleic acids were obtained from M. pneumoniae-positive samples by using the GENECUBE system from nine hospitals. After confirmation by re-evaluation of M. pneumoniae positivity, Sanger-based sequencing of 23S rRNA and mutant typing using GENECUBE Mycoplasma were performed.Results. The system reproducibly identified all synthetic oligonucleotides associated with high-level macrolide resistance. Detection errors were only observed for A2067G (in 2 of the 10 measurements). The point mutation in 23S rRNA was detected in 67 (26.9 %) of 249 confirmed M. pneumoniae-positive clinical samples. The mutations at positions 2063, 2064 and 2617 were observed in 65 (97.0 %), 2 (3.0 %) and 0 (0.0 %) of the 67 samples, respectively. The mutations at positions 2063 and 2064 were A2063G and A2064G, respectively. The results from mutant typing using GENECUBE Mycoplasma were in full agreement with the results from sequence-based typing.Conclusion. GENECUBE Mycoplasma is a reliable test for the identification of clinically significant macrolide-resistant M. pneumoniae.

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Tsai TA, Tsai CK, Kuo KC, Yu HR. Rational stepwise approach for Mycoplasma pneumoniae pneumonia in children. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2020;54:557-565. [PMID: 33268306 DOI: 10.1016/j.jmii.2020.10.002] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 10/04/2020] [Accepted: 10/08/2020] [Indexed: 01/14/2023]

Accurate, rapid and low-cost diagnosis of Mycoplasma pneumoniae via fast narrow-thermal-cycling denaturation bubble-mediated strand exchange amplification. Anal Bioanal Chem 2020;412:8391-8399. [PMID: 33040157 PMCID: PMC7548028 DOI: 10.1007/s00216-020-02977-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/23/2020] [Accepted: 09/26/2020] [Indexed: 12/12/2022]

Evaluation of Commercial Molecular Diagnostic Methods for Detection and Determination of Macrolide Resistance in Mycoplasma pneumoniae. J Clin Microbiol 2020;58:JCM.00242-20. [PMID: 32269102 DOI: 10.1128/jcm.00242-20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/01/2020] [Indexed: 12/11/2022] Open

Mbano IM, Mandizvo T, Rogich J, Kunota TTR, Mackenzie JS, Pillay M, Balagaddé FK. Light Forge: A Microfluidic DNA Melting-based Tuberculosis Test. J Appl Lab Med 2020;5:440-453. [PMID: 32445364 PMCID: PMC7192548 DOI: 10.1093/jalm/jfaa019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/15/2019] [Indexed: 01/09/2023]

Kutty PK, Jain S, Taylor TH, Bramley AM, Diaz MH, Ampofo K, Arnold SR, Williams DJ, Edwards KM, McCullers JA, Pavia AT, Winchell JM, Schrag SJ, Hicks LA. Mycoplasma pneumoniae Among Children Hospitalized With Community-acquired Pneumonia. Clin Infect Dis 2020;68:5-12. [PMID: 29788037 DOI: 10.1093/cid/ciy419] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 05/14/2018] [Indexed: 12/22/2022] Open

Voronina EN, Gordukova MA, Turina IE, Mishukova OV, Dymova MA, Galeeva EV, Korsunskiy AA, Filipenko ML. Molecular characterization of Mycoplasma pneumoniae infections in Moscow from 2015 to 2018. Eur J Clin Microbiol Infect Dis 2019;39:257-263. [PMID: 31655931 DOI: 10.1007/s10096-019-03717-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 09/20/2019] [Indexed: 11/28/2022]

Wang J, Yang J, Gao S, Liu A, Rashid M, Li Y, Liu Z, Liu J, Liu G, Luo J, Guan G, Yin H. Rapid detection and differentiation of Theileria annulata, T. orientalis and T. sinensis using high-resolution melting analysis. Ticks Tick Borne Dis 2019;11:101312. [PMID: 31645296 DOI: 10.1016/j.ttbdis.2019.101312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/24/2019] [Accepted: 10/09/2019] [Indexed: 11/18/2022]

Affiliation(s)

