Molecular Detection and Characterization of Mycoplasma pneumoniae Among Patients Hospitalized With Community-Acquired Pneumonia in the United States

• Type of Material: Article
• Authors: Maureen H. Diaz, Centers for Disease Control and Prevention; Alvaro J. Benitez, Centers for Disease Control and Prevention; Kristen E. Cross, Centers for Disease Control and Prevention; Lauri A. Hicks, Centers for Disease Control and Prevention; Preeta Kutty, Centers for Disease Control and Prevention; Anna M. Bramley, Centers for Disease Control and Prevention; James D. Chappell, Vanderbilt University; Weston Hymas, University of Utah Health Sciences Center; Anami Patel, Le Bonheur Children's Hospital; Chao Qi, Northwestern University; Derek J. Williams, Vanderbilt University; Sandra R. Arnold, Le Bonheur Children's Hospital; Krow Ampofo, University of Utah; Wesley H. Self, Vanderbilt University; Carlos G. Grijalva, Vanderbilt University; Evan Anderson, Emory University; Jonathan A. McCullers, Le Bonheur Children's Hospital; Andrew T. Pavia, University of Utah; Richard G. Wunderink, Northwestern University; Kathryn M. Edwards, Vanderbilt University; Seema Jain, Centers for Disease Control and Prevention; Jonas M. Winchell, Centers for Disease Control and Prevention
• Language: English
• Date: 2015-06-01
• Publisher: Oxford University Press (OUP)
• Publication Version: Final Published Version
• Copyright Statement: Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.
• License: Creative Commons Creative Commons CC0 1.0 Universal
• Final Published Version (URL): http://dx.doi.org/10.1093/ofid/ofv106
• Title of Journal or Parent Work: Open Forum Infectious Diseases
• ISSN: 2328-8957
• Volume: 2
• Issue: 3
• Start Page: ofv106
• End Page: ofv106
• Grant/Funding Information: Financial support. This work was supported by the Influenza Division in the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention (CDC) through cooperative agreements with each study site and was based on a competitive research funding opportunity.
• Keywords: CHILDREN; CHLAMYDIA-PNEUMONIAE; CHINA; REAL-TIME PCR; PEDIATRIC-PATIENTS; Infectious Diseases; RESOLUTION MELT ANALYSIS; community-acquired pneumonia; Life Sciences & Biomedicine; macrolide resistance; OUTBREAK; MACROLIDE-RESISTANT STRAINS; Microbiology; molecular epidemiology; Mycoplasma pneumonia; Science & Technology; Immunology; TANDEM-REPEAT ANALYSIS; INFECTIONS
• Research Categories: Health Sciences, Public Health; Health Sciences, General

Abstract

Background.  Mycoplasma pneumoniae is a common cause of community-acquired pneumonia (CAP). The molecular characteristics of M pneumoniae detected in patients hospitalized with CAP in the United States are poorly described. Methods.  We performed molecular characterization of M pneumoniae in nasopharyngeal/oropharyngeal swabs from children and adults hospitalized with CAP in the Centers for Disease Control and Prevention Etiology of Pneumonia in the Community (EPIC) study, including P1 typing, multilocus variable-number tandem-repeat analysis (MLVA), and macrolide susceptibility genotyping. Results.  Of 216 M pneumoniae polymerase chain reaction-positive specimens, 40 (18.5%) were obtained from adults and 176 (81.5%) from children. P1 type distribution differed between adults (64% type 1 and 36% type 2) and children (84% type 1, 13% type 2, and 3% variant) (P < .05) and among sites (P < .01). Significant differences in the proportions of MLVA types 4/5/7/2 and 3/5/6/2 were also observed by age group (P < .01) and site (P < .01). A macrolide-resistant genotype was identified in 7 (3.5%) specimens, 5 of which were from patients who had recently received macrolide therapy. No significant differences in clinical characteristics were identified among patients with various strain types or between macrolide-resistant and -sensitive M pneumoniae infections. Conclusions.  The P1 type 1 genotype and MLVA type 4/5/7/2 predominated, but there were differences between children and adults and among sites. Macrolide resistance was rare. Differences in strain types did not appear to be associated with differences in clinical outcomes. Whole genome sequencing of M pneumoniae may help identify better ways to characterize strains.