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ORIGINAL ARTICLE
Korean J Pediatr 2017 May;60(5) :151-157.
Published online 2017 May 15.       
Prevalence and clinical manifestations of macrolide resistant Mycoplasma pneumoniae pneumonia in Korean children
Eun Lee1, Hyun-Ju Cho2, Soo-Jong Hong2, Jina Lee2, Heungsup Sung3, Jinho Yu2
1Department of Pediatrics, Chonnam National University Hospital, Gwangju, Korea
2Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
3Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Corresponding Author: Jinho Yu ,Tel: +82-2-3010-3922, Fax: +82-2-473-3725, Email: jyu3922@gmail.com
Copyright © 2017 by The Korean Pediatric Society
ABSTRACT
Purpose: Macrolide resistance rate of Mycoplasma pneumoniae has rapidly increased in children. Studies on the clinical features between macrolide susceptible-M. pneumoniae (MSMP) and macrolide resistant-M. pneumoniae (MRMP) are lacking. The aim of this study was to identify the macrolide resistance rate of M. pneumoniae in Korean children with M. pneumoniae penupmonia in 2015 and compare manifestations between MSMP and MRMP.
Methods: Among 122 children (0–18 years old) diagnosed with M. pneumoniae pneumonia, 95 children with the results of macrolide sensitivity test were included in this study. Clinical manifestations were acquired using retrospective medical records.
Results: The macrolide resistant rate of M. pneumoniae was 87.2% (82 of 94 patients) in children with M. pneumoniae pneumonia. One patient showed a mixed type of wild type and A2063G mutation in 23S rRNA of M. pneumoniae. There were no significant differences in clinical, laboratory, and radiologic findings between the MSMP and MRMP groups at the first visit to our hospital. The time interval between initiation of macrolide and defervescence was significantly longer in the MRMP group (4.93.3 vs. 2.83.1 days, P=0.039).
Conclusion: The macrolide resistant rate of M. pneumoniae is very high in children with M. pneumoniae pneumonia in Korea. The clinical manifestations of MRMP are similar to MSMP except for the defervescence period after administration of macrolide. Continuous monitoring of the occurrence and antimicrobial susceptibility of MRMP is required to control its spread and establish strategies for treating second-line antibiotic resistant M. pneumoniae infection.
Keywords: Child | Macrolide | Mycoplasma pneumoniae | Drug resistance
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