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41. Allele-specific real-time PCR testing for minor macrolide-resistant Mycoplasma Pneumoniae. Full Text available with Trip Pro

Allele-specific real-time PCR testing for minor macrolide-resistant Mycoplasma Pneumoniae. The point mutations in 23S rRNA gene of Mycoplasma pneumoniae (M. pneumoniae) can lead to high-level resistance to macrolides. This study aimed to evaluate allele-specific real-time PCR (ASPCR) to detect the resistance-related mutations located at positions A2063G and A2064G of 23S rRNA gene.We detected 178 pharyngeal swab specimens and calculated the proportions of resistant and sensitive quasispecies (...) using ASPCR assays. ASPCR assays can detect down to 10 copies of 23S rRNA gene and achieved sensitivities of < 0.1% for A2063G and A2064G. We also compared the findings of ASPCR with the results of nested PCR with sequencing.Of 178 samples, 164 were found to have M. pneumoniae including 90.85% (149/164) samples with macrolide-resistant M. pneumoniae (MRMP) quasispecies by ASPCR, while 153 were found to be M. pneumoniae-positive including 71.90% (110/153) samples with MRMP quasispecies by nested PCR

2019 BMC Infectious Diseases

42. Computed tomographic findings of macrolide-resistant Mycobacterium massiliense pulmonary disease and changes after antibiotic treatment. Full Text available with Trip Pro

Computed tomographic findings of macrolide-resistant Mycobacterium massiliense pulmonary disease and changes after antibiotic treatment. The purpose of this study was to present the computed tomographic (CT) findings of lung abnormalities in macrolide-resistant Mycobacterium massiliense pulmonary disease and its changes in follow-up CT after antibiotic treatment.Chest CT scans of patients with macrolide-resistant M massiliense pulmonary disease (n = 19) were retrospectively reviewed. Patients (...) were treated with multidrug therapy, and sputum examinations were performed. Follow-up CT scans obtained during antibiotic treatment after detection of macrolide resistance were also reviewed, if available (n = 13). The CT scores at detection of macrolide resistance and at the last follow-up periods were also compared.Of all patients with macrolide-resistant M massiliense pulmonary disease, 2 (11%) patients achieved sputum culture conversion during the follow-up period. The most common CT findings

2019 Medicine

43. Macrolide Resistance in MORDOR I - A Cluster-Randomized Trial in Niger. Full Text available with Trip Pro

Macrolide Resistance in MORDOR I - A Cluster-Randomized Trial in Niger. 31167060 2019 06 18 2019 06 18 1533-4406 380 23 2019 06 06 The New England journal of medicine N. Engl. J. Med. Macrolide Resistance in MORDOR I - A Cluster-Randomized Trial in Niger. 2271-2273 10.1056/NEJMc1901535 Doan Thuy T Francis I. Proctor Foundation, San Francisco, CA thuy.doan@ucsf.edu. Arzika Ahmed M AM Carter Center, Niamey, Niger. Hinterwirth Armin A Francis I. Proctor Foundation, San Francisco, CA. Maliki (...) , CA. MORDOR Study Group eng ClinicalTrials.gov NCT02047981 United States N Engl J Med 0255562 0028-4793 0 Anti-Bacterial Agents 0 Macrolides 83905-01-5 Azithromycin AIM IM N Engl J Med. 2019 Jun 6;380(23):2264-2265 31167057 N Engl J Med. 2019 Nov 28;381(22):2184 31774978 Administration, Oral Anti-Bacterial Agents pharmacology therapeutic use Azithromycin therapeutic use Child, Preschool Drug Resistance, Bacterial Humans Infant Macrolides pharmacology therapeutic use Niger Pneumococcal Infections

2019 The New England journal of medicine Controlled trial quality: uncertain

44. Species Distribution and Macrolide Susceptibility of <i>Mycobacterium fortuitum</i> Complex Clinical Isolates. Full Text available with Trip Pro

