title: Characteristics of Mycoplasma pneumoniae infection identified on culture in a pediatric clinic.
abstract: BACKGROUND
  The appropriate choice of antibiotics against Mycoplasma pneumoniae infection has become difficult, as the prevalence of macrolide-resistant M. pneumoniae has increased.
  
  
  METHODS
  Throat swab specimens were collected from children with clinically suspected M. pneumoniae infection while visiting an outpatient clinic. Cultures for M. pneumoniae were done, and all isolates were sequenced for the presence of a mutation in 23S rRNA.
  
  
  RESULTS
  Of the 80 specimens collected between February 2012 and March 2013, 27 (34%) were positive for M. pneumoniae on culture. Macrolide-resistant mutation was detected in 24 isolates (89%): 23 isolates had an A2063G transition, and one had a C2617G mutation. Both the median age and the prevalence of pneumonia were significantly higher in M. pneumoniae-positive than in M. pneumoniae-negative children (median, 7 years vs 4 years; 88.9% vs 60.4%, respectively). The percentage of serum samples with particle agglutination titer ≥ 1:160 was 69.6% in M. pneumoniae-positive cases and 17.6% in M. pneumoniae-negative cases when the serum was collected ≥ 4 days after the onset of fever. Defervescence within 72 h after the initiation of macrolides never occurred in M. pneumoniae-positive children and also did not occur in 54% of M. pneumoniae-negative children. Switching to either minocycline or tosufloxacin resulted in fever resolution within 48 h in M. pneumoniae-positive children.
  
  
  CONCLUSIONS
  The described clinical and laboratory characteristics of M. pneumoniae infection may be useful in guiding appropriate treatment in an outpatient clinic.
authors.affiliation: Katsushima Pediatric Clinic, Yamagata, Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Katsushima
authors.forename: Fumio
authors.initials: F
authors.lastname: Katsushima
authors.forename: Yu
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Junji
authors.initials: J
authors.lastname: Seto
authors.forename: Katsumi
authors.initials: K
authors.lastname: Mizuta
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Nishimura
authors.forename: Yoko
authors.initials: Y
authors.lastname: Matsuzaki
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D005260:Female; D006801:Humans; D007223:Infant; D018942:Macrolides / Q000627:therapeutic use*; D008297:Male; D008826:Microbial Sensitivity Tests; D009154:Mutation; D009177:Mycoplasma pneumoniae / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D011019:Pneumonia, Mycoplasma / Q000188:drug therapy / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D015995:Prevalence
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides
keywords: Mycoplasma pneumoniae; macrolide resistance; minocycline; tosufloxacin; viral infection