Jinming Wang State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, Gansu, 730046, PR China
Jifei Yang State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, Gansu, 730046, PR China
Shandian Gao State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, Gansu, 730046, PR China
Aihong Liu State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, Gansu, 730046, PR China
Muhammad Rashid State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, Gansu, 730046, PR China
Youquan Li State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, Gansu, 730046, PR China
Zhijie Liu State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, Gansu, 730046, PR China
Junlong Liu State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, Gansu, 730046, PR China
Guangyuan Liu State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, Gansu, 730046, PR China
Jianxun Luo State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, Gansu, 730046, PR China
Guiquan Guan State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, Gansu, 730046, PR China.
Hong Yin State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Xujiaping 1, Lanzhou, Gansu, 730046, PR China; Jiangsu Co-Innovation Center for the Prevention and Control of Important Animal Infectious Disease and Zoonosis, Yangzhou University, Yangzhou 225009, PR China.

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Guo D, Hu W, Xu B, Li J, Li D, Li S, Wu Z, Wei R, Tian X, Shen K, Xin D. Allele-specific real-time PCR testing for minor macrolide-resistant Mycoplasma Pneumoniae. BMC Infect Dis 2019;19:616. [PMID: 31299916 PMCID: PMC6626384 DOI: 10.1186/s12879-019-4228-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 06/26/2019] [Indexed: 11/17/2022] Open

Suzuki Y, Seto J, Shimotai Y, Itagaki T, Katsushima Y, Katsushima F, Ikeda T, Mizuta K, Hongo S, Matsuzaki Y. Polyclonal spread of multiple genotypes of Mycoplasma pneumoniae in semi-closed settings in Yamagata, Japan. J Med Microbiol 2019;68:785-790. [PMID: 30932805 DOI: 10.1099/jmm.0.000969] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open

Carrim M, Wolter N, Benitez AJ, Tempia S, du Plessis M, Walaza S, Moosa F, Diaz MH, Wolff BJ, Treurnicht FK, Hellferscee O, Dawood H, Variava E, Cohen C, Winchell JM, von Gottberg A. Epidemiology and Molecular Identification and Characterization of Mycoplasma pneumoniae, South Africa, 2012-2015. Emerg Infect Dis 2019;24:506-513. [PMID: 29460736 PMCID: PMC5823326 DOI: 10.3201/eid2403.162052] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open

Lee H, Yun KW, Lee HJ, Choi EH. Antimicrobial therapy of macrolide-resistantMycoplasma pneumoniaepneumonia in children. Expert Rev Anti Infect Ther 2017;16:23-34. [DOI: 10.1080/14787210.2018.1414599] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]

Yin YD, Wang R, Zhuo C, Wang H, Wang MG, Xie CM, She DY, Yuan X, Wang RT, Cao B, Liu YN. Macrolide-resistant Mycoplasma pneumoniae prevalence and clinical aspects in adult patients with community-acquired pneumonia in China: a prospective multicenter surveillance study. J Thorac Dis 2017;9:3774-3781. [PMID: 29268385 DOI: 10.21037/jtd.2017.09.75] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]

Kogoj R, Praprotnik M, Mrvič T, Korva M, Keše D. Genetic diversity and macrolide resistance of Mycoplasma pneumoniae isolates from two consecutive epidemics in Slovenia. Eur J Clin Microbiol Infect Dis 2017;37:99-107. [PMID: 28948376 DOI: 10.1007/s10096-017-3106-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 09/07/2017] [Indexed: 11/26/2022]

Waites KB, Xiao L, Liu Y, Balish MF, Atkinson TP. Mycoplasma pneumoniae from the Respiratory Tract and Beyond. Clin Microbiol Rev 2017;30:747-809. [PMID: 28539503 PMCID: PMC5475226 DOI: 10.1128/cmr.00114-16] [Citation(s) in RCA: 458] [Impact Index Per Article: 57.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open

Yoon IA, Hong KB, Lee HJ, Yun KW, Park JY, Choi YH, Kim WS, Lee H, Eun BW, Ahn YM, Cho EY, Cho HJ, Choi EH. Radiologic findings as a determinant and no effect of macrolide resistance on clinical course of Mycoplasma pneumoniae pneumonia. BMC Infect Dis 2017;17:402. [PMID: 28592263 PMCID: PMC5463359 DOI: 10.1186/s12879-017-2500-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 05/28/2017] [Indexed: 11/18/2022] Open

Abstract

Background

With the emergence of macrolide resistance, concerns about the efficacy of macrolides for the treatment of Mycoplasma pneumoniae (MP) pneumonia in children have been raised. This study aimed to determine the effect of macrolide resistance on the outcome of children who were hospitalized with MP pneumonia.

Methods

Between 2010 and 2015, we performed culture of MP from nasopharyngeal samples obtained from children who were hospitalized with pneumonia at five hospitals in Korea. Macrolide resistance was determined by the analysis of 23S rRNA gene transition and the minimal inhibitory concentrations of four macrolides. Medical records were reviewed to analyze the clinical response to treatment with macrolides.

Results

MP was detected in 116 (4.8%) of the 2436 children with pneumonia. MP pneumonia was prevalent in 2011 and 2015. Of the 116 patients with MP pneumonia, 82 (70.7%) were macrolide-resistant. There were no differences in the age distribution, total duration of fever, and chest x-ray patterns between the macrolide-susceptible and macrolide-resistant groups. After macrolide initiation, mean days to defervescence were longer in the macrolide-resistant group than in macrolide-susceptible group (5.7 days vs. 4.1 days, P = 0.021). However, logistic regression analysis revealed that the presence of extrapulmonary signs (P = 0.039), homogeneous lobar consolidation (P = 0.004), or parapneumonic effusion (P < 0.001) were associated with fever duration of ≥7 days after the initiation of macrolides, regardless of macrolide resistance.

Conclusions

This study demonstrated that fever duration in MP pneumonia was determined by the radiologic findings of chest x-ray, not by the presence of macrolide resistance. The results highlight the need for future studies to assess therapeutic benefit from macrolides in the treatment of children with MP pneumonia.

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Epidemiology and Molecular Characteristics of Mycoplasma pneumoniae During an Outbreak of M. pneumoniae-associated Stevens-Johnson Syndrome. Pediatr Infect Dis J 2017;36:564-571. [PMID: 28060039 PMCID: PMC5893500 DOI: 10.1097/inf.0000000000001476] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]

Abstract

BACKGROUND

An increase in Mycoplasma pneumoniae-associated Stevens-Johnson syndrome (SJS) cases at a Colorado pediatric hospital led to an outbreak investigation. We describe the epidemiologic and molecular characteristics of M. pneumoniae among SJS case-patients and surrounding community members during the outbreak.

METHODS

M. pneumoniae polymerase chain reaction-positive respiratory specimens from 5 Colorado hospitals and 4 referral laboratories underwent confirmatory polymerase chain reaction testing; positive specimens then underwent multilocus variable-number tandem-repeat analysis (MLVA) and macrolide resistance testing. Three SJS-M. pneumoniae case-patient households were surveyed using a standardized questionnaire, and nasopharyngeal/oropharyngeal swabs were obtained from all consenting/assenting household contacts. International Classification of Diseases, 9th revision codes were used to identify pneumonia cases among Colorado patients 5-21 years of age from January 2009 to March 2014.

RESULTS

Three different M. pneumoniae MLVA types were identified among the 5 SJS case-patients with confirmed infection; MLVA type 3-X-6-2 was seen more commonly in SJS case-patients (60%) than in 69 non-SJS community specimens (29%). Macrolide resistance was identified in 7% of community specimens but not among SJS case-patients. Of 15 household contacts, 5 (33%) were M. pneumoniae positive; all MLVA types were identical to those of the corresponding SJS case-patient, although the specimen from 1 contact was macrolide resistant. Overall pneumonia cases as well as those caused by M. pneumoniae specifically peaked in October 2013, coinciding with the SJS outbreak.

CONCLUSIONS

The outbreak of M. pneumoniae-associated SJS may have been associated with a community outbreak of M. pneumoniae; clinicians should be aware of the M. pneumoniae-SJS relationship. Household transmission of M. pneumoniae was common within the households investigated.

