Epidemiology and clinical manifestations of children with macrolide-resistant Mycoplasma pneumoniae pneumonia in Southern Taiwan

• Published in: Pediatrics and neonatology 2021-09, Vol.62 (5), p.536-542
• Main Authors: Chang, Chih-Hao, Tsai, Chang-Ku, Tsai, Ti-An, Wang, Sui-Ching, Lee, Yi-Chen, Tsai, Chih-Min, Liu, Ta-Yu, Kuo, Kuang-Che, Chen, Chih-Cheng, Yu, Hong-Ren
• Format: Article
• Language: English
• Subjects: children; macrolide resistance; mycoplasma; pneumonia
• ISSN: 1875-9572
• DOI: 10.1016/j.pedneo.2021.05.017

Mycoplasma pneumoniae is a pneumonia-causing pathogen commonly found in pediatric patients in Taiwan. Recently, macrolide-resistant (MR) strains have been emerging globally. The prevalence of pneumonia due to MR-M. pneumoniae (hereafter, MPP) in northern Taiwan before 2017 has been reported to be 12.3–24%. The prevalence of MR-MPP within a specific location can vary. Hence, we investigated the prevalence of MR-MPP in southern Taiwan. Eighty-one children with PCR-confirmed MPP were enrolled between July 2016 and June 2019. They were assigned to macrolide-sensitive (MS) and MR groups based on their PCR results, and their clinical manifestations and laboratory data were compared. The proportions of patients with MS-MPP and MR-MPP varied with time. The average ratio of the proportion of MR-MPP was 54.3% in this study. Patients with MR-MPP had lower neutrophil counts, higher lymphocyte counts, and higher platelet counts than those with MS-MPP. In contrast with the 40% of the MR-MPP group that still had a fever after three days of azithromycin treatment, only 11.8% of the MS-MPP group still had a fever. Our study provided valuable epidemiological survey information for children with MR-MPP in southern Taiwan. The prevalence of MR-MPP was different from that reported in previous studies in northern Taiwan. Specific MR strains should be considered in children with MPP if they still have a fever after three days of macrolide treatment.