Emerging Macrolide Resistance in Mycoplasma Pneumoniae

肺炎支原体中新出现的大环内酯类耐药性

• 批准号: 7712312
• 负责人: THOMAS PRESCOTT ATKINSON
• 金额: $ 21.96万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-22 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7712312
• 关键词: 8 year old; Acute; Acute suppurative arthritis due to bacteria; Age; Alabama; Antibiotic Resistance; Antibiotic susceptibility; Antibiotics; Asia; Autoimmune Diseases; Azithromycin; Bacteria; Biological Assay; Centers for Disease Control and Prevention (U.S.); Child; China; Clarithromycin; Clindamycin; Clinical; Communities; Complex; Culture Techniques; Detection; Disease Outbreaks; Drug usage; Encephalitis; Encephalomyelitis; Erythromycin; Europe; Fluoroquinolones; Frequencies; Genes; Genome; Genotype; Guillain-Barré Syndrome; Hospitalized Child; Human; In Vitro; Infection; Ketolides; Knowledge; Laboratories; Left; Macrolide Antibiotics; Macrolide-resistance; Macrolides; Methods; Molecular; Mutation; Mycoplasma pneumoniae; Organism; Outcome; Outpatients; Patients; Pharmaceutical Preparations; Physicians; Pneumonia; Population; Prevalence; Prospective Studies; Repetitive Sequence; Reporting; Resistance; Respiratory Tract Infections; Rhode Island; Sequence Analysis; Southeastern United States; Specimen; Technology; Testing; Tetracyclines; Time; United States; atypical pneumonia; base; clinical practice; clinically significant; epidemiologic data; follow-up; mutant; public health relevance; rRNA Genes; rRNA Operon; research study; resistant strain; surveillance data; surveillance study; telithromycin

DESCRIPTION (provided by applicant): Mycoplasma pneumoniae is major cause of respiratory infections including community acquired pneumonia, and the organism is an established cause of extrapulmonary complications such as encephalitis. At present three classes of drugs are used to treat M. pneumoniae infections: macrolides, tetracyclines, and fluoroquinolones. Of these only macrolides are generally considered acceptable for use in children under the age of 8 years. Recent epidemiologic data from Europe and Asia have documented the rapid and extensive emergence of macrolide resistance in M. pneumoniae. However, there is at present no surveillance of antibiotic resistance in M. pneumoniae in the United States to give physicians an idea of the scope of this problem. We propose to conduct a surveillance study of macrolide resistance in children in Alabama using traditional culture and molecular-based methods for detection of M. pneumoniae respiratory infections and to evaluate a PCR-based assay that will detect macrolide resistance directly in clinical specimens. We also plan to sub-type M. pneumoniae isolates to determine whether resistance is occurring frequently throughout the population or if clonal spread of resistant strains is occurring. The application of molecular methods to detect macrolide resistance in clinical specimens is essential for physicians to adequately treat serious infections cause by this organism. PUBLIC HEALTH RELEVANCE: Mycoplasma pneumoniae is a major cause of respiratory infections in humans. Recent reports from Europe and Asia have documented a rapid and extensive rise in resistance to macrolide antibiotics such as azithromycin, but there is no knowledge about the extent of this problem in the United States and no prospective studies to provide any surveillance data. We propose to conduct a prospective study in children using traditional culture and molecular-based methods to test for antibiotic resistance in M. pneumoniae.

描述（由申请方提供）：肺炎支原体是呼吸道感染（包括社区获得性肺炎）的主要原因，并且该微生物是肺外并发症（如脑炎）的确定原因。目前治疗M.肺炎感染：大环内酯类、四环素类和氟喹诺酮类。在这些药物中，只有大环内酯类通常被认为可用于8岁以下儿童。最近来自欧洲和亚洲的流行病学数据表明，M.肺炎。然而，目前还没有监测M.肺炎在美国，让医生对这个问题的范围有一个概念。我们建议在亚拉巴马使用传统培养和基于分子的方法检测M.肺炎呼吸道感染，并评估基于PCR的检测，将直接检测临床标本中的大环内酯类耐药性。我们还计划分型M。pneumoniae分离株，以确定耐药性是否在整个人群中频繁发生，或者是否发生耐药菌株的克隆传播。应用分子生物学方法检测临床标本中大环内酯类抗生素耐药性对于医生充分治疗由该微生物引起的严重感染至关重要。公共卫生相关性：肺炎支原体是人类呼吸道感染的主要原因。最近来自欧洲和亚洲的报告表明，对阿奇霉素等大环内酯类抗生素的耐药性迅速而广泛地上升，但对美国这一问题的程度一无所知，也没有前瞻性研究提供任何监测数据。我们建议在儿童中进行一项前瞻性研究，使用传统培养和基于分子的方法来检测M。肺炎。