Abstract
OBJECTIVES: This study aimed to investigate the epidemiological trends, antimicrobial resistance patterns, and genetic mutations associated with Mycoplasma pneumoniae infections in Caidian District, Wuhan, Hubei Province. METHODS: Totally 7,234 nasopharyngeal swabs were collected from patients with respiratory symptoms. RT-qPCR was used to detect M. pneumoniae DNA, and antimicrobial susceptibility testing was performed on cultured isolates. The 23S rRNA gene was sequenced to identify resistance-associated mutations at positions A2063G, A2064G, A2067G, and C2617G by Pyrosequencing. RESULTS: The overall positivity rate for M. pneumoniae was 19.37 % (1,401/7,234), with significantly higher infection rates in children (32.75 %) compared to adults (9.84 %). Moreover, 20.51 % of M. pneumoniae isolates were susceptible to all tested antibiotics, while 24.36 % exhibited resistance to a single antibiotic class, with macrolide resistance being predominant (15.38 %). Multidrug resistance was observed in 55.13 % of isolates, primarily driven by macrolide-lincosamide co-resistance (34.62 %). The mutation rate in the 23S rRNA V domain was 94.87 %, with A2063G being predominant (65.38 %). CONCLUSIONS: This study reveals a high prevalence of macrolide resistance and multidrug resistance, primarily involving macrolide and lincosamide, in clinical isolates of M. pneumoniae. The high mutation rate in the 23S rRNA V domain underscores the need for continuous surveillance of resistance patterns and genetic mutations.