%0 Journal Article
%T Macrolide-resistant  Mycoplasma pneumoniae prevalence  and clinical aspects in adult patients with community-acquired pneumonia in China: a prospective multicenter surveillance study
%A Bin Cao
%A Can-Mao Xie
%A Chao Zhuo
%A Dan-Yang She
%A Hui Wang
%A Ming-Gui Wang
%A Ren-Tao Wang
%A Rui Wang
%A Xin Yuan
%A You-Ning Liu
%A Yu-Dong Yin
%J SCIE-indexed Journal
%D 2017
%R 10.21037/jtd.2017.09.75
%X Community-acquired pneumonia (CAP) is a common infectious disease affecting people of any age. Mycoplasma pneumoniae (MP) is a major cause of CAP worldwide and accounts for up to 40% of the cases in China (1). International guidelines have recommended macrolides or tetracyclines (TET) as the first-line drugs and fluoroquinolones as the second-line drugs in adults, whereas azithromycin (AZM) as the first-line drug, and clarithromycin, erythromycin (ERY), or doxycycline (for patients aged >8 years) along with fluoroquinolones [levofloxacin (LVX) or MOX for adolescent patients] as the second-line oral drugs, for mild pediatric cases (2). However, the emergence of macrolide-resistant MP (MRMP) has gradually increased worldwide in the last decade, especially in China and Japan the resistance rate has reached up to 90% (2-5). Macrolides are preferred over other antimicrobials due to the lack of cell wall in MP; however, macrolides are susceptible to resistance due to point mutations in few positions of domain V of the peptidyl transferase loop of 23S ribosomal RNA (rRNA) gene (such as A2063G, A2064G, A2063C, A2063T, A2067G, and C2617G) and at the location of macrolide binding to the 50S bacterial ribosome subunit reduces the affinity of the antibiotic towards the ribosome (1,2,6). Eventually fluoroquinolone therapy has emerged as an efficient treatment option for MP CAP (7). However, in vitro studies have reported resistance of MP to fluoroquinolones which indicates a high chance of fluoroquinolone-resistant MP infection in the near future (8). Though, bacterial resistance is evident for different antibiotics, the correlation between the resistance and clinical failure of therapies are still controversial. Hence, epidemiological monitoring is essential to acquire a better understanding of clinical characteristics of MP infection with resistant strains and emphasizing the need for judicious use of antimicrobial agents. For this purpose, we conducted a multicenter surveillance study on adult Chinese CAP patients in three major provincial cities Beijing, Shanghai and Guangzhou, to monitor the resistance patterns and characterize the mechanisms of resistance
%U http://jtd.amegroups.com/article/view/16269/html