Prevalence of Macrolide-Resistant Mycoplasma pneumoniae Infections After the COVID-19 Pandemic in Southern Italy, 2023-2025.

IF 5.3 3区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases and Therapy Pub Date : 2025-10-08 DOI:10.1007/s40121-025-01244-w

Francesca Centrone, Marisa Accogli, Raffaella Melilli, Alfredo Marziani, Valentina A Orlando, Daniele Casulli, Vittoria Scolamacchia, Nicola Netti, Davide Sacco, Anna Sallustio, Maria Chironna

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引用次数: 0

Abstract

Introduction: The COVID-19 pandemic and associated non-pharmaceutical interventions (NPIs) markedly reduced the circulation of respiratory pathogens. In late 2023, a resurgence of Mycoplasma pneumoniae (MP) infections, including macrolide-resistant strains (MRMP), was documented worldwide. This study aimed to determine MRMP prevalence and epidemiological characteristics in Southern Italy during the post-pandemic period.

Methods: Between January 2023 and May 2025, 5362 respiratory specimens were tested for M. pneumoniae and other respiratory pathogens using multiplex real-time polymerase chain reaction (PCR). Macrolide resistance-associated mutations in the 23S rRNA gene were identified through PCR amplification and Sanger sequencing. Data were stratified by age group and clinical setting.

Results: MP prevalence peaked at 15.8% in May 2025. Of 305 positive cases, the median age was 10 years, 52.1% were male, and 86.9% were hospitalized. Coinfections occurred in 23.3% of cases, particularly among children < 5 years. Macrolide resistance was detected in 7.5% of MP-positive samples, predominantly the A2063G mutation (96%), with the highest prevalence in patients aged 10-14 years (12.6%). No resistance was identified in ICU patients.

Conclusion: The post-pandemic resurgence of M. pneumoniae in Southern Italy, coupled with sustained macrolide resistance, underscores the need for continuous molecular surveillance and targeted antimicrobial stewardship to optimize therapy and prevent further resistance spread.

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2023-2025年意大利南部COVID-19大流行后大环内酯耐药肺炎支原体感染流行情况

导论：COVID-19大流行和相关的非药物干预措施（npi）显著减少了呼吸道病原体的循环。2023年底，在世界范围内记录了肺炎支原体（MP）感染的死灰复燃，包括大环内酯耐药菌株（MRMP）。本研究旨在确定大流行后时期意大利南部MRMP的患病率和流行病学特征。方法：2023年1月~ 2025年5月，对5362份呼吸道标本采用多重实时聚合酶链反应（PCR）检测肺炎支原体及其他呼吸道病原体。通过PCR扩增和Sanger测序鉴定23S rRNA基因的大环内酯耐药相关突变。数据按年龄组和临床情况分层。结果：2025年5月MP患病率最高，为15.8%。305例阳性病例中，年龄中位数为10岁，男性占52.1%，住院率为86.9%。结论：意大利南部肺炎支原体大流行后卷土重来，加上大环内酯类药物持续耐药，强调需要持续进行分子监测和有针对性的抗菌药物管理，以优化治疗并防止耐药性进一步传播。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infectious Diseases and Therapy Medicine-Microbiology (medical)

CiteScore

8.60

自引率

1.90%

发文量

136

审稿时长

6 weeks

期刊介绍： Infectious Diseases and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of infectious disease therapies and interventions, including vaccines and devices. Studies relating to diagnostic products and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, bacterial and fungal infections, viral infections (including HIV/AIDS and hepatitis), parasitological diseases, tuberculosis and other mycobacterial diseases, vaccinations and other interventions, and drug-resistance, chronic infections, epidemiology and tropical, emergent, pediatric, dermal and sexually-transmitted diseases.