Epidemiological trends, antimicrobial resistance, and genetic mutations of Mycoplasma pneumoniae in Wuhan, China: a post-COVID-19 perspective

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.