Mycoplasma pneumoniae: Susceptibility and Resistance to Antibiotics

Cécile Bébéar; Sabine Pereyre; Olivia Peuchant


Future Microbiol. 2011;6(4):423-431. 

In This Article

Abstract and Introduction


Mycoplasma pneumoniae is a pathogenic mycoplasma responsible for respiratory tract infections in humans, which occurs worldwide in children and adults. This article focuses on its antibiotic susceptibility profile and on the development of acquired resistance in this microorganism. The lack of a cell wall in mycoplasmas makes them intrinsically resistant to β-lactams and to all antimicrobials that target the cell wall. M. pneumoniae is susceptible to macrolides and related antibiotics, tetracyclines and fluoroquinolones. Macrolides and related antibiotics are the first-line treatment for respiratory infections caused by M. pneumoniae. However, strains with acquired resistance to macrolides have recently emerged worldwide and have been spreading in Europe, USA and A sia especially, with more than 90% of Chinese isolates resistant to erythromycin and azithromycin. This acquired resistance can be detected by PCR methods directly from respiratory specimens and is related to 23S rRNA mutations.


Mycoplasma pneumoniae is a worldwide cause of community acquired pneumonia and benign respiratory disorders such as tracheobronchitis, especially in children and young adults.[1,2] Furthermore, a wide array of extrapulmonary infectious and postinfectious events may accompany M. pneumoniae infections. M. pneumoniae belongs to the Mollicutes class and is the best known human pathogenic mycoplasma species. Three other species, Mycoplasma hominis, Mycoplasma genitalium and Ureaplasma spp. have a documented pathogenic role.[3] Development of molecular diagnostic methods in combination with traditional tests has highlighted new aspects of the epidemiology and characteristics of M. pneumoniae infections.[2] It has been implicated in the pathogenesis as well as in exacerbation of asthma in children and adults.[4,5] This article summarizes the in vitro activities of antimicrobials available for the treatment of M. pneumoniae infections, intrinsic and acquired antibiotic resistance and includes new data about macrolide resistance since the last published review.[6]


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