BACKGROUND: We detected a community outbreak of macrolide-resistant Mycoplasma pneumoniae infection that occurred predominantly among students at 2 schools in Yamagata, Japan. METHODS: Throat swab specimens were collected from patients who were clinically suspected to have M. pneumoniae infection after testing negative for influenza virus by a nasopharyngeal swab rapid antigen test. We performed cultures for M. pneumoniae, and all isolates were sequenced for the presence of a mutation of the 23S rRNA gene. RESULTS: Of 96 specimens collected between July 2009 and January 2010, 83 were from students attending junior high school A and primary schools B, C and D. A total of 47 M. pneumoniae isolates were obtained; among them, 25, 15 and 4 were isolated from students attending schools A, B and D, respectively, and M. pneumoniae could not be isolated from students who attended school C. An A2063T mutation in domain V of the 23S rRNA gene, which is associated with macrolide resistance, was identified in 39 (83.0%) isolates. The rates of macrolide resistance at schools A, B and D were 96.0%, 86.7% and 0%, respectively. The minimum inhibitory concentrations for isolates with an A2063T transversion showed high resistance to clarithromycin (minimum inhibitory concentration, 16-64 mg/L), and clarithromycin prescribed initially was clinically ineffective. CONCLUSIONS: This school-based cluster of macrolide-resistant M. pneumoniae infections, which was identified in 2 geographically close schools, indicates that the transmission principally occurred by close contact between students at school. Monitoring the spread of macrolide-resistant M. pneumoniae and clinical guidelines for the appropriate medication against such infections would be needed to control outbreaks of M. pneumoniae.
BACKGROUND: We detected a community outbreak of macrolide-resistant Mycoplasma pneumoniae infection that occurred predominantly among students at 2 schools in Yamagata, Japan. METHODS: Throat swab specimens were collected from patients who were clinically suspected to have M. pneumoniae infection after testing negative for influenza virus by a nasopharyngeal swab rapid antigen test. We performed cultures for M. pneumoniae, and all isolates were sequenced for the presence of a mutation of the 23S rRNA gene. RESULTS: Of 96 specimens collected between July 2009 and January 2010, 83 were from students attending junior high school A and primary schools B, C and D. A total of 47 M. pneumoniae isolates were obtained; among them, 25, 15 and 4 were isolated from students attending schools A, B and D, respectively, and M. pneumoniae could not be isolated from students who attended school C. An A2063T mutation in domain V of the 23S rRNA gene, which is associated with macrolide resistance, was identified in 39 (83.0%) isolates. The rates of macrolide resistance at schools A, B and D were 96.0%, 86.7% and 0%, respectively. The minimum inhibitory concentrations for isolates with an A2063T transversion showed high resistance to clarithromycin (minimum inhibitory concentration, 16-64 mg/L), and clarithromycin prescribed initially was clinically ineffective. CONCLUSIONS: This school-based cluster of macrolide-resistant M. pneumoniae infections, which was identified in 2 geographically close schools, indicates that the transmission principally occurred by close contact between students at school. Monitoring the spread of macrolide-resistant M. pneumoniae and clinical guidelines for the appropriate medication against such infections would be needed to control outbreaks of M. pneumoniae.
Authors: Victoria Tsai; Bernard B Pritzker; Maureen H Diaz; Jonas M Winchell; Lauri A Hicks; Brianna Petrone; Alvaro Benitez; Bernard J Wolff; Kenneth L Soyemi Journal: J Clin Microbiol Date: 2013-08-21 Impact factor: 5.948
Authors: David Oldach; Kay Clark; Jennifer Schranz; Anita Das; J Carl Craft; Drusilla Scott; Brian D Jamieson; Prabhavathi Fernandes Journal: Antimicrob Agents Chemother Date: 2013-03-18 Impact factor: 5.191
Authors: Kwok-Hung Chan; Kelvin K W To; Betsy W K Chan; Clara P Y Li; Susan S Chiu; Kwok-Yung Yuen; Pak-Leung Ho Journal: J Clin Microbiol Date: 2013-05-29 Impact factor: 5.948