from therapeutic ML use. Although type 3-5-62, 2c strain, as well as type 4-5-7-3, 1 strain, had
１． Atkinson TP, Balish MF, Waites KB: Epidemiology,
low prevalence in Yamagata Prefecture prior to
clinical manifestations, pathogenesis and laboratory
detection of Mycoplasma pneumoniae infections. FEMS
2011
, ML-resistant type 3-5-6-2, 2c strain did not
11）
12）
appear throughout its epidemic period. However, we
previously reported that ML resistance-associated
mutation emerged after ML treatment in a child
infected with type 3-5-6-2, 2c M. pneumoniae as well
as in children infected with type 4-5-7-3, 113）. Hence,
our current findings suggest that type 3-5-6-2, 2c M.
pneumoniae with a ML resistance-associated mutation
has poor transmission ability compared with other
genotypes. Further surveillance is needed to clarify
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２． Waites KB, Talkington DF: Mycoplasma pneumoniae
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３． Foy HM: Infections caused by Mycoplasma pneumoniae
and possible carrier state in different populations of
patients. Clin Infect Dis 1993; 17: S37-46
４． Block S, Hedrick J, Hammerschlag MR, Cassell
GH, Craft JC: Mycoplasma pneumoniae and Chlamydia
pneumoniae in pediatric community- acquired
the potential emergence of a ML-resistant type 3-5-6-
pneumonia: comparative efficacy and safety of
2, 2c strain in this area.
clarithromycin vs. erythromycin ethylsuccinate. Pediatr
There are several limitations in this study. First,
this study was conducted based on M. pneumoniae
Infect Dis J 1995; 14: 471-477
５． Korppi M, Heiskanen-Kosma T, Kleemola M:
Incidence of community-acquired pneumonia in children
caused by Mycoplasma pneumoniae: serological results of
strains isolated from patients who visited only two
pediatric clinics. The two clinics are located in
a prospective, population-based study in primary health
Yamanobe Town and Yamagata City of Yamagata
Prefecture; therefore, obtained findings may not
reflect the situation of the whole prefecture. Second,
we could not collect clinical information on anything
except clinical diagnosis; therefore, we could not
care. Respirology 2004; 9: 109-114
６． Yamazaki T, Kenri T: Epidemiology of Mycoplasma
pneumoniae Infections in Japan and Therapeutic
Strategies for Macrolide-Resistant M. pneumoniae. Front
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sufficiently compare severity among patients
who were infected with different genotypes of M.
７． Sasaki T, Kenri T, Okazaki N, Iseki M, Yamashita R,
Shintani M, et al. : Epidemiological study of Mycoplasma
pneumoniae. Our study was restricted to a local area
pneumoniae infections in Japan based on PCR-restriction
fragment length polymorphism of the P1 cytadhesin
and retrospectively performed; however, no similar
studies that described regional difference in the
prevalence of ML resistance-associated mutation by
gene. J Clin Microbiol 1996; 34: 447-449
８． Dégrange S, Cazanave C, Charron A, Renaudin H,
combining the molecular typing results is reported
from other areas in Japan.
In summary, this study reveals that the three
distinct genotypes of M. pneumoniae geographically
－23－
Bébéar C, Bébéar CM: Development of multiple-locus
variable-number tandem-repeat analysis for molecular
typing of Mycoplasma pneumoniae. J Clin Microbiol 2009;
47: 914-923
Suzuki，Seto，Shimotai，Itagaki，Katsushima，Katsushima，Ikeda，Mizuta，Hongo，Matsuzaki
９．
Pereyre S, Goret J, Bébéar C: Mycoplasma pneumoniae:
current knowledge on macrolide resistance and
Period. Jpn J Infect Dis 2017; 70: 642-646
12．
Suzuki Y, Seto J, Itagaki T, Aoki T, Abiko C,
treatment. Front Microbiol 2016; 7: 974
Matsuzaki Y: Gene mutations associated with
macrolide-resistance p1 gene typing of Mycoplasma
10. Suzuki Y, Seto J, Shimotai Y, Itagaki T, Katsushima
Y, Katsushima F, et al. : Polyclonal spread of multiple
genotypes of Mycoplasma pneumoniae in semi-closed
pneumoniae isolated in Yamagata, Japan, between 2004
settings in Yamagata, Japan. J Med Microbiol 2019; 68:
in Japanese）
785-790
and 2013. Kansenshogaku Zasshi 2015; 89: 16-22（Article
13． Suzuki Y, Shimotai Y, Itagaki T, Seto J, Ikeda T,
11. Suzuki Y, Seto J, Shimotai Y, Itagaki T, Katsushima Y,
Yahagi K, et al. : Development of macrolide resistance-
Katsushima F, et al. : Multiple-Locus Variable-Number
Tandem-Repeat Analysis of Mycoplasma pneumoniae
associated mutations after macrolide treatment in
children infected with Mycoplasma pneumoniae. J Med
Isolates between 2004 and 2014 in Yamagata, Japan:
Microbiol 2017; 66: 1531-1538
Change in Molecular Characteristics during an 11-year
－24－
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