1887

Journal of Medical Microbiology logo

Volume 62, Issue 12

Clinical outcomes and macrolide resistance in infection in Scotland, UK Free

Abstract

has a cyclical, epidemic pattern of infection and the most recent epidemic occurred in Europe in 2011. Macrolides are recommended for the treatment of respiratory tract infection, but macrolide resistance has been reported at low levels in Europe. The aim of the study was to examine the clinical impact of the recent epidemic in a hospital setting in Scotland and to determine whether macrolide-resistant strains are present. Data were analysed retrospectively for 307 patients with respiratory infection diagnosed in 2010 and 2011 in Edinburgh, UK. Genotypic macrolide resistance testing was also carried out in 32 patients in whom resistance was considered most likely, based on their clinical picture. We found that 175 patients (59 %) were admitted to hospital, 20 (7 %) were admitted to critical care and 97 (38 %) required oxygen. All 48 adult patients (100 %) were admitted to hospital, compared with 127 children (51 %). Adults were also more likely to require oxygen [odds ratio (OR) 4.964, <0.001, 95 % confidence interval (CI) 2.129–11.803] and to be admitted to critical care (OR 4.909,  = 0.001, 95 % CI 1.735–13.829), compared with children. Macrolide resistance conferred by the 23S rRNA gene mutation was found in samples from 6 out of 32 patients (19 %) in the subset tested. The results suggest that the recent epidemic was associated with a significant burden of hospital admission locally. The study also describes the first case series of macrolide-resistant in the UK, indicating that macrolide resistance surveillance is warranted in preparation for the next epidemic.

  • Received:
  • Accepted:
  • Published Online:
© 2013 SGM
Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.066191-0
2013-12-01
2024-04-26
Loading full text...

Full text loading...

/deliver/fulltext/jmm/62/12/1876.html?itemId=/content/journal/jmm/10.1099/jmm.0.066191-0&mimeType=html&fmt=ahah

