Clinical impact of rapid test for macrolide-resistance gene mutation among cases with Mycoplasma pneumoniae in Japan.

Macrolide-resistant Mycoplasma pneumoniae (MP) infections are reported worldwide. Smart Gene® (SG) Myco, a point-of-care testing tool, detects nucleic acids and macrolide-resistance gene mutations of MP. The objective of this study was to evaluate the clinical impact of the rapid detection of macrolide resistance gene mutations in children with MP. This retrospective study included children ≤ 18 years of age with microbiologically confirmed MP requiring antimicrobial treatment. Clinical outcomes were compared between the SG Myco test and untested groups. A total of 298 participants (121 in the SG Myco test group and 177 in the untested group) were included. Macrolide resistance gene mutations were detected in 47.9 % of patients in the SG Myco-tested group. SG Myco test implementation was positively associated with macrolide use (adjusted odds ratio 2.20 [1.22, 3.99]; p = 0.009) and negatively associated with tetracycline use (adjusted odds ratio 0.41 [0.23, 0.75]; p = 0.003). A significant reduction in tetracycline use was observed following the implementation of the SG Myco test among children and adolescents with MP who required antimicrobial treatment. The results of our study demonstrated that rapid testing of macrolide resistance gene mutations facilitates timely and appropriate antimicrobial selection.