Species Distribution and Macrolide Susceptibility of Mycobacterium fortuitum Complex Clinical Isolates. The understanding of species distribution and inducible macrolide resistance in the Mycobacterium fortuitum complex (MFC) is limited. Of 90 mostly respiratory MFC clinical isolates, half were M. fortuitum, followed by M. peregrinum, M. porcinum, M. septicum, and M. conceptionense Most M. fortuitum, M. porcinum, and M. septicum isolates were inducibly resistant to clarithromycin

2019 Antimicrobial Agents and Chemotherapy

45. Comparative risks of chronic inhaled corticosteroids and macrolides for bronchiectasis. (Abstract)

Comparative risks of chronic inhaled corticosteroids and macrolides for bronchiectasis. Non-cystic fibrosis bronchiectasis ("bronchiectasis") is a chronic airway disease for which little data exist to inform treatment decisions. We sought to compare the risks of respiratory infections in chronic users of inhaled corticosteroids (ICS) versus macrolide monotherapy.We identified a cohort of U.S. Medicare enrollees with a bronchiectasis diagnosis (494.0/494.1) between 2006 and 2014, excluding (...) cystic fibrosis. We defined chronic new use as the first 28+ day prescription of ICS or macrolide monotherapy. We compared characteristics of the exposure cohorts using standardised mean differences (SMD) and computed a propensity score (PS) to account for treatment differences. The risks of acute exacerbation, hospitalised respiratory infection, all-cause hospitalisation, and mortality were compared using PS decile-adjusted Cox regression models.We identified 83 589 new users of ICS and 6500

2019 European Respiratory Journal

46. Macrolides inhibit capsule formation of highly virulent <i>Cryptococcal gattii</i> and promotes innate immune susceptibility. Full Text available with Trip Pro

Macrolides inhibit capsule formation of highly virulent Cryptococcal gattii and promotes innate immune susceptibility. Cryptococcus gattii is a fungal pathogen, endemic in tropical and subtropical regions, the west coast of Canada and the United States, causes a potentially fatal infection in otherwise healthy individuals. Because the cryptococcal polysaccharide capsule is a leading virulence factor due to its resistance against innate immunity, the inhibition of capsule formation may (...) be a promising new therapeutic strategy for Cgattii Macrolides have numerous non-antibiotic effects including immunomodulation of mammalian cells and suppression of bacterial (but not fungal) pathogenicity. Thus, we hypothesized that a macrolide would inhibit cryptococcal capsule formation and improve the host immune response. Co-incubation with clarithromycin and azithromycin significantly reduced the capsule thickness and the amount of capsular polysaccharide of both Cgattii and C. neoformas CAM-treated C

2019 Antimicrobial Agents and Chemotherapy

47. Structure of dirithromycin bound to the bacterial ribosome suggests new ways for rational improvement of macrolides. Full Text available with Trip Pro

Structure of dirithromycin bound to the bacterial ribosome suggests new ways for rational improvement of macrolides. Although macrolides are known as excellent antibacterials, their medical use has been significantly limited due to the spread of bacterial drug resistance. Therefore, it is necessary to develop new potent macrolides to combat the emergence of drug-resistant pathogens. One of the key steps in rational drug design is the identification of chemical groups that mediate drug binding (...) to its target and their subsequent derivatization to strengthen drug-target interactions. In the case of macrolides, a few groups are known to be important for drug binding to the ribosome, such as desosamine. Search for the new chemical moieties improving the interactions of a macrolide with the 70S ribosome might be of crucial importance for the invention of new macrolides. For this purpose, here we studied a "classic" macrolide dirithromycin, which has extended (2-methoxyethoxy)-methyl side chain

2019 Antimicrobial Agents and Chemotherapy

48. Bordetella pertussis Infection in Infants and Young Children in Shanghai, China, 2016-2017: Clinical Features, Genotype Variations of Antigenic Genes and Macrolides Resistance. (Abstract)

