title: Epidemiology and clinical manifestations of children with macrolide-resistant Mycoplasma pneumoniae pneumonia in Taiwan.
abstract: Mycoplasma pneumoniae accounts for 10-30% of community-acquired pneumonia (CAP) in children. This study reveals the epidemiology and clinical manifestations of children with macrolide-resistant (ML(r) ) M. pneumoniae pneumonia in Taiwan. Respiratory tract specimens were collected from children hospitalized with CAP for evaluation via PCR followed by DNA sequencing for several point mutations related to the ML(r) character. Of the 412 specimens collected during the study period, 60 (15%) were positive for M. pneumoniae, 14 (23%) of which presented point mutation (all A2063G) in 23S rRNA. Clinical symptoms and chest X-ray findings between the ML(s) and ML(r) groups were not significantly different. However, the ML(r) group had longer mean duration of fever after azithromycin treatment (3.2 days vs. 1.6 days, P = 0.02) and significantly higher percentage of changing antibiotics for suspected ML(r) strain (42% vs. 13%, P = 0.04). Although 58% of children in the ML(r) group did not receive effective antibiotics, all children were discharged without sequelae. In conclusion, 15% of CAP in children is caused by M. pneumoniae and the macrolide-resistance rate is 23% in Taiwan. Despite ineffective antibiotics, children with ML(r) M. pneumoniae pneumonia recover completely.
authors.affiliation: Department of Pediatrics, Buddhist Tzu Chi General Hospital, Taipei Branch, Taiwan.
authors.forename: Ping-Sheng
authors.initials: PS
authors.lastname: Wu
authors.forename: Luan-Yin
authors.initials: LY
authors.lastname: Chang
authors.forename: Hsiao-Chuan
authors.initials: HC
authors.lastname: Lin
authors.forename: Hsin
authors.initials: H
authors.lastname: Chi
authors.forename: Yu-Chia
authors.initials: YC
authors.lastname: Hsieh
authors.forename: Yi-Chuan
authors.initials: YC
authors.lastname: Huang
authors.forename: Ching-Chuan
authors.initials: CC
authors.lastname: Liu
authors.forename: Yhu-Chering
authors.initials: YC
authors.lastname: Huang
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Huang
mesh_terms: D002648:Child; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology; D024881:Drug Resistance, Bacterial / Q000502:physiology*; D005260:Female; D006801:Humans; D018942:Macrolides / Q000627:therapeutic use*; D008297:Male; D011019:Pneumonia, Mycoplasma / Q000188:drug therapy* / Q000453:epidemiology*; D011446:Prospective Studies; D013624:Taiwan / Q000453:epidemiology
chemical_list: D018942:Macrolides