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Lee E, Cho HJ, Hong SJ, Lee J, Sung H, Yu J. Prevalence and clinical manifestations of macrolide resistant Mycoplasma pneumoniae pneumonia in Korean children. KOREAN JOURNAL OF PEDIATRICS 2017;60:151-157. [PMID: 28592978 PMCID: PMC5461279 DOI: 10.3345/kjp.2017.60.5.151] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 12/01/2016] [Accepted: 12/21/2016] [Indexed: 11/27/2022]

Molecular Characterization of Mycoplasma pneumoniae Infections in Two Rural Populations of Thailand from 2009 to 2012. J Clin Microbiol 2017;55:2222-2233. [PMID: 28490485 DOI: 10.1128/jcm.00350-17] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/01/2017] [Indexed: 11/20/2022] Open

Diaz MH, Desai HP, Morrison SS, Benitez AJ, Wolff BJ, Caravas J, Read TD, Dean D, Winchell JM. Comprehensive bioinformatics analysis of Mycoplasma pneumoniae genomes to investigate underlying population structure and type-specific determinants. PLoS One 2017;12:e0174701. [PMID: 28410368 PMCID: PMC5391922 DOI: 10.1371/journal.pone.0174701] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 03/13/2017] [Indexed: 11/28/2022] Open

Affiliation(s)

Maureen H. Diaz Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Heta P. Desai Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Shatavia S. Morrison Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Alvaro J. Benitez Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Bernard J. Wolff Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Jason Caravas Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
Timothy D. Read Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
Deborah Dean Center for Immunobiology and Vaccine Research, University of California San Francisco Benioff Children’s Hospital Oakland Research Institute, Oakland, California, United States of America Joint Graduate Program in Bioengineering, University of California San Francisco and University of California Berkeley, Oakland, California, United States of America
Jonas M. Winchell Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America * E-mail:

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Kim JH, Kim JY, Yoo CH, Seo WH, Yoo Y, Song DJ, Choung JT. Macrolide Resistance and Its Impacts on M. Pneumoniae Pneumonia in Children: Comparison of Two Recent Epidemics in Korea. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2017;9:340-346. [PMID: 28497921 PMCID: PMC5446949 DOI: 10.4168/aair.2017.9.4.340] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 01/06/2017] [Accepted: 02/09/2017] [Indexed: 11/20/2022]

Rapid Detection of Common HIV-1 Drug Resistance Mutations by Use of High-Resolution Melting Analysis and Unlabeled Probes. J Clin Microbiol 2016;55:122-133. [PMID: 27795333 DOI: 10.1128/jcm.01291-16] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 10/05/2016] [Indexed: 01/08/2023] Open

Sharma L, Losier A, Tolbert T, Dela Cruz CS, Marion CR. Atypical Pneumonia: Updates on Legionella, Chlamydophila, and Mycoplasma Pneumonia. Clin Chest Med 2016;38:45-58. [PMID: 28159161 DOI: 10.1016/j.ccm.2016.11.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]

Development of an endpoint genotyping assay to detect the Mycoplasma pneumoniae 23S rRNA gene and distinguish the existence of macrolide resistance-associated mutations at position 2063. J Microbiol Methods 2016;131:130-134. [PMID: 27789313 DOI: 10.1016/j.mimet.2016.10.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 10/21/2016] [Accepted: 10/21/2016] [Indexed: 11/24/2022]

Smith S, Adamson PJ, Sadlon TA, Gordon DL. Prevalence of macrolide-resistant Mycoplasma pneumoniae in South Australia. Pathology 2016;48:639-42. [PMID: 27596238 DOI: 10.1016/j.pathol.2016.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 06/08/2016] [Indexed: 10/21/2022]

Pereyre S, Goret J, Bébéar C. Mycoplasma pneumoniae: Current Knowledge on Macrolide Resistance and Treatment. Front Microbiol 2016;7:974. [PMID: 27446015 PMCID: PMC4916212 DOI: 10.3389/fmicb.2016.00974] [Citation(s) in RCA: 160] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 06/06/2016] [Indexed: 11/16/2022] Open

