Epidemiology and clinical manifestations of children with macrolide-resistant Mycoplasma pneumoniae pneumonia in China

Abstract

Summary. 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 Xray 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 ¼ 0.02) and significantly higher percentage of changing antibiotics for suspected ML r strain (42% vs. 13%, P ¼ 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.