2002. High prevalence of macrolide resistant Mycoplasma pneumoniae among middle age pneumonia in Japan.
Session: Poster Abstract Session: Clinical: Respiratory Track
Saturday, October 7, 2017
Room: Poster Hall CD
Background: Mycoplasma pneumoniae ( M pneumoniae) is one of the most important pathogens in adult pneumonia especially among younger people. Recently, macrolide resistance is emerging problem and it is isolated from around 70 percent of pneumonia children in Japan. Although only few papers reported the percentage of macrolide resistant strains in adult patients, it has been considered as much low percentage among middle age patients even in Japan.

Methods: Adult Pneumonia Study Group – Japan conducted multi center prospective surveillance to evaluate disease burden and epidemiology of community onset pneumonia (≧15years or older ) in Japan from 2012 to 2015. We enrolled 3,740 community onset pneumonia cases and collected 2,616 sputum samples. Sputum samples were tested for 13 viruses and 6 bacteria including M pneumoniae by multiplex PCR assays. We performed gene sequencing of Domain V of 23s rRNA in M pneumoniaepositive DNA samples to detect macrolide resistant genes, A2063G and A2064G, when enough amount of DNA was available.

Results: Of 2,616 sputum samples, M pneumoniae P1 protein gene was positive in 88 (3.4%) cases by multiplex PCR. M pneumoniae positive patients were younger, more likely to have mild disease and more likely to be treated as outpatient. Annual incidences of M pneumoniae pneumonia among younger than 65 years and older than 65 years in 2012 were estimated to be 1/1000 person・year and 0.5 person・year, respectively. From 88 M pneumoniae positive samples, 55 samples were successfully sequenced Domain V of 23s rRNA gene and 32 cases (62.7%) were shown as positive for macrolide resistance gene. Unexpectedly, 80% of M pneumoniaewere macrolide resistant among middle aged patients.

Conclusion: Among middle aged patients with M pneumoniae pneumonia in Japan, high prevalence of macrolide resistant gene is emerging problem. Because macrolide has been considered as first choice drug to treat adult M pneumoniae pneumonia and it is sometimes self-limiting, well-designed control trials are needed to determine appropriate treatment of adult M pneumoniae pneumonia.

Konosuke Morimoto, M.D., Ph.D.1,2, Motoi Suzuki, M.D., Ph.D.1,2, Lay-Mint Yoshida, MD2,3, Le Nhat Minh, MD3, Koya Ariyoshi, MD.PhD2,4 and Adult Pneumonia Study Group - Japan, (1)Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan, (2)Adult Pneumonia Study Group-Japan, Nagasaki, Japan, (3)Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan, (4)Clinical Medicine, Nagasaki University Institute of Tropical Medicine, Nagasaki City, Japan


K. Morimoto, None

M. Suzuki, None

L. M. Yoshida, None

L. N. Minh, None

K. Ariyoshi, None

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