Epidemiology and clinical manifestations of children with macrolide-resistant Mycoplasma pneumoniae pneumonia in Taiwan†‡
Ping-Sheng Wu MD
Department of Pediatrics, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan
Search for more papers by this authorLuan-Yin Chang MD, PhD
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorHsiao-Chuan Lin MD
Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan
Search for more papers by this authorHsin Chi MD
Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
Search for more papers by this authorYu-Chia Hsieh MD, PhD
Division of Infectious Diseases, Department of Pediatrics, Taoyuan Chang-Gung Memorial Hospital and Chang-Gung University College of Medicine, Taoyuan, Taiwan, Taiwan
Search for more papers by this authorYi-Chuan Huang MD
Division of Infectious Diseases, Department of Pediatrics, Kaohsiung Chang-Gung Memorial Hospital and Chang-Gung University College of Medicine, Kaohsiung, Taiwan
Search for more papers by this authorChing-Chuan Liu MD, MPH
Department of Pediatrics, National Cheng-Kung University Hospital, Tainan, Taiwan
Search for more papers by this authorCorresponding Author
Yhu-Chering Huang MD, PhD
Division of Infectious Diseases, Department of Pediatrics, Taoyuan Chang-Gung Memorial Hospital and Chang-Gung University College of Medicine, Taoyuan, Taiwan, Taiwan
Yhu-Chering Huang, Department of Pediatrics, Chang-Gung Memorial Hospital, No. 5, Fu-Hsin Street, Kweishan, Taoyuan 333, Taiwan.
Li-Min Huang, Department of Pediatrics, National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei 100, Taiwan.
Search for more papers by this authorCorresponding Author
Li-Min Huang MD, PhD
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
Yhu-Chering Huang, Department of Pediatrics, Chang-Gung Memorial Hospital, No. 5, Fu-Hsin Street, Kweishan, Taoyuan 333, Taiwan.
Li-Min Huang, Department of Pediatrics, National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei 100, Taiwan.
Search for more papers by this authorPing-Sheng Wu MD
Department of Pediatrics, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan
Search for more papers by this authorLuan-Yin Chang MD, PhD
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
Search for more papers by this authorHsiao-Chuan Lin MD
Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan
Search for more papers by this authorHsin Chi MD
Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
Search for more papers by this authorYu-Chia Hsieh MD, PhD
Division of Infectious Diseases, Department of Pediatrics, Taoyuan Chang-Gung Memorial Hospital and Chang-Gung University College of Medicine, Taoyuan, Taiwan, Taiwan
Search for more papers by this authorYi-Chuan Huang MD
Division of Infectious Diseases, Department of Pediatrics, Kaohsiung Chang-Gung Memorial Hospital and Chang-Gung University College of Medicine, Kaohsiung, Taiwan
Search for more papers by this authorChing-Chuan Liu MD, MPH
Department of Pediatrics, National Cheng-Kung University Hospital, Tainan, Taiwan
Search for more papers by this authorCorresponding Author
Yhu-Chering Huang MD, PhD
Division of Infectious Diseases, Department of Pediatrics, Taoyuan Chang-Gung Memorial Hospital and Chang-Gung University College of Medicine, Taoyuan, Taiwan, Taiwan
Yhu-Chering Huang, Department of Pediatrics, Chang-Gung Memorial Hospital, No. 5, Fu-Hsin Street, Kweishan, Taoyuan 333, Taiwan.
Li-Min Huang, Department of Pediatrics, National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei 100, Taiwan.
Search for more papers by this authorCorresponding Author
Li-Min Huang MD, PhD
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
Yhu-Chering Huang, Department of Pediatrics, Chang-Gung Memorial Hospital, No. 5, Fu-Hsin Street, Kweishan, Taoyuan 333, Taiwan.
Li-Min Huang, Department of Pediatrics, National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei 100, Taiwan.
Search for more papers by this authorPing-Sheng Wu and Luan-Yin Chang contributed equally to this work.
Conflict of interest: None.
Abstract
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 (MLr) 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 MLr 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 X-ray findings between the MLs and MLr groups were not significantly different. However, the MLr group had longer mean duration of fever after azithromycin treatment (3.2 days vs. 1.6 days, P = 0.02) and significantly higher percentage of changing antibiotics for suspected MLr strain (42% vs. 13%, P = 0.04). Although 58% of children in the MLr 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 MLr M. pneumoniae pneumonia recover completely. Pediatr Pulmonol. 2013; 48:904–911. © 2012 Wiley Periodicals, Inc.
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