Bordetella pertussis Infection in Infants and Young Children in Shanghai, China, 2016-2017: Clinical Features, Genotype Variations of Antigenic Genes and Macrolides Resistance. The global resurgence of pertussis in countries with high vaccination coverage has been a concern of public health.Nasopharyngeal swabs were collected for Bordetella pertussis culture from children with suspected pertussis. Clinical and vaccination information were reviewed through electronic medical chart (...) (17.7%) had completed at least 3 doses of DTaP and 75 (53.2%) had a clear exposure to household members with persistent cough. Fully vaccinated cases manifested milder disease than unvaccinated and not-fully vaccinated cases. All strains were MLST2. High-virulent strains characteristic of ptxP3/prn2/ptxC2 constituted 41.1% (58/141) and were all susceptible to macrolides while low-virulent strains characteristic of ptxP1/prn1/ptxC1 constituted 58.9% (83/141) and 97.6% (81/83), respectively, were

2019 Pediatric Infectious Dsease Journal

49. Mycoplasma genitalium in symptomatic male urethritis: macrolide use is associated with increased resistance. Full Text available with Trip Pro

Mycoplasma genitalium in symptomatic male urethritis: macrolide use is associated with increased resistance. Mycoplasma genitalium (Mg) causes symptomatic urethritis in men, and can infect alone or together with other STI agents.The prevalence of Mg and other STIs were determined in 1816 men with symptomatic urethritis. Resistance of Mg to macrolides and fluoroquinolones was determined by sequencing; the impact of recent antimicrobial usage on the distribution of Mg single or mixed infections (...) was determined.Overall, prevalence of Mg infection was 19.7% (358/1816). 54.1% (166/307) of Mg infections occurred alone in the absence of other STI agents. Men with single Mg infection self-administered or were prescribed antibiotics more often in the 30 days prior to enrollment than subjects with urethritis caused by Mg coinfection (P<0.0001). Higher rates (96.7%) of infection with macrolide resistance in Mg were identified in men who had taken macrolides prior to enrollment (P< 0.03). Overall, 88.9% (303/341

2019 Clinical Infectious Diseases

50. Impact of Previous Exposure to Macrolide Antibiotics on Helicobacter pylori Infection Treatment Outcomes. (Abstract)

Impact of Previous Exposure to Macrolide Antibiotics on Helicobacter pylori Infection Treatment Outcomes. Helicobacter pylori (H. pylori) guidelines, including the recent ACG clinical guideline, recommend avoiding clarithromycin-based triple therapy (TT-C) among patients with past macrolide exposure. Data to support this recommendation are scarce, and the impact of macrolide exposure on quadruple therapies is unclear. We aimed to determine the impact of macrolide exposure on the efficacy of H (...) . pylori treatment in our region.We searched the Clalit Health Services database to identify subjects aged 25-60 years who underwent the first-ever C-urea breath test between 2010 and 2015. Patients who underwent a previous H. pylori stool antigen test or gastroscopy were excluded. Pharmacy dispensation data were retrieved.We identified 7,842 subjects (36.1% male individuals, age: 40.3 ± 10.5 years), including 3,062 (39.0%) with previous macrolide exposure. The efficacy of TT-C was 74.3% and 82.4

2019 American Journal of Gastroenterology

51. <i>In Vitro</i> Activity of Bedaquiline and Delamanid Against Nontuberculous Mycobacteria Including Macrolide-Resistant Clinical Isolates. Full Text available with Trip Pro

In Vitro Activity of Bedaquiline and Delamanid Against Nontuberculous Mycobacteria Including Macrolide-Resistant Clinical Isolates. We evaluated the in vitro activities of the antimicrobial drugs bedaquiline and delamanid against the major pathogenic nontuberculous mycobacteria (NTM). Delamanid showed high MIC values for all NTM except Mycobacterium kansasii However, bedaquiline showed low MIC values for the major pathogenic NTM, including M. avium complex, M. abscessus, M. massiliense (...) , and M. kansasii Bedaquiline also had low MIC values with macrolide-resistant NTM and warrants further investigation as a potential antibiotic for NTM treatment.Copyright © 2019 American Society for Microbiology.

