{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T12:31:35Z","timestamp":1773145895665,"version":"3.50.1"},"reference-count":12,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T00:00:00Z","timestamp":1589846400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Mycoplasma pneumoniae<\/jats:italic> is one of the most common bacterial causes of pneumonia. Macrolide\u2010resistant <jats:italic>M\u00a0pneumoniae<\/jats:italic> (MRMP) was documented in 7.5% of isolates in the United States. Resistance portends poor outcomes to macrolide therapy, yet patients respond well to fluoroquinolones or tetracyclines such as minocycline. However, MRMP may be under\u2010appreciated because <jats:italic>M\u00a0pneumoniae<\/jats:italic> generally causes relatively mild infections in non\u2010immunosuppressed adults that may resolve without effective therapy and because microbiological confirmation and susceptibility are not routinely performed. We report two cases of pneumonia due to MRMP in kidney transplant recipients. Both patients required hospital admission, worsened on macrolide therapy, and rapidly defervesced on doxycycline or levofloxacin. In one case, <jats:italic>M\u00a0pneumoniae<\/jats:italic> was only identified by multiplex respiratory pathogen panel analysis of BAL fluid. Macrolide resistance was confirmed in both cases by real\u2010time PCR and point mutations associated with macrolide resistance were identified. <jats:italic>M\u00a0pneumoniae<\/jats:italic> was isolated from both cases, and molecular genotyping revealed the same genotype. In conclusion, clinicians should be aware of the potential for macrolide resistance in <jats:italic>M\u00a0pneumoniae<\/jats:italic>, and may consider non\u2010macrolide\u2010based therapy for confirmed or non\u2010responding infections in patients who are immunocompromised or hospitalized.<\/jats:p>","DOI":"10.1111\/tid.13318","type":"journal-article","created":{"date-parts":[[2020,5,9]],"date-time":"2020-05-09T12:27:25Z","timestamp":1589027245000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Macrolide\u2010resistant <i>Mycoplasma pneumoniae<\/i> pneumonia in transplantation: Increasingly typical?"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5971-0531","authenticated-orcid":false,"given":"Gregory A.","family":"Eschenauer","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy University of Michigan College of Pharmacy Ann Arbor MI 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N.","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Internal Medicine Michigan Medicine \u2010 University of Michigan Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"IV","given":"James","family":"Riddell","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Internal Medicine Michigan Medicine \u2010 University of Michigan Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel R","family":"Kaul","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Internal Medicine Michigan Medicine \u2010 University of Michigan Ann Arbor MI 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