title: A comparative clinical study of macrolide-sensitive and macrolide-resistant Mycoplasma pneumoniae infections in pediatric patients.
abstract: In recent years, the increased prevalence of macrolide-resistant Mycoplasma pneumoniae (MR-M. pneumoniae) has become a significant issue in Japan. We isolated 94 strains of M. pneumoniae, and determined the minimum inhibitory concentrations (MICs) of macrolides and other antimicrobial agents for these strains. We also performed a comparative clinical evaluation of macrolide efficacy for cases of MR-M. pneumoniae infections and cases of macrolide-sensitive Mycoplasma pneumoniae infections (MS-M. pneumoniae). Of the 94 isolates of M. pneumoniae, 64 (68.1%) were classified as MS-M. pneumoniae and 30 (31.9%) as MR-M. pneumoniae strains. The clinical study included an assessment of 47 pediatric cases of MS-M. pneumoniae and 22 pediatric cases of MR-M. pneumoniae. The patient demographics, such as sex, age, the period from the onset of the infection to the first examination, laboratory findings, diagnosis, and the severity of symptoms, showed no significant difference between the two study groups. However, the efficacy of macrolide treatment was 91.5% for MS-M. pneumoniae and 22.7% for MR-M. pneumoniae, a statistically significant difference (P < 0.01). Although M. pneumoniae infection is generally considered a treatable condition, the increasing prevalence of macrolide-resistant strains of M. pneumoniae has become a significant clinical issue in pediatric patients, and it is therefore necessary to give careful consideration to the appropriate antimicrobial therapy for MR-M. pneumoniae infection.
authors.affiliation: Department of Pediatrics, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, Japan. kmatsuba@ntmc.hosp.go.jp
authors.forename: Keita
authors.initials: K
authors.lastname: Matsubara
authors.forename: Miyuki
authors.initials: M
authors.lastname: Morozumi
authors.forename: Takafumi
authors.initials: T
authors.lastname: Okada
authors.forename: Takahiro
authors.initials: T
authors.lastname: Matsushima
authors.forename: Osamu
authors.initials: O
authors.lastname: Komiyama
authors.forename: Michi
authors.initials: M
authors.lastname: Shoji
authors.forename: Takashi
authors.initials: T
authors.lastname: Ebihara
authors.forename: Kimiko
authors.initials: K
authors.lastname: Ubukata
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Sato
authors.forename: Hironobu
authors.initials: H
authors.lastname: Akita
authors.forename: Keisuke
authors.initials: K
authors.lastname: Sunakawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iwata
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D018942:Macrolides / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008826:Microbial Sensitivity Tests; D009177:Mycoplasma pneumoniae / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D011019:Pneumonia, Mycoplasma / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides