Emergence of macrolide-resistant strains during an outbreak of Mycoplasma pneumoniae infections in children

M. Chironna, A. Sallustio, S. Esposito, M. Perulli, I. Chinellato, C. di Bari, M. Quarto, F. Cardinale

Research output: Contribution to journalArticle

Abstract

Objectives: Mycoplasma pneumoniae is a frequent cause of human lower respiratory tract infections (LRTIs) for which macrolides are the treatment of choice. The aim of this study was to determine the rate of macrolide resistance and to subtype M. pneumoniae strains in Italy. Patients and methods: During an outbreak of M. pneumoniae infections in southern Italy in 2010, 48 clinical specimens from 43 paediatric patients hospitalized for LRTIs were analysed for macrolide resistance. The mutations associated with resistance (A2063G and A2064G) and M. pneumoniae subtypes were detected by sequencing the targeted domain V region of the 23S rRNA gene and a region in the MPN528a gene, respectively. Results: Macrolide resistance genotypes were detected in 11 (26%) of the 43 M. pneumoniae-positive children. The A2063G mutation was identified in seven patients and the A2064G mutation was identified in the remaining four. Upon admission, the isolates from three patients showed a susceptible genotype but subsequently acquired the A2063G mutation. Genotyping revealed M. pneumoniae subtype 1 in 33 of 40 sequenced strains and subtype 2 in the remaining 7. There was no association between macrolide resistance or susceptibility and the M. pneumoniae subtypes. Conclusions: This is the first report of macrolide resistance among M. pneumoniae strains in Italy. Our findings indicate an unexpected high prevalence of macrolide resistance genotypes in children, and so macrolide resistance should be carefully considered in patients who do not respond appropriately to antibiotic treatment. The epidemiological monitoring of macrolide resistance has become necessary in Italy and in the rest of Europe.

Original languageEnglish
Article numberdkr003
Pages (from-to)734-737
Number of pages4
JournalJournal of Antimicrobial Chemotherapy
Volume66
Issue number4
DOIs
Publication statusPublished - Apr 2011

Fingerprint

Mycoplasma pneumoniae
Macrolides
Disease Outbreaks
Infection
Italy
Mutation
Genotype
Respiratory Tract Infections
Epidemiological Monitoring
rRNA Genes
Pediatrics
Anti-Bacterial Agents

Keywords

  • 23S rRNA
  • Antimicrobial resistance epidemiology
  • LRTIs
  • Macrolides
  • Subtyping

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Chironna, M., Sallustio, A., Esposito, S., Perulli, M., Chinellato, I., di Bari, C., ... Cardinale, F. (2011). Emergence of macrolide-resistant strains during an outbreak of Mycoplasma pneumoniae infections in children. Journal of Antimicrobial Chemotherapy, 66(4), 734-737. [dkr003]. https://doi.org/10.1093/jac/dkr003

Emergence of macrolide-resistant strains during an outbreak of Mycoplasma pneumoniae infections in children. / Chironna, M.; Sallustio, A.; Esposito, S.; Perulli, M.; Chinellato, I.; di Bari, C.; Quarto, M.; Cardinale, F.

In: Journal of Antimicrobial Chemotherapy, Vol. 66, No. 4, dkr003, 04.2011, p. 734-737.

Research output: Contribution to journalArticle

Chironna, M, Sallustio, A, Esposito, S, Perulli, M, Chinellato, I, di Bari, C, Quarto, M & Cardinale, F 2011, 'Emergence of macrolide-resistant strains during an outbreak of Mycoplasma pneumoniae infections in children', Journal of Antimicrobial Chemotherapy, vol. 66, no. 4, dkr003, pp. 734-737. https://doi.org/10.1093/jac/dkr003
Chironna, M. ; Sallustio, A. ; Esposito, S. ; Perulli, M. ; Chinellato, I. ; di Bari, C. ; Quarto, M. ; Cardinale, F. / Emergence of macrolide-resistant strains during an outbreak of Mycoplasma pneumoniae infections in children. In: Journal of Antimicrobial Chemotherapy. 2011 ; Vol. 66, No. 4. pp. 734-737.
@article{108512b8712a4186b1dc13a8f3ca2939,
title = "Emergence of macrolide-resistant strains during an outbreak of Mycoplasma pneumoniae infections in children",
abstract = "Objectives: Mycoplasma pneumoniae is a frequent cause of human lower respiratory tract infections (LRTIs) for which macrolides are the treatment of choice. The aim of this study was to determine the rate of macrolide resistance and to subtype M. pneumoniae strains in Italy. Patients and methods: During an outbreak of M. pneumoniae infections in southern Italy in 2010, 48 clinical specimens from 43 paediatric patients hospitalized for LRTIs were analysed for macrolide resistance. The mutations associated with resistance (A2063G and A2064G) and M. pneumoniae subtypes were detected by sequencing the targeted domain V region of the 23S rRNA gene and a region in the MPN528a gene, respectively. Results: Macrolide resistance genotypes were detected in 11 (26{\%}) of the 43 M. pneumoniae-positive children. The A2063G mutation was identified in seven patients and the A2064G mutation was identified in the remaining four. Upon admission, the isolates from three patients showed a susceptible genotype but subsequently acquired the A2063G mutation. Genotyping revealed M. pneumoniae subtype 1 in 33 of 40 sequenced strains and subtype 2 in the remaining 7. There was no association between macrolide resistance or susceptibility and the M. pneumoniae subtypes. Conclusions: This is the first report of macrolide resistance among M. pneumoniae strains in Italy. Our findings indicate an unexpected high prevalence of macrolide resistance genotypes in children, and so macrolide resistance should be carefully considered in patients who do not respond appropriately to antibiotic treatment. The epidemiological monitoring of macrolide resistance has become necessary in Italy and in the rest of Europe.",
keywords = "23S rRNA, Antimicrobial resistance epidemiology, LRTIs, Macrolides, Subtyping",
author = "M. Chironna and A. Sallustio and S. Esposito and M. Perulli and I. Chinellato and {di Bari}, C. and M. Quarto and F. Cardinale",
year = "2011",
month = "4",
doi = "10.1093/jac/dkr003",
language = "English",
volume = "66",
pages = "734--737",
journal = "Journal of Antimicrobial Chemotherapy",
issn = "0305-7453",
publisher = "Oxford University Press",
number = "4",

}

TY - JOUR

T1 - Emergence of macrolide-resistant strains during an outbreak of Mycoplasma pneumoniae infections in children

AU - Chironna, M.

AU - Sallustio, A.

AU - Esposito, S.

AU - Perulli, M.

AU - Chinellato, I.

AU - di Bari, C.

AU - Quarto, M.

AU - Cardinale, F.

PY - 2011/4

Y1 - 2011/4

N2 - Objectives: Mycoplasma pneumoniae is a frequent cause of human lower respiratory tract infections (LRTIs) for which macrolides are the treatment of choice. The aim of this study was to determine the rate of macrolide resistance and to subtype M. pneumoniae strains in Italy. Patients and methods: During an outbreak of M. pneumoniae infections in southern Italy in 2010, 48 clinical specimens from 43 paediatric patients hospitalized for LRTIs were analysed for macrolide resistance. The mutations associated with resistance (A2063G and A2064G) and M. pneumoniae subtypes were detected by sequencing the targeted domain V region of the 23S rRNA gene and a region in the MPN528a gene, respectively. Results: Macrolide resistance genotypes were detected in 11 (26%) of the 43 M. pneumoniae-positive children. The A2063G mutation was identified in seven patients and the A2064G mutation was identified in the remaining four. Upon admission, the isolates from three patients showed a susceptible genotype but subsequently acquired the A2063G mutation. Genotyping revealed M. pneumoniae subtype 1 in 33 of 40 sequenced strains and subtype 2 in the remaining 7. There was no association between macrolide resistance or susceptibility and the M. pneumoniae subtypes. Conclusions: This is the first report of macrolide resistance among M. pneumoniae strains in Italy. Our findings indicate an unexpected high prevalence of macrolide resistance genotypes in children, and so macrolide resistance should be carefully considered in patients who do not respond appropriately to antibiotic treatment. The epidemiological monitoring of macrolide resistance has become necessary in Italy and in the rest of Europe.

AB - Objectives: Mycoplasma pneumoniae is a frequent cause of human lower respiratory tract infections (LRTIs) for which macrolides are the treatment of choice. The aim of this study was to determine the rate of macrolide resistance and to subtype M. pneumoniae strains in Italy. Patients and methods: During an outbreak of M. pneumoniae infections in southern Italy in 2010, 48 clinical specimens from 43 paediatric patients hospitalized for LRTIs were analysed for macrolide resistance. The mutations associated with resistance (A2063G and A2064G) and M. pneumoniae subtypes were detected by sequencing the targeted domain V region of the 23S rRNA gene and a region in the MPN528a gene, respectively. Results: Macrolide resistance genotypes were detected in 11 (26%) of the 43 M. pneumoniae-positive children. The A2063G mutation was identified in seven patients and the A2064G mutation was identified in the remaining four. Upon admission, the isolates from three patients showed a susceptible genotype but subsequently acquired the A2063G mutation. Genotyping revealed M. pneumoniae subtype 1 in 33 of 40 sequenced strains and subtype 2 in the remaining 7. There was no association between macrolide resistance or susceptibility and the M. pneumoniae subtypes. Conclusions: This is the first report of macrolide resistance among M. pneumoniae strains in Italy. Our findings indicate an unexpected high prevalence of macrolide resistance genotypes in children, and so macrolide resistance should be carefully considered in patients who do not respond appropriately to antibiotic treatment. The epidemiological monitoring of macrolide resistance has become necessary in Italy and in the rest of Europe.

KW - 23S rRNA

KW - Antimicrobial resistance epidemiology

KW - LRTIs

KW - Macrolides

KW - Subtyping

UR - http://www.scopus.com/inward/record.url?scp=79952780070&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79952780070&partnerID=8YFLogxK

U2 - 10.1093/jac/dkr003

DO - 10.1093/jac/dkr003

M3 - Article

C2 - 21393214

AN - SCOPUS:79952780070

VL - 66

SP - 734

EP - 737

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

SN - 0305-7453

IS - 4

M1 - dkr003

ER -