Prevalence and frequency of macrolide-resistant in Mycoplasma pneumoniae in children with acute respiratory infections in Korea, 2018-2019

Kim So Hyeon, Jung Sang Oun, Yoo Jaeil, Hwang Kyu Jam
Division of Bacterial Diseases, Center for Laboratory Control of Infectious Disease, KCDC

Mycoplasma pneumoniae represents one of the most common causative agents of community-acquired among upper and lower respiratory tract infections. The pathogen is found in all age groups, with higher prevalence in school-age children. M. penumoniae incidence usually increases during epidemics, which occur at intervals of 3 to 4 years.
Our study was conducted between August 2018 and June 2019 in pediatric age groups with acute respiratory infection of pathogen surveillance and have surveyed also the types of antibiotic resistance from the positive specimens of M. pneumoniae . A total of 707 respiratory specimens of Pharyngitis (n=181) and CAP (n=526) were investigated by PCR for the presence of M. pneumoniae . 96 (13.6%) samples showed as PCR positive for M. pneumoniae . The age distribution of the specimens was highest among children age 1 to 3 years (37.5%, 265 cases) and 7 to 11 years (22.1%, 156 cases), 4 to 6 years(20.9%, 148 cases), and then in infants age 0 to 1 years (15.6%, 110 cases). In the analysis of monthly distribution, positive rate of M. pneumoniae increased in October 2018 (26.1%) and January 2019 (31.1%). M. pneumoniae -positive samples were also investigated for the presence of macrolide resistance by PCR and sequence analysis for the detection of 23S rRNA domain V gene of point mutation. The prevalence of A2063G transition was observed as 66.7% (64/96). As further study, surveillance system for M. pneumoniae infections should be maintained continuously in pediatric patients.

Keywords: Mycoplasma pneumoniae , macrolide resistance, 23S rRNA domain V, surveillance