{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:14:50Z","timestamp":1785420890558,"version":"3.56.0"},"reference-count":18,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["ASM Case Rep"],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:sec>\n                      <jats:title>Background<\/jats:title>\n                      <jats:p>\n                        <jats:italic toggle=\"yes\">Mycoplasma pneumoniae<\/jats:italic>\n                        (MPN) is a major pathogen of community-acquired respiratory tract infections, and macrolides are the drug of choice for treating MPN infections. Macrolide resistance in our patient population has been low; however, an increase in resistance rates was observed during a recent resurgence.\n                      <\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>Case Summary<\/jats:title>\n                      <jats:p>\n                        A previously healthy 11-year-old male was diagnosed with MPN infection and received azithromycin treatment. His symptoms continued after two courses of azithromycin, and he tested positive for MPN DNA three times. Sanger sequencing of samples collected after his first course of azithromycin revealed a mutation conferring macrolide resistance, while the sample collected before the initiation of antibiotics did not. Additionally, whole genome sequencing (WGS) and single-nucleotide polymorphism (SNP) analysis demonstrated that samples collected before and after receiving azithromycin differed by one SNP, indicating that the two isolates are the same strain, and the development of macrolide resistance occurred\n                        <jats:italic toggle=\"yes\">de novo<\/jats:italic>\n                        during treatment.\n                      <\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>Conclusion<\/jats:title>\n                      <jats:p>\n                        Our case utilized WGS to confirm that the development of\n                        <jats:italic toggle=\"yes\">de novo<\/jats:italic>\n                        macrolide resistance can occur rapidly following macrolide use. Clinicians should be vigilant for macrolide treatment failure and consider alternative drugs if symptoms persist or there are signs of clinical deterioration.\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/asmcr.00088-25","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T09:00:21Z","timestamp":1751446821000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Whole genome sequencing confirmed the\n                    <i>de novo<\/i>\n                    development of macrolide resistance in a child with\n                    <i>Mycoplasma pneumoniae<\/i>\n                    infection receiving azithromycin treatment"],"prefix":"10.1128","volume":"1","author":[{"given":"Huanyu","family":"Wang","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/003rfsp33","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pathology and Laboratory Medicine, Nationwide Children\u2019s Hospital","place":["Columbus, USA"]},{"id":[{"id":"https:\/\/ror.org\/00rs6vg23","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pathology, The Ohio State University","place":["Columbus, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9372-3491","authenticated-orcid":true,"given":"Sophonie J.","family":"Oyeniran","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/003rfsp33","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pathology and Laboratory Medicine, Nationwide Children\u2019s Hospital","place":["Columbus, 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