Analysis of Mycoplasma pneumoniae antibiotic resistance based on data obtained in the Tula region

Objective. To study the prevalence of mutations causing resistance to macrolides in Mycoplasma pneumoniae in the Tula region and compare the data with similar studies from European and Asian countries. Material and methods. A retrospective study of 76 samples of biological materials (nasal and pharynx swabs) was conducted. The materials were collected from the patients with an established diagnosis: the lower respiratory tract infection (pneumonia, bronchitis). All the patients included in the study were treated in specialized infections units and clinics of the Tula region for the period 2017–2018. Antibiotic therapy was not conducted before the initial survey. All the samples contained M. pneumoniae DNA. A real-time polymerase chain reaction (real-time PCR) technology was used to detect the DNA of M. pneumoniae in the materials. The analysis of mutations in the 23S rRNA gene was performed at the Scientific Research Institute of Antimicrobial Chemotherapy in Smolensk. During the study, a modified real-time PCR technique with the effect of the fluorescence quenching of the probe with a primer (patent No. 2646123) was used. The statistical analysis was carried out with the MS Excel software package. Results. It was identified that 9 samples (11.84%) had mutations associated with resistance to macrolides. Two samples had the A2059G mutation, while seven samples had the A2058G mutation (numbering of nucleotide sequences in the M. pneumoniae rRNA gene was compiled following E. coli numbering). The data obtained by us are slightly higher than the mean values of European countries and are significantly lower according to the studies of Asian countries. Conclusions. Provided unique data on the prevalence and identification of mutations of macrolide-resistant strains of M. pneumoniae in one of the regions of the Central Federal District is a contribution to the study of antibiotic-resistant strains of M. pneumoniae in Russia and all over the world. There is a necessity to monitor antibiotic resistance in other regions and increase diligence on atypical forms of community-acquired pneumonia since the co-infection of M. pneumoniae patients with COVID-19 leads to a deterioration in the condition and an increase in the duration of treatment. Keywords: community-acquired pneumonia, macrolides mycoplasmas, mutations of antibiotic resistance