Increased rates of intensive care unit admission in patients with Mycoplasma pneumoniae: a retrospective study. (August 2016)

• Record Type: Journal Article
• Authors: Khoury, T.; Sviri, S.; Rmeileh, A.A.; Nubani, A.; Abutbul, A.; Hoss, S.; van Heerden, P.V.; Bayya, A.E.; Hidalgo-Grass, C.; Moses, A.E.; Nir-Paz, R.
• Is Part Of: Clinical microbiology and infection. Volume 22:Number 8(2016)
• Page Start: 711
• Page End: 714
• Publication Date: 2016-08
• Subjects: Disease severity -- Intensive care unit -- Mortality -- Mycoplasma pneumoniae -- Pneumonia; Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1016/j.cmi.2016.05.028
• Languages: English
• ISSNs: 1198-743X

Abstract

Abstract: Mycoplasma pneumoniae is a leading cause of respiratory disease. In the Intensive Care Unit (ICU) setting M. pneumoniae is not considered a common pathogen. In 2010–13 an epidemic of M. pneumoniae -associated infections was reported and we observed an increase of M. pneumoniae patients admitted to ICU. We analysed the cohort of all M. pneumoniae -positive patients' admissions during 2007 to 2012 at the Hadassah-Hebrew University Medical Centre (a 1100-bed tertiary medical centre). Mycoplasma pneumoniae diagnosis was made routinely using PCR on throat swabs and other respiratory samples. Clinical parameters were retrospectively extracted. We identified 416 M. pneumoniae -infected patients; of which 68 (16.3%) were admitted to ICU. Of these, 48