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Mycoplasma pneumoniae, a major pathogen causing community-acquired pneumonia, has a reduced genome of [approximately equal to]800 kb, which has been relatively stable over time and geographic distance (1). Widespread use [...]

Streptococcus pneumoniae is a major human pathogen that causes bacteremia, meningitis, pneumonia, and sepsis (1). Although the use of pneumococcal conjugate vaccines (PCVs) has dramatically decreased incidence rates of diseases [...]

Genomic changes in Mycoplasma pneumoniae caused by adaptation to environmental or ecologic pressures are poorly understood. We collected M. pneumoniae from children who had confirmed pneumonia in Taiwan during 2017-2020. We used whole-genome sequencing to compare these isolates with a worldwide collection of current and historical clinical strains for characterizing population structures. A phylogenetic tree for 284 strains showed that all sequenced strains consisted of 5 clades: T1-1 (sequence type [ST]1), T1-2 (mainly ST3), T1-3 (ST17), T2-1 (mainly ST2), and T2-2 (mainly ST14). We identified a putative recombination block containing 6 genes (MPN366‒371). Macrolide resistance involving 23S rRNA mutations was detected for each clade. Clonal expansion of macrolide resistance occurred mostly within subtype 1 strains, of which clade T1-2 showed the highest recombination rate and genome diversity. Functional characterization of recombined regions provided clarification of the biologic role of these recombination events in the evolution of M. pneumoniae. [ABSTRACT FROM AUTHOR]