2019 Antimicrobial Agents and Chemotherapy

52. Macrolide-Resistant Mycoplasma genitalium in Southeastern Region of the Netherlands, 2014-2017. Full Text available with Trip Pro

Macrolide-Resistant Mycoplasma genitalium in Southeastern Region of the Netherlands, 2014-2017. Mycoplasma genitalium infections of the urogenital tract are usually treated with azithromycin; however, for the past several years, rates of azithromycin treatment failure have increased. To document the occurrence and frequency of macrolide resistance-mediating mutations (MRMMs) in M. genitalium infections, we collected 894 M. genitalium-positive samples during April 2014-December 2017

2019 Emerging Infectious Diseases

53. Emerging <i>erm</i>(B)-Mediated Macrolide Resistance Associated with Novel Multidrug Resistance Genomic Islands in <i>Campylobacter</i>. Full Text available with Trip Pro

Emerging erm(B)-Mediated Macrolide Resistance Associated with Novel Multidrug Resistance Genomic Islands in Campylobacter. The rapid dissemination of the macrolide resistance gene erm(B) will likely compromise the efficacy of macrolides as the treatment of choice for campylobacteriosis. More importantly, erm(B) is always associated with several multidrug resistance genomic islands (MDRGIs), which confer resistance to multiple other antimicrobials. Continuous monitoring (...) of the emergence of erm(B) and analysis of its associated genetic environments are crucial for our understanding of macrolide resistance in Campylobacter In this study, 290 Campylobacter isolates (216 Campylobacter coli isolates and 74 Campylobacter jejuni isolates) were obtained from 1,039 fecal samples collected in 2016 from pigs and chickens from three regions of China (344 samples from Guangdong, 335 samples from Shanghai, and 360 samples from Shandong). Overall, 74 isolates (72 C. coli isolates and 2 C

2019 Antimicrobial Agents and Chemotherapy

54. Risk of mortality and cardiovascular events following macrolide prescription in chronic rhinosinusitis patients: a cohort study using linked primary care electronic health records. Full Text available with Trip Pro

Risk of mortality and cardiovascular events following macrolide prescription in chronic rhinosinusitis patients: a cohort study using linked primary care electronic health records. Macrolide antibiotics have demonstrated important anti-inflammatory and immunomodulatory properties in chronic rhinosinusitis (CRS) patients. However, reports of increased risks of cardiovascular events have led to safety concerns. We investigated the risk of all-cause and cardiac death, and cardiovascular outcomes (...) , associated with macrolide use.Observational cohort (1997-2016) using linked data from the Clinical Practice Research Datalink, Hospital Episodes Statistics, and the Office for National Statistics. Patients aged 16-80 years with CRS prescribed a macrolide antibiotic or penicillin were included, comparing prescriptions for macrolide antibiotics to penicillin. Outcomes were all-cause mortality, cardiac death, myocardial infarction, stroke, diagnosis of peripheral vascular disease, and cardiac

2019 Rhinology

55. An adult case of severe life-threatening Mycoplasma pneumoniae pneumonia due to a macrolide-resistant strain, Japan: a case report. Full Text available with Trip Pro

An adult case of severe life-threatening Mycoplasma pneumoniae pneumonia due to a macrolide-resistant strain, Japan: a case report. Until now, the prevalence of macrolide-resistant Mycoplasma pneumoniae (MP) infection among adult patients has been low, and severe MP pneumonia due to a macrolide-resistant strain has seldom been reported. Here, we describe a rare case of severe life-threatening MP pneumonia due to a macrolide-resistant strain in an adult, which was finally treated (...) with fluoroquinolone and tetracycline after failed treatment with macrolide and corticosteroid.A 39-year-old apparently healthy woman complained of fever and productive cough. Three days after onset, she was admitted to a local general hospital. On admission, her vital signs were stable except for high-grade fever. The patient's chest X-ray and chest computed tomography images revealed subsegmental consolidation in her right lower lobe. Treatment with ampicillin/sulbactam, and azithromycin were initiated under

2019 BMC Infectious Diseases

56. A review of non-cystic fibrosis bronchiectasis in children with a focus on the role of long-term treatment with macrolides. (Abstract)