Abstract

Mycoplasma pneumoniae causes community-acquired respiratory tract infections, particularly in school-aged children and young adults. These infections occur both endemically and epidemically worldwide. M. pneumoniae lacks cell wall and is subsequently resistant to beta-lactams and to all antimicrobials targeting the cell wall. This mycoplasma is intrinsically susceptible to macrolides and related antibiotics, to tetracyclines and to fluoroquinolones. Macrolides and related antibiotics are the first-line treatment of M. pneumoniae respiratory tract infections mainly because of their low MIC against the bacteria, their low toxicity and the absence of contraindication in young children. The newer macrolides are now the preferred agents with a 7-to-14 day course of oral clarithromycin or a 5-day course of oral azithromycin for treatment of community-acquired pneumonia due to M. pneumoniae, according to the different guidelines worldwide. However, macrolide resistance has been spreading for 15 years worldwide, with prevalence now ranging between 0 and 15% in Europe and the USA, approximately 30% in Israel and up to 90–100% in Asia. This resistance is associated with point mutations in the peptidyl-transferase loop of the 23S rRNA and leads to high-level resistance to macrolides. Macrolide resistance-associated mutations can be detected using several molecular methods applicable directly from respiratory specimens. Because this resistance has clinical outcomes such as longer duration of fever, cough and hospital stay, alternative antibiotic treatment can be required, including tetracyclines such as doxycycline and minocycline or fluoroquinolones, primarily levofloxacin, during 7–14 days, even though fluoroquinolones and tetracyclines are contraindicated in all children and in children < 8 year-old, respectively. Acquired resistance to tetracyclines and fluoroquinolones has never been reported in M. pneumoniae clinical isolates but reduced susceptibility was reported in in vitro selected mutants. This article focuses on M. pneumoniae antibiotic susceptibility and on the development and the evolution of acquired resistance. Molecular detection of resistant mutants and therapeutic options in case of macrolide resistance will also be assessed.

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Gullsby K, Bondeson K. No detection of macrolide-resistant Mycoplasma pneumoniae from Swedish patients, 1996-2013. Infect Ecol Epidemiol 2016;6:31374. [PMID: 27258207 PMCID: PMC4891970 DOI: 10.3402/iee.v6.31374] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 04/19/2016] [Accepted: 04/27/2016] [Indexed: 02/01/2023] Open

Zheng X, Lee S, Selvarangan R, Qin X, Tang YW, Stiles J, Hong T, Todd K, Ratliff AE, Crabb DM, Xiao L, Atkinson TP, Waites KB. Macrolide-Resistant Mycoplasma pneumoniae, United States. Emerg Infect Dis 2016. [PMID: 26196107 PMCID: PMC4517703 DOI: 10.3201/eid2108.150273] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open

Diaz MH, Winchell JM. The Evolution of Advanced Molecular Diagnostics for the Detection and Characterization of Mycoplasma pneumoniae. Front Microbiol 2016;7:232. [PMID: 27014191 PMCID: PMC4781879 DOI: 10.3389/fmicb.2016.00232] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 02/15/2016] [Indexed: 12/12/2022] Open

Benitez AJ, Winchell JM. Rapid detection and typing of pathogenic nonpneumophila Legionella spp. isolates using a multiplex real-time PCR assay. Diagn Microbiol Infect Dis 2016;84:298-303. [PMID: 26867966 DOI: 10.1016/j.diagmicrobio.2016.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 01/05/2016] [Accepted: 01/09/2016] [Indexed: 11/26/2022]

P40 and P90 from Mpn142 are Targets of Multiple Processing Events on the Surface of Mycoplasma pneumoniae. Proteomes 2015;3:512-537. [PMID: 28248283 PMCID: PMC5217387 DOI: 10.3390/proteomes3040512] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 12/02/2015] [Accepted: 12/07/2015] [Indexed: 12/18/2022] Open

Development of a multiplex real-time PCR assay for detection of Mycoplasma pneumoniae, Chlamydia pneumoniae and mutations associated with macrolide resistance in Mycoplasma pneumoniae from respiratory clinical specimens. SPRINGERPLUS 2015;4:684. [PMID: 26576327 PMCID: PMC4641141 DOI: 10.1186/s40064-015-1457-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 10/20/2015] [Indexed: 11/17/2022]