References

  1. Atkinson T. P., Balish M. F., Waites K. B. 2008; Epidemiology, clinical manifestations, pathogenesis and laboratory detection of Mycoplasma pneumoniae infections. FEMS Microbiol Rev 32:956–973 [View Article][PubMed]
     [Google Scholar]
  2. Averbuch D., Hidalgo-Grass C., Moses A. E., Engelhard D., Nir-Paz R. 2011; Macrolide resistance in Mycoplasma pneumoniae, Israel, 2010. Emerg Infect Dis 17:1079–1082 [View Article][PubMed]
     [Google Scholar]
  3. Bezerra P. G., Britto M. C., Correia J. B., Duarte M. C., Fonceca A. M., Rose K., Hopkins M. J., Cuevas L. E., McNamara P. S. 2011; Viral and atypical bacterial detection in acute respiratory infection in children under five years. PLoS ONE 6:e18928 [View Article][PubMed]
     [Google Scholar]
  4. Blystad H., Ånestad G., Vestrheim D. F., Madsen S., Rønning K. 2012; Increased incidence of Mycoplasma pneumoniae infection in Norway 2011. Euro Surveill 17:20074[PubMed]
     [Google Scholar]
  5. Cao B., Zhao C.-J., Yin Y.-D., Zhao F., Song S.-F., Bai L., Zhang J.-Z., Liu Y.-M., Zhang Y.-Y. other authors 2010; High prevalence of macrolide resistance in Mycoplasma pneumoniae isolates from adult and adolescent patients with respiratory tract infection in China. Clin Infect Dis 51:189–194 [View Article][PubMed]
     [Google Scholar]
  6. Chalker V. J., Stocki T., Mentasti M., Harnden A., Wang K., Harrison T. G. 2012; Macrolide resistant Mycoplasma pneumoniae in England and Wales: Abstract P724, 22nd European Congress of Clinical Microbiology and Infectious Diseases. Clin Microbiol Infect 18:S3135
     [Google Scholar]
  7. Chanock R. M., Rifkind D., Kravetz H. M., Knight V., Johnson K. M. 1961; Respiratory disease in volunteers infected with Eaton agent: a preliminary report. Proc Natl Acad Sci U S A 47:887–890 [View Article][PubMed]
     [Google Scholar]
  8. Chironna M., Sallustio A., Esposito S., Perulli M., Chinellato I., Di Bari C., Quarto M., Cardinale F. 2011; Emergence of macrolide-resistant strains during an outbreak of Mycoplasma pneumoniae infections in children. J Antimicrob Chemother 66:734–737 [View Article][PubMed]
     [Google Scholar]
  9. Dhanoa A., Fang N. C., Hassan S. S., Kaniappan P., Rajasekaram G. 2011; Epidemiology and clinical characteristics of hospitalized patients with pandemic influenza A (H1N1) 2009 infections: the effects of bacterial coinfection. Virol J 8:501 [View Article][PubMed]
     [Google Scholar]
  10. Dumke R., von Baum H., Lück P. C., Jacobs E. 2010; Occurrence of macrolide-resistant Mycoplasma pneumoniae strains in Germany. Clin Microbiol Infect 16:613–616 [View Article][PubMed]
     [Google Scholar]
  11. Gadsby N. J., Hardie A., Claas E. C., Templeton K. E. 2010; Comparison of the Luminex Respiratory Virus Panel fast assay with in-house real-time PCR for respiratory viral infection diagnosis. J Clin Microbiol 48:2213–2216 [View Article][PubMed]
     [Google Scholar]
  12. Gadsby N. J., Reynolds A. J., McMenamin J., Gunson R. N., McDonagh S., Molyneaux P. J., Yirrell D. L., Templeton K. E. 2012; Increased reports of Mycoplasma pneumoniae from laboratories in Scotland in 2010 and 2011 - impact of the epidemic in infants. Euro Surveill 17:20110[PubMed]
     [Google Scholar]
  13. Hantz S., Garnier F., Peuchant O., Menetrey C., Charron A., Ploy M. C., Bébéar C., Pereyre S. 2012; Multilocus variable-number tandem-repeat analysis-confirmed emergence of a macrolide resistance-associated mutation in Mycoplasma pneumoniae during macrolide therapy for interstitial pneumonia in an immunocompromised child. J Clin Microbiol 50:3402–3405 [View Article][PubMed]
     [Google Scholar]
  14. Harris M., Clark J., Coote N., Fletcher P., Harnden A., McKean M., Thomson A. British Thoracic Society Standards of Care Committee 2011; British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011. Thorax 66:Suppl 2ii1–ii23 [View Article][PubMed]
     [Google Scholar]
  15. Kannan T. R., Hardy R. D., Coalson J. J., Cavuoti D. C., Siegel J. D., Cagle M., Musatovova O., Herrera C., Baseman J. B. 2012; Fatal outcomes in family transmission of Mycoplasma pneumoniae . Clin Infect Dis 54:225–231 [View Article][PubMed]
