Therapeutic efficacy of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant and macrolide-sensitive Mycoplasma pneumoniae pneumonia in pediatric patients

被引：65

作者：

Ishiguro, Nobuhisa ^{[1
]}

Koseki, Naoko ^{[1
]}

Kaiho, Miki ^{[1
]}

Ariga, Tadashi ^{[1
]}

Kikuta, Hideaki ^{[2
]}

Togashi, Takehiro ^{[3
]}

Oba, Koji ^{[4
,5
]}

Morita, Keisuke ^{[6
]}

Nagano, Naoko ^{[7
]}

Nakanishi, Masanori ^{[8
]}

Hara, Kazuya ^{[8
]}

Hazama, Kyosuke ^{[9
]}

Watanabe, Toru ^{[10
]}

Yamanaka, Tatsuru ^{[11
]}

Sasaki, Satoshi ^{[12
]}

Furuyama, Hideto ^{[13
]}

Shibata, Mutsuo ^{[14
]}

Shida, Satoru ^{[15
]}

Ishizaka, Akihito ^{[16
]}

Tabata, Yuichi ^{[17
]}

Aoyagi, Hayato ^{[18
]}

Naito, Hiroyuki ^{[19
]}

Yoshioka, Mikio ^{[20
]}

Horino, Atsuko ^{[21
]}

Kenri, Tsuyoshi ^{[21
]}

机构：

[1] Hokkaido Univ, Grad Sch Med, Dept Pediat, Sapporo, Hokkaido, Japan

[2] Touei Hosp, Pediat Clin, Sapporo, Hokkaido, Japan

[3] Sapporo Fukujuji Clin, Hokkaido AntiTB Assoc, Sapporo, Hokkaido, Japan

[4] Univ Tokyo, Grad Sch Med, Sch Publ Hlth, Dept Biostat, Tokyo, Japan

[5] Univ Tokyo, Interfaculty Initiat Informat Studies, Tokyo, Japan

[6] Asahikawa Red Cross Hosp, Dept Pediat, Asahikawa, Hokkaido, Japan

[7] Nagano Pediat Clin, Asahikawa, Hokkaido, Japan

[8] Kushiro Red Cross Hosp, Dept Pediat, Kushiro, Hokkaido, Japan

[9] Hazama Pediat Clin, Muroran, Hokkaido, Japan

[10] Watanabe Pediat Allergy Clin, Sapporo, Hokkaido, Japan

[11] Yamanaka Tatsuru Pediat Clin, Sapporo, Hokkaido, Japan

[12] Aiiku Hosp, Dept Pediat, Sapporo, Hokkaido, Japan

[13] Japan Community Healthcare Org Hokkaido Hosp, Deparment Pediat, Sapporo, Hokkaido, Japan

[14] Hokkaido Univ, Dept Pediat Hlth Sci, Sapporo, Hokkaido, Japan

[15] Ebetsu Municipal Hosp, Deparment Pediat, Ebetsu, Hokkaido, Japan

[16] Sumiyoshi Kodomo Clin, Chitose, Hokkaido, Japan

[17] Iwamizawa Pediat & Gynecol Clin, Iwamizawa, Hokkaido, Japan

[18] Obihiro Kyokai Hosp, Deparment Pediat, Obihiro, Hokkaido, Japan

[19] Chitose City Hosp, Deparment Pediat, Chitose, Hokkaido, Japan

[20] KKR Sapporo Med Ctr, Deparment Pediat, Sapporo, Hokkaido, Japan

[21] Natl Inst Infect Dis, Dept Bacteriol 2, Tokyo, Japan

来源：

PLOS ONE | 2017年 / 12卷 / 03期

关键词：

STRAINS; INFECTION; SURVEILLANCE; ADOLESCENTS; OUTBREAK; CHILDREN; ADULTS; GENE;

