ABSTRACT
Among Mycoplasma pneumoniae (MP) is one of the major pathogens causing lower respiratory tract infection. Macrolide-resistant Mycoplasma pneumoniae (MRMP) isolates have been increasing and has become a global concern, especially in East Asian countries. This affects the treatment of MP infection; that is, some patients with MRMP infections fever cannot be controlled despite macrolide therapy. Therefore, alternative therapies, including secondary antimicrobials, including tetracyclines, fluoroquinolones, or systemic corticosteroids, were introduced. However, there are insufficient data on these alternative therapies. Thus, this article provides reviews of the recent trends in the epidemiology, diagnosis, and treatment of MRMP.
ABSTRACT
Recombinant viral vaccines expressing antigens of pathogenic microbes (e.g., HIV, Ebola virus, and malaria) have been designed to overcome the insufficient immune responses induced by the conventional vaccines. Our knowledge of and clinical experience with the new recombinant viral vaccines are insufficient, and a clear regulatory pathway is needed for the further development and evaluation of recombinant viral vaccines. In 2018, the research group supported by the Ministry of Health, Labour and Welfare, Japan (MHLW) published a concept paper to address the development of recombinant viral vaccines against infectious diseases. Herein we summarize the concept paper-which explains the Japanese regulatory concerns about recombinant viral vaccines-and provide a focus of discussion about the development of recombinant viral vaccines.
Subject(s)
Drug and Narcotic Control/legislation & jurisprudence , Vaccines, Synthetic/standards , Viral Vaccines/standards , Animals , Contraceptive Agents, Male/pharmacology , Disease Models, Animal , Drug Evaluation, Preclinical , Humans , Immunocompromised Host , Japan , Microorganisms, Genetically-Modified , Quality Control , Tissue Distribution , Vaccines, Synthetic/pharmacology , Viral Vaccines/pharmacokinetics , Virus Replication/physiology , Virus SheddingABSTRACT
We compared the antimicrobial susceptibility of Mycoplasma pneumoniae isolates from pediatric patients in Japan in 2011-2012 and 2015-2016, when epidemics occurred. The antimicrobial activity of macrolides and tetracyclines against M. pneumoniae infection tended to be restored in 2015-2016. There was no change in the antimicrobial activity of quinolones against M. pneumoniae infection.
Subject(s)
Anti-Infective Agents/therapeutic use , Mycoplasma pneumoniae/drug effects , Pneumonia, Mycoplasma/drug therapy , Child , Epidemics , Humans , Japan/epidemiology , Macrolides/therapeutic use , Microbial Sensitivity Tests/methods , Mycoplasma pneumoniae/isolation & purification , Pneumonia, Mycoplasma/epidemiology , Pneumonia, Mycoplasma/microbiology , Tetracyclines/therapeutic useABSTRACT
We evaluated isolates obtained from children with Mycoplasma pneumoniae infection throughout Japan during 2008-2015. The highest prevalence of macrolide-resistant M. pneumoniae was 81.6% in 2012, followed by 59.3% in 2014 and 43.6% in 2015. The prevalence of macrolide-resistant M. pneumoniae among children in Japan has decreased.
Subject(s)
Drug Resistance, Bacterial/genetics , Macrolides/therapeutic use , Mycoplasma pneumoniae/genetics , Pneumonia, Mycoplasma/drug therapy , Pneumonia, Mycoplasma/epidemiology , RNA, Ribosomal, 23S/genetics , Adolescent , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Japan/epidemiology , Male , Microbial Sensitivity Tests , Mutation Rate , Mycoplasma pneumoniae/classification , Mycoplasma pneumoniae/drug effects , Mycoplasma pneumoniae/isolation & purification , Pneumonia, Mycoplasma/microbiology , PrevalenceABSTRACT
We investigated differences in the clinical findings between 30 patients with macrolide-resistant Mycoplasma pneumoniae pneumonia and 43 patients with macrolide-sensitive M. pneumoniae pneumonia in adolescents and adults. No differences in clinical presentation were observed between the two groups. Among patients with macrolide-resistant Mycoplasma pneumoniae pneumonia, treatment was more effective in the groups that received quinolones and minocycline than in the group that received macrolides (P = 0.0361 and P = 0.0237, respectively).
Subject(s)
Macrolides/pharmacology , Mycoplasma pneumoniae/drug effects , Adolescent , Adult , Anti-Bacterial Agents/pharmacology , Female , Humans , Male , Microbial Sensitivity Tests , Minocycline/pharmacology , Quinolones/pharmacologyABSTRACT
Biosynthesized tea polyphenols showed antichlamydial activity against Chlamydia trachomatis D/UW-3/Cx and L2/434/Bu using cell culture. The most active compounds were (-)-epigallocatechin gallate and (-)-epicatechin gallate, followed by (-)-epicatechin (EC). (+)-Epicatechin and (-)-epigallocatechin were intermediate. EC was the least toxic. These results warrant evaluation of tea polyphenols as topical antichlamydial agents.