Macrolide Resistance of Mycoplasma pneumoniae, South Korea, 2000–2011

Ki Bae Hong, Eun Hwa Choi

, Hoan Jong Lee, Seong Yeon Lee, Eun Young Cho, Jae Hong Choi, Hyun Mi Kang, Jina Lee, Young Min Ahn, Yeon-Ho Kang, and Joon-Ho Lee

Author affiliations: Seoul National University Hospital, Seoul, South Korea (K.B. Hong, E.H. Choi, H.J. Lee, S.Y. Lee, E.Y. Cho, J.H. Choi, H.M. Kang); Seoul National University College of Medicine, Seoul (E.H. Choi, H.J. Lee); Seoul National University Bundang Hospital, Seongnam, South Korea (J. Lee); Seoul Eulji Hospital, Seoul (Y.M. Ahn); Korea Centers for Disease Control and Prevention, Seoul (Y.-H. Kang); Kangwon National University Hospital, Chuncheon, South Korea (J.-H. Lee)

Abstract

In Korea, Mycoplasma pneumoniae was detected in 255/2,089 respiratory specimens collected during 2000–2011; 80 isolates carried 23S rRNA gene mutations, and 69/123 culture-positive samples with the mutation were resistant to 5 macrolides. During 2000–2011, prevalence of the mutation increased substantially. These findings have critical implications for the treatment of children with mycoplasma pneumonia.

Mycoplasma pneumoniae is 1 of the most common causes of community-acquired pneumonia in children and young adults (1). Epidemics of mycoplasma pneumonia typically occur every 4–7 years; however, epidemics have occurred every 3–4 years in South Korea (2,3). The first-line treatment for mycoplasma pneumonia is macrolide antimicrobial drugs, but macrolide-resistant infections have been recognized in conjunction with an increase in cases in children in Japan, China, Germany, France, Israel, and the United States (1,4–10). Because of the risk to children administered tetracycline and fluoroquinolone (nonmacrolide drugs), M. pneumoniae resistance to macrolide drugs has critical implications for the treatment of mycoplasma pneumonia in children. This study was conducted to identify the prevalence of macrolide resistance among M. pneumoniae strains isolated from children with lower respiratory tract infections (LRTIs) during 4 consecutive epidemics (2000–2011) in South Korea.