Abstract

Background

The factors that predict the progression of Mycoplasma pneumoniae infection remain inconclusive. Therefore, we investigated macrolide resistance prevalence, M pneumoniae genotype, and clinical characteristics of childhood M pneumoniae respiratory tract infections in Taiwan.

Methods

A total of 295 children hospitalized with respiratory tract infections with positive serological M pneumoniae immunoglobulin M test results were enrolled in this 3-year prospective study. Oropharyngeal swabs were obtained for M pneumoniae cultures and polymerase chain reaction tests. All M pneumoniae specimens were further characterized by P1 typing, multilocus variable-number tandem-repeat analysis (MLVA), and macrolide resistance genotyping. The clinical characteristics and blood cytokine profiles were analyzed accordingly.

Results

Of 138 M pneumoniae specimens, type I P1 was the predominant (136 of 138, 98.6%). The MLVA type P (4-4-5-7-2) was the leading strain (42 of 138, 30.4%), followed by type J, U, A, and X. The overall macrolide-resistant rate was 38.4% (53 of 138); the resistance rate increased dramatically yearly: 10.6% in 2017, 47.5% in 2018, and 62.5% in 2019 (P < .001). All macrolide-resistant M pneumoniae (MRMP) harbored the A2063G mutation and were MLVA type 4-5-7-2 (49 of 53, 92.5%), especially type U and X. No significant differences in clinical symptoms, duration of hospital stay, and radiographic findings were identified among patients between MRMP and macrolide-sensitive M pneumoniae (MSMP) groups. Patients with MRMP infection had more febrile days before and during hospitalization and higher interleukin (IL)-13 and IL-33 levels than patients with MSMP infection (P < .05).

Conclusions

Macrolide-resistant M pneumoniae surged in Taiwan throughout the study period, but macrolide resistance was not a determinant factor of clinical severity.

Details

Title
Macrolide Resistance, Clinical Features, and Cytokine Profiles in Taiwanese Children With Mycoplasma pneumoniae Infection
Author
Tsung-Hua Wu 1 ; Wang, Nancy M 2 ; Fang-Ching, Liu 3 ; Hui-Hsien Pan 4 ; Fang-Liang, Huang 5 ; Yu-Ping, Fang 6 ; Ting-Wei, Chiang 2 ; Yu-Ying, Yang 7 ; Song, Chiah-Sing 8 ; Hsiang-Chin, Wu 9 ; Chun-Yi, Lee 6 

 Department of Pediatrics, Show Chwan Memorial Hospital, Changhua, Taiwan 
 Department of Biology, National Changhua University of Education, Changhua, Taiwan 
 Department of Pediatrics, Jen-Ai Hospital, Taichung, Taiwan 
 Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan 
 Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan 
 Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan 
 Department of Clinical Laboratory, Show Chwan Memorial Hospital, Changhua, Taiwan 
 Department of Clinical Laboratory, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan 
 Department of Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan 
Publication year
2021
Publication date
Sep 2021
Publisher
Oxford University Press
e-ISSN
23288957
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3171174180
Copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.