D O I：

10.1371/journal.pone.0173635

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Objective To clarify therapeutic effects of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant Mycoplasma pneumoniae (MRMP) pneumonia and against macrolide-sensitive Mycoplasma pneumoniae (MSMP) pneumonia in pediatric patients. Methods A prospective, multicenter observational study was conducted from July 2013 to August 2015. The therapeutic effects of azithromycin, clarithromycin, minocycline and tosufloxacin were evaluated in 59 patients with pneumonia caused by MRMP and in 50 patients with pneumonia caused by MSMP. In vitro activities of antimicrobial agents against isolates of Mycoplasma pneumoniae were also measured. Results Mean durations of fever following commencement of treatment in patients infected with MRMP and MSMP were 5.2 and 1.9 days, respectively (log-rank test, P < 0.0001). Among patients infected with MRMP, mean durations of fever were 4.6, 5.5, 1.0 and 7.5 days for patients treated with azithromycin, clarithromycin, minocycline and tosufloxacin, respectively (log-rank test, P < 0.0001). Among patients infected with MSMP, mean durations of fever were 2.5, 1.7, 0.9 and 4.3 days for patients treated with azithromycin, clarithromycin, minocycline and tosufloxacin, respectively (log-rank test, P = 0.0162). The MIC90s of azithromycin and clarithromycin among the 27 isolates of MRMP were 64 and 256 mu g/ml, respectively, and those among the 23 isolates of MSMP were < 0.000125 and 0.001 mu g/ml, respectively. The MIC90s of minocycline and tosufloxacin among the 27 isolates of MRMP were 1.0 and 0.25 mu g/ml, respectively, and those among the 23 isolates of MSMP were 1.0 and 0.5 mu g/ml, respectively. Conclusion Both minocycline and tosufloxacin showed good in vitro activities against MRMP. Minocycline, but not tosufloxacin, shortened the duration of fever in pediatric patients infected with MRMP compared to the duration of fever in patients treated with macrolides.

引用

页数：13

共 35 条

[1] Emergence of macrolide-resistant strains during an outbreak of Mycoplasma pneumoniae infections in children [J].

Chironna, M. ;

Sallustio, A. ;

Esposito, S. ;

Perulli, M. ;

Chinellato, I. ;

Di Bari, C. ;

Quarto, M. ;

Cardinale, F. .

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2011, 66 (04) :734-737

[2]

Committee for the Guidelines in Management of Respiratory Infectious Diseases in Children, 2011, COMM GUID MAN RESP I

[3] Occurrence of macrolide-resistant Mycoplasma pneumoniae strains in Germany [J].

Dumke, R. ;

von Baum, H. ;

Lueck, P. C. ;

Jacobs, E. .

CLINICAL MICROBIOLOGY AND INFECTION, 2010, 16 (06) :613-616

[4]

Eshaghi A, 2013, EMERGING INFECT DIS, V19

[5]

Grady Richard W, 2005, Expert Opin Drug Saf, V4, P623, DOI 10.1517/14740338.4.4.623

[6]

HAYFLICK L, 1965, TEX REP BIOL MED, VS 23, P285

[7]

Ishiguro N, 2015, JAPANESE J INFECT DI

[8]

Kawai Yasuhiro, 2012, Respirology, V17, P354, DOI 10.1111/j.1440-1843.2011.02102.x

[9] Nationwide Surveillance of Macrolide-Resistant Mycoplasma pneumoniae Infection in Pediatric Patients [J].

Kawai, Yasuhiro ;

Miyashita, Naoyuki ;

Kubo, Mika ;

Akaike, Hiroto ;

Kato, Atsushi ;

Nishizawa, Yoko ;

Saito, Aki ;

Kondo, Eisuke ;

Teranishi, Hideto ;

Wakabayashi, Tokio ;

Ogita, Satoko ;

Tanaka, Takaaki ;

Kawasaki, Kozo ;

Nakano, Takashi ;

Terada, Kihei ;

Ouchi, Kazunobu .

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2013, 57 (08) :4046-4049

[10] Therapeutic Efficacy of Macrolides, Minocycline, and Tosufloxacin against Macrolide-Resistant Mycoplasma pneumoniae Pneumonia in Pediatric Patients [J].