Macrolide-resistant Mycoplasma pneumoniae in adults with community acquired pneumonia: challenges and risks
Abstract
Mycoplasma pneumoniae is an important atypical microorganism that causes community-acquired pneumonia (1). These atypical microorganisms are responsible for 7–20% of community-acquired pneumonia cases, yet β-lactam agents are not effective against M. pneumoniae because it lacks a rigid cell wall. Currently, macrolides are considered as first line agents to treat atypical community-acquired pneumonia due to M. pneumoniae, while respiratory fluoroquinolones (such as levofloxacin), and tetracyclines are alternative treatment options (2). However, macrolide-resistant M. pneumoniae is growing globally and the prevalence rate shows variations across countries and regions. Epidemiologic studies have shown that the macrolide-resistant M. pneumoniae rate is between 0% and 15% in the United States of America, while reaching 100% in Asia, with resistance more dominant in low and middle-income countries (3). Moreover, for some countries there has been little or no macrolide-resistant M. pneumoniae reporting, including the Islamic Republic of Iran, where studies determining the prevalence of community-acquired pneumonia due to M. pneumoniae and macrolide-resistant M. pneumoniae incidence remain scarce. Research by Arfaatabar et al. indicated that the frequency of M. pneumoniae among patients with atypical communityacquired pneumonia was reported to be high (4). Study by Noori et al. estimated the macrolide-resistant M. pneumoniae incidence to be almost 57% (5). In clinical practice,…
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