Abstract

BackgroundMycoplasma pneumoniae is a leading cause of community-acquired pneumonia, with large epidemics previously described to occur every 4 to 7 years.AimTo better understand the diagnostic methods used to detect M. pneumoniae; to better understand M. pneumoniae testing and surveillance in use; to identify epidemics; to determine detection number per age group, age demographics for positive detections, concurrence of epidemics and annual peaks across geographical areas; and to determine the effect of geographical location on the timing of epidemics.MethodsA questionnaire was sent in May 2016 to Mycoplasma experts with national or regional responsibility within the ESCMID Study Group for Mycoplasma and Chlamydia Infections in 17 countries across Europe and Israel, retrospectively requesting details on M. pneumoniae-positive samples from January 2011 to April 2016. The Moving Epidemic Method was used to determine epidemic periods and effect of country latitude across the countries for the five periods under investigation.ResultsRepresentatives from 12 countries provided data on M. pneumoniae infections, accounting for 95,666 positive samples. Two laboratories initiated routine macrolide resistance testing since 2013. Between 2011 and 2016, three epidemics were identified: 2011/12, 2014/15 and 2015/16. The distribution of patient ages for M. pneumoniae-positive samples showed three patterns. During epidemic years, an association between country latitude and calendar week when epidemic periods began was noted.ConclusionsAn association between epidemics and latitude was observed. Differences were noted in the age distribution of positive cases and detection methods used and practice. A lack of macrolide resistance monitoring was noted.

Highlights

  • Mycoplasma pneumoniae is a major cause of respiratory infection in humans and macrolide antibiotics, such as azithromycin, are used as the first-line of treatment in many countries

  • Prudent use of antibiotics has been urged for all cases of M. pneumoniae infection because of worldwide reports of macrolide resistance, which have been reported as ranging from 0.2% in Sweden to more than 90% in China [2,3,4,5]

  • Additional information was requested, including what diagnostic methods were used to detect M. pneumoniae; whether surveillance for M. pneumoniae was in use; if macrolide resistance was being monitored by countries; and M. pneumoniae detection number per age group

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Summary

Introduction

Mycoplasma pneumoniae is a major cause of respiratory infection in humans and macrolide antibiotics, such as azithromycin, are used as the first-line of treatment in many countries. Prudent use of antibiotics has been urged for all cases of M. pneumoniae infection because of worldwide reports of macrolide resistance, which have been reported as ranging from 0.2% in Sweden to more than 90% in China [2,3,4,5]. Methods: A questionnaire was sent in May 2016 to Mycoplasma experts with national or regional responsibility within the ESCMID Study Group for Mycoplasma and Chlamydia Infections in 17 countries across Europe and Israel, retrospectively requesting details on M. pneumoniae-positive samples from January 2011 to April 2016. An association between country latitude and calendar week when epidemic periods began was noted

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