title: Macrolide resistance of Mycoplasma pneumoniae and its detection rate by real-time PCR in primary and tertiary care hospitals.
abstract: BACKGROUND
  This study aimed to evaluate the prevalence of Mycoplasma pneumoniae in primary and tertiary care hospitals and its macrolide resistance rate.
  
  
  METHODS
  Nasopharyngeal swabs were collected from 195 pediatric patients in primary and tertiary care hospitals from October to November 2010. The AccuPower MP real-time PCR kit (Bioneer, Korea) was used for the detection of M. pneumoniae. Direct amplicon sequencing was performed to detect point mutations conferring resistance to macrolides in the 23S rRNA gene.
  
  
  RESULTS
  Among the 195 specimens, 17 (8.7%) were M. pneumoniae positive, and 3 of the strains (17.6%) obtained from these 17 specimens displayed the A2063G mutation in 23S rRNA. Three macrolide-resistant M. pneumoniae isolates were isolated from patients hospitalized at the primary care hospital. The positive rates of M. pneumoniae for the primary and tertiary care hospitals were 12.1% (15/124) and 2.8% (2/71), respectively (P=0.033).
  
  
  CONCLUSIONS
  The positive rate of M. pneumoniae in the primary care hospital was higher than that in the tertiary care hospital. Simultaneous detection of M. pneumoniae and macrolide-resistant mutation genes in the 23S rRNA by real-time PCR is needed for rapid diagnosis and therapy of M. pneumoniae infections.
authors.affiliation: Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Young
authors.initials: Y
authors.lastname: Uh
authors.forename: Joo Hee
authors.initials: JH
authors.lastname: Hong
authors.forename: Ki Jin
authors.initials: KJ
authors.lastname: Oh
authors.forename: Hyun Mi
authors.initials: HM
authors.lastname: Cho
authors.forename: Soon Deok
authors.initials: SD
authors.lastname: Park
authors.forename: Juwon
authors.initials: J
authors.lastname: Kim
authors.forename: Kap Jun
authors.initials: KJ
authors.lastname: Yoon
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018942:Macrolides / Q000494:pharmacology*; D008297:Male; D009177:Mycoplasma pneumoniae / Q000235:genetics / Q000302:isolation & purification*; D009305:Nasopharynx / Q000382:microbiology; D011019:Pneumonia, Mycoplasma / Q000453:epidemiology / Q000382:microbiology; D011320:Primary Health Care; D012338:RNA, Ribosomal, 23S / Q000032:analysis; D011933:Reagent Kits, Diagnostic; D060888:Real-Time Polymerase Chain Reaction; D063128:Tertiary Health Care
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides; D012338:RNA, Ribosomal, 23S; D011933:Reagent Kits, Diagnostic
keywords: 23S rRNA; Antibiotic resistance; Macrolide; Mycoplasma pneumoniae