Peer-reviewed article
Global molecular epidemiology of Mycoplasma pneumoniae and its association with macrolide resistance and disease severity: a systematic review and meta-analysis.
Xinyue Zhu, Yuyi Tang, Karen Spruyt, Janne Estill, Ivan D Florez et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a systematic review and meta-analysis of Mycoplasma pneumoniae molecular epidemiology, focusing on genotype distribution, macrolide resistance patterns, and disease severity across global populations. The study analyzes 116 studies to identify dominant genotypes by region and age group, and examines associations between genotypes and antibiotic resistance. While the work involves pediatric patients, it is fundamentally a clinical microbiology and infectious disease study rather than a child well-being evaluation.
Key points
- P1-1 and genotype 4572 were predominant in Western Pacific and European regions; ST3 was predominant in Western Pacific region
- P1-1, 4572, and ST3 genotypes showed highest macrolide resistance rates
- Genotype dominance cycled between P1-1 and P1-2, and between 4572 and 3662 over time
- Proportions of P1-1 and 4572 were higher in children than adults
- No association was detected between P1 genotypes and disease severity due to limited sample size
Limitations
This document is a laboratory epidemiology study focused on pathogen molecular characteristics and antibiotic resistance patterns. It does not evaluate interventions for child health outcomes or assess child well-being holistically.
Abstract
The global molecular epidemiology of Mycoplasma pneumoniae (MP) and its associations with macrolide resistance and disease severity remain unclear. Studies reporting MP genotypes distribution by P1 typing, multiple locus variable number tandem repeat analysis (MLVA), or multilocus sequence typing analysis (MLST) among MP-infected patients were included. Data quality was assessed using the Joanna Briggs Institute tool and the Newcastle-Ottawa scale. Random-effects models were used to calculate pooled proportions of each MP genotype, with subgroup analyses by geographic region, age group, sex, time period, specimen type, and test assay. The proportions of macrolide-resistant MP and severe MP pneumonia cases were also evaluated. A total of 116 studies met the criteria. Predominant genotypes were P1-1 by P1 typing and 4572 by MLVA in the Western Pacific region and European region, and ST3 by MLST in the Western Pacific region. The proportions of P1-1 and 4572 were higher in the Western Pacific region than in other regions, and in children than in adults, whereas P1-2 and 3562 were opposite. Genotype dominance cycled between P1-1 and P1-2, and between 4572 and 3662. Macrolide resistance rates were highest in P1-1, 4572, and ST3 genotypes. Based on the currently available data, no association was detected between P1 genotypes and disease severity, although the limited sample size restricted the statistical power of this analysis. This comprehensive analysis elucidates the global molecular epidemiology of MP, highlights its clinical implications, and underscores the need for ongoing molecular surveillance to guide management and control strategies.