     [Google Scholar]
  16. Lenglet A., Herrador Z., Magiorakos A. P., Leitmeyer K., Coulombier D. European Working Group on Mycoplasma pneumoniae surveillance 2012; Surveillance status and recent data for Mycoplasma pneumoniae infections in the European Union and European Economic Area, January 2012. Euro Surveill 17:20075[PubMed]
     [Google Scholar]
  17. Linde A., Ternhag A., Törner A., Claesson B. E. 2012; Antibiotic prescriptions and laboratory-confirmed cases of Mycoplasma pneumoniae during the epidemic in Sweden in 2011. Euro Surveill 17:20082[PubMed]
     [Google Scholar]
  18. Nir-Paz R., Abutbul A., Moses A. E., Block C., Hidalgo-Grass C. 2012; Ongoing epidemic of Mycoplasma pneumoniae infection in Jerusalem, Israel, 2010 to 2012. Euro Surveill 17:20095[PubMed]
     [Google Scholar]
  19. Richard N., Komurian-Pradel F., Javouhey E., Perret M., Rajoharison A., Bagnaud A., Billaud G., Vernet G., Lina B. other authors 2008; The impact of dual viral infection in infants admitted to a pediatric intensive care unit associated with severe bronchiolitis. Pediatr Infect Dis J 27:213–217 [View Article][PubMed]
     [Google Scholar]
  20. Sánchez-Vargas F. M., Gómez-Duarte O. G. 2008; Mycoplasma pneumoniae – an emerging extra-pulmonary pathogen. Clin Microbiol Infect 14:105–117[PubMed] [CrossRef]
     [Google Scholar]
  21. Semple M. G., Cowell A., Dove W., Greensill J., McNamara P. S., Halfhide C., Shears P., Smyth R. L., Hart C. A. 2005; Dual infection of infants by human metapneumovirus and human respiratory syncytial virus is strongly associated with severe bronchiolitis. J Infect Dis 191:382–386 [View Article][PubMed]
     [Google Scholar]
  22. Spuesens E. B., Fraaij P. L., Visser E. G., Hoogenboezem T., Hop W. C., van Adrichem L. N., Weber F., Moll H. A., Broekman B. other authors 2013; Carriage of Mycoplasma pneumoniae in the upper respiratory tract of symptomatic and asymptomatic children: an observational study. PLoS Med 10:e1001444 [View Article][PubMed]
     [Google Scholar]
  23. Templeton K. E., Scheltinga S. A., Graffelman A. W., Van Schie J. M., Crielaard J. W., Sillekens P., Van Den Broek P. J., Goossens H., Beersma M. F., Claas E. C. 2003; Comparison and evaluation of real-time PCR, real-time nucleic acid sequence-based amplification, conventional PCR, and serology for diagnosis of Mycoplasma pneumoniae . J Clin Microbiol 41:4366–4371 [View Article][PubMed]
     [Google Scholar]
  24. Templeton K. E., Scheltinga S. A., van den Eeden W. C., Graffelman A. W., van den Broek P. J., Claas E. C. 2005; Improved diagnosis of the etiology of community-acquired pneumonia with real-time polymerase chain reaction. Clin Infect Dis 41:345–351 [View Article][PubMed]
     [Google Scholar]
  25. Uldum S. A., Bangsborg J. M., Gahrn-Hansen B., Ljung R., Mølvadgaard M., Føns Petersen R., Wiid Svarrer C. 2012; Epidemic of Mycoplasma pneumoniae infection in Denmark, 2010 and 2011. Euro Surveill 17:20073[PubMed]
     [Google Scholar]
  26. Waites K. B., Talkington D. F. 2004; Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev 17:697–728 [View Article][PubMed]
     [Google Scholar]
  27. Wolf D. G., Greenberg D., Kalkstein D., Shemer-Avni Y., Givon-Lavi N., Saleh N., Goldberg M. D., Dagan R. 2006; Comparison of human metapneumovirus, respiratory syncytial virus and influenza A virus lower respiratory tract infections in hospitalized young children. Pediatr Infect Dis J 25:320–324 [View Article][PubMed]
     [Google Scholar]
  28. Wolff B. J., Thacker W. L., Schwartz S. B., Winchell J. M. 2008; Detection of macrolide resistance in Mycoplasma pneumoniae by real-time PCR and high-resolution melt analysis. Antimicrob Agents Chemother 52:3542–3549 [View Article][PubMed]
     [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.066191-0
Loading
Clinical outcomes and macrolide resistance in Mycoplasma pneumoniae infection in Scotland, UK
J. Med. Microbiol. 62, 1876 (2013); https://doi.org/10.1099/jmm.0.066191-0
/content/journal/jmm/10.1099/jmm.0.066191-0
/content/journal/jmm/10.1099/jmm.0.066191-0
Loading

Data & Media loading...

Most cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error