Laboratory of Molecular Epidemiology for Infectious Agents, Graduate School of Infection Control Sciences, Kitasato Institute for Life Sciences, Kitasato University, 5-9-1 Shirokane, Minatoku, Tokyo, 108-8641, Japan.
J Infect Chemother. 2010 Apr;16(2):78-86. doi: 10.1007/s10156-009-0021-4. Epub 2010 Jan 22.
Mycoplasma pneumoniae is one of the main pathogens causing community-acquired respiratory tract infections in children and adults. Macrolide (ML) antibiotics are recognized generally as first-choice agents for M. pneumoniae infections, and these antibiotics were thought to have excellent effectiveness against M. pneumoniae for many years. In 2000, however, M. pneumoniae showing resistance to macrolides was isolated from clinical samples obtained from Japanese pediatric patients with community-acquired pneumonia (CAP). Since then, prevalence of ML-resistant M. pneumoniae isolates in pediatric patients has increased rapidly. In 2007, ML-resistant M. pneumoniae isolates were obtained from Japanese adults with CAP; numbers of such isolates also have gradually increased in Japan. Recently, similar antimicrobial resistance in M. pneumoniae has begun to emerge worldwide. In this review, we focus on changes of ML-resistant M. pneumoniae from year to year and consider resistance mechanisms as well as clinical features of patients with resistant M. pneumoniae infection.
肺炎支原体是导致儿童和成人社区获得性呼吸道感染的主要病原体之一。大环内酯（ML）抗生素通常被认为是肺炎支原体感染的首选药物，多年来，这些抗生素被认为对肺炎支原体具有极好的疗效。然而，2000 年从日本社区获得性肺炎（CAP）患儿的临床标本中分离出了对大环内酯类药物耐药的肺炎支原体。此后，儿科患者中对 ML 耐药的肺炎支原体分离株的流行率迅速增加。2007 年，从日本 CAP 成人患者中获得了对 ML 耐药的肺炎支原体分离株；在日本，此类分离株的数量也逐渐增加。最近，肺炎支原体在全球范围内也开始出现类似的抗菌药物耐药性。在这篇综述中，我们重点关注 ML 耐药肺炎支原体的年度变化，并考虑耐药机制以及耐药肺炎支原体感染患者的临床特征。
