title: Mycoplasma pneumoniae in children: carriage, pathogenesis, and antibiotic resistance.
abstract: OBJECTIVE
  Both the diagnosis and treatment of Mycoplasma pneumoniae infections in children are currently facing two main challenges: a relatively high carriage in asymptomatic children, and a worldwide increase in macrolide-resistant M. pneumoniae (MRMP). This review focuses on the scientific and clinical implications of these crucial issues.
  
  
  RESULTS
  Recent studies have indicated that the prevalence of M. pneumoniae in the upper respiratory tract is similar among asymptomatic, healthy children and children with a symptomatic respiratory tract infection, and that current diagnostic procedures for M. pneumoniae are unable to differentiate between bacterial carriage and infection. It is therefore possible that the burden of M. pneumoniae-associated disease is overestimated. Another phenomenon that has an important impact on the treatment of M. pneumoniae infections is the rapid worldwide emergence of MRMP isolates.
  
  
  CONCLUSIONS
  The current diagnostic procedures for M. pneumoniae cannot discern between bacterial carriage and infection in a clinically relevant time frame. It is therefore imperative that these procedures be modified such as to unambiguously detect symptomatic M. pneumoniae infections. Moreover, the emergence of MRMP necessitates the application of methods to detect macrolide resistance as well as the implementation of restrictive policies regarding the use of macrolides.
authors.affiliation: aLaboratory of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, Erasmus MC - Sophia Children's Hospital, University Medical Center bErasmus University College, Erasmus University, Rotterdam, The Netherlands.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Meyer Sauteur
authors.forename: Annemarie M C
authors.initials: AM
authors.lastname: van Rossum
authors.forename: Cornelis
authors.initials: C
authors.lastname: Vink
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial / Q000187:drug effects; D006801:Humans; D018942:Macrolides / Q000627:therapeutic use*; D008826:Microbial Sensitivity Tests; D009177:Mycoplasma pneumoniae / Q000302:isolation & purification*; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000382:microbiology* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides