Table 1. Mycoplasma pneumoniae detection methods, percent of positive samples and macrolide resistance monitoring by country, 11 countries in Europe and Israel, 2011–2016.

Country	Nucleic acid amplification test		Culture		Serology		Total number of positive samples	Total number of negative samples	Percent of positive samples (%)	Macrolide resistance monitoring
	Performed	Number of positive detections	Performed	Number of positive detections	Performed	Number of positive detections
Belgium	Yes	894	Yes	49	Yes	12,047	21,094a	ND	NA	Only monitored when samples test positive at the NRC. No testing in sentinel laboratories.
Denmark	Yes	20,081	No	NA	No	NA	20,081	264,770	7.0	No routine surveillance system in place. In 2010/11, 2011/12 and 2015/16, 809 samples were examined identifying 13 macrolide resistance-associated mutations (1.5%). Samples are investigated upon physician request.
France	Yes	92	Yes	53b	Yes	298	390	7,463	5.0	Performed on all clinical specimens detected as M. pneumoniae-positive by NAAT since 2013 [13].
Germany	Yes	127	No	NA	Yes	316	443	10,143	4.2	No comment
Greece	No	NA	No	NA	Yes	140	140	1,498	8.5	Information not provided
Hungary	Yes	17	No	NA	Yes	1,117	1,134	6,109	15.7	Information not provided
Ireland	No	NA	No	NA	Yes	535	535	2,853	15.8	Information not provided
Israel	Yes	848	No	NA	No	NA	848	5,309	13.8	No active monitoring.
Norway	Yes	13,980	No	NA	Yes	10,678	24,658	ND	NA	Information not provided
Slovenia	Yes	1,172	Yes	827	No	NA	1,172	8,872	11.7	Only upon physician request
Sweden	Yes	9,499	No	NA	Yes	10,024	19,523	169,501	10.3	No active monitoring.
United Kingdom (excluding Northern Ireland)	Yes	385	No	NA	Yes	5,263	5,648	ND	NA	No national system. All positive samples referred to PHE are tested.
Total	NA	47,095	NA	876	NA	40,418	95,666	476,518	NA	NA

NA: not applicable; NAAT: Nucleic acid amplification test; ND: no data available; NRC: National Reference Centre; PHE: Public Health England.

^a Method of detection not known for sentinel laboratories.

^b Not included in the overall total for the purpose of de-duplication as these 53 samples were already listed in NAAT or serological counts.

Responses were received to state M. pneumoniae testing and surveillance is not in place on a national scale or case data were not available within the timespan of the survey from European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Mycoplasma Infections (ESGMI) members from Cyprus, Malta, the Netherlands, Poland, Slovakia or Spain.