A review of non-cystic fibrosis bronchiectasis in children with a focus on the role of long-term treatment with macrolides. Bronchiectasis is a rare chronic airway disease arising from several respiratory and systemic diseases. The grade of evidence for specific treatment of childhood bronchiectasis unrelated to cystic fibrosis (CF) is low with very few randomized controlled trials. Treatment has been based mainly on evidence from studies in adults with non-cystic fibrosis bronchiectasis (...) and patients with cystic fibrosis. Recently, long-term treatment with macrolides has been proposed. These molecules offer the advantage of anti-inflammatory and immunomodulatory properties in addition to their antibacterial properties. A total of three randomized double-blind placebo-controlled trials conducted in adults showed that macrolides taken for 6-12 months led to a significant reduction in exacerbation rates. Only one long-term, randomized double-blind placebo-controlled trial was conducted

2019 Pediatric pulmonology Controlled trial quality: predicted high

57. Treatment with a macrolide-containing regimen for Mycobacterium kansasii pulmonary disease. (Abstract)

Treatment with a macrolide-containing regimen for Mycobacterium kansasii pulmonary disease. Mycobacterium kansasii is a major pathogen associated with nontuberculous mycobacterial pulmonary disease. For treatment of M. kansasii pulmonary disease, daily therapy with isoniazid, rifampin, and ethambutol is traditionally recommended. Although a regimen containing a macrolide, instead of isoniazid, has been recently recommended, supporting data are limited. We compared the treatment outcomes (...) of a macrolide-containing regimen (macrolide group) and an isoniazid-containing regimen (isoniazid group) on patients with M. kansasii pulmonary disease.A total of 49 patients were identified between January 2002 and December 2016. Treatment outcomes for the isoniazid group (n = 24) and the macrolide group (n = 25) were compared.Baseline characteristics of the isoniazid and macrolide groups were similar. Favorable outcomes did not differ between the isoniazid group (79%, n = 19) and macrolide group (88%, n 

2019 Respiratory medicine

58. Staphylococcus aureus with an erm-mediated constitutive macrolide-lincosamide-streptogramin B resistance phenotype has reduced susceptibility to the new ketolide, solithromycin. Full Text available with Trip Pro

Staphylococcus aureus with an erm-mediated constitutive macrolide-lincosamide-streptogramin B resistance phenotype has reduced susceptibility to the new ketolide, solithromycin. Solithromycin, the fourth generation of ketolides, has been demonstrated potent antibacterial effect against commonly-isolated gram-positive strains. However, Staphylococcus aureus (S. aureus) strains with a higher solithromycin MIC have already been emerged, the mechanism of which is unknown.Antimicrobial (...) of the erm gene between the constitutive macrolide-lincosamide-streptogramin B (cMLSB)- and inducible MLSB (iMLSB)-phenotypes.In the erm-positive S. aureus strains, the minimum inhibitory concentration (MIC)50/90 of solithromycin (2/> 16 mg/L) was significantly higher than that in the erm-negative strains (0.125/0.25 mg/L). Of note, the MIC50 value of the strains with iMLSB (0.25 mg/L) was significantly lower than that of the strains with cMLSB (4 mg/L). A comparison among strains demonstrated

2019 BMC Infectious Diseases

59. Rapid molecular detection of macrolide resistance. Full Text available with Trip Pro

Rapid molecular detection of macrolide resistance. Emerging antimicrobial resistance is a significant threat to human health. However, methods for rapidly diagnosing antimicrobial resistance generally require multi-day culture-based assays. Macrolide efflux gene A, mef(A), provides resistance against erythromycin and azithromycin and is known to be laterally transferred among a wide range of bacterial species.We use Recombinase Polymerase Assay (RPA) to detect the antimicrobial resistance gene

2019 BMC Infectious Diseases

60. Idiopathic chronic productive cough and response to open-label macrolide therapy: An observational study. Full Text available with Trip Pro

Idiopathic chronic productive cough and response to open-label macrolide therapy: An observational study. Adult patients with chronic productive cough of unknown cause are commonly seen in respiratory clinics. We have previously described a subgroup of these patients who have a short-lived response to standard antibiotic treatment but a prolonged response to 3 months of low-dose azithromycin therapy.This observational study describes the physiological, radiological and pathological features

2019 Respirology

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