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Current Opinion in Infectious Diseases:
doi: 10.1097/QCO.0000000000000063
PAEDIATRIC AND NEONATAL INFECTIONS: Edited by Paul T. Heath

Mycoplasma pneumoniae in children: carriage, pathogenesis, and antibiotic resistance

Meyer Sauteur, Patrick M.a; van Rossum, Annemarie M.C.a; Vink, Cornelisa,b

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Abstract

Purpose of review

Both the diagnosis and treatment of Mycoplasma pneumoniae infections in children are currently facing two main challenges: a relatively high carriage in asymptomatic children, and a worldwide increase in macrolide-resistant M. pneumoniae (MRMP). This review focuses on the scientific and clinical implications of these crucial issues.

Recent findings

Recent studies have indicated that the prevalence of M. pneumoniae in the upper respiratory tract is similar among asymptomatic, healthy children and children with a symptomatic respiratory tract infection, and that current diagnostic procedures for M. pneumoniae are unable to differentiate between bacterial carriage and infection. It is therefore possible that the burden of M. pneumoniae-associated disease is overestimated. Another phenomenon that has an important impact on the treatment of M. pneumoniae infections is the rapid worldwide emergence of MRMP isolates.

Summary

The current diagnostic procedures for M. pneumoniae cannot discern between bacterial carriage and infection in a clinically relevant time frame. It is therefore imperative that these procedures be modified such as to unambiguously detect symptomatic M. pneumoniae infections. Moreover, the emergence of MRMP necessitates the application of methods to detect macrolide resistance as well as the implementation of restrictive policies regarding the use of macrolides.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

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