Arfaatabar Maryam, Sadeghi Yasaman, Goodarzi Narjes Noori, Pourmand Mohammad Reza
Department of Medical Laboratory Sciences, Kashan Branch, Islamic Azad University, Kashan, Iran.
Department of Pathobiology, School of Public Health, and Recombinant Vaccine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Sci Rep. 2026 Feb 5;16(1):7432. doi: 10.1038/s41598-026-35614-2.
The rising incidence of macrolide-resistant Mycoplasma pneumoniae (MRMP) in Asia is a significant public health concern due to its implications in severe diseases. However, limited reliable data is available on this topic from Iran. To address this gap, we carried out a study in Tehran focusing on antimicrobial susceptibility and genotype distribution of MRMP. Following the CLSI M43-A guidelines, we assessed the growth inhibition of 54 M. pneumoniae isolates from outpatient clinics using four antimicrobial agents including azithromycin, erythromycin, clindamycin, and levofloxacin. In addition, Multilocus sequence typing (MLST) was performed on 20 randomly selected MRMP isolates. Our findings revealed alarming high resistance rates to erythromycin (85.1%) and azithromycin (85.1%), with significantly lower rates for clindamycin (9.25%). Notably, all isolates were susceptible to levofloxacin. Clonal complex analysis identified CC1 as the predominant complex (65% of isolates), with ST3 (50%) and ST14 (15%) being the most prevalent sequence types. This study provides novel insights into antimicrobial resistance and molecular epidemiology of M. pneumoniae in Iran. The high rates of MRMP isolates underscores the strong need for continued monitoring and antimicrobial stewardship of M. pneumoniae infections.
由于大环内酯类耐药肺炎支原体（MRMP）与严重疾病相关，其在亚洲的发病率不断上升成为一个重大的公共卫生问题。然而，伊朗在这一主题上可获得的可靠数据有限。为填补这一空白，我们在德黑兰开展了一项针对MRMP的抗菌药物敏感性和基因型分布的研究。按照美国临床和实验室标准协会（CLSI）M43 - A指南，我们使用阿奇霉素、红霉素、克林霉素和左氧氟沙星四种抗菌药物评估了来自门诊诊所的54株肺炎支原体分离株的生长抑制情况。此外，对20株随机选择的MRMP分离株进行了多位点序列分型（MLST）。我们的研究结果显示，对红霉素（85.1%）和阿奇霉素（85.1%）的耐药率高得惊人，而对克林霉素的耐药率（9.25%）则显著较低。值得注意的是，所有分离株对左氧氟沙星均敏感。克隆复合体分析确定CC1为主要复合体（占分离株的65%），其中ST3（50%）和ST14（15%）是最常见的序列类型。本研究为伊朗肺炎支原体的抗菌药物耐药性和分子流行病学提供了新的见解。MRMP分离株的高比例凸显了持续监测肺炎支原体感染以及进行抗菌药物管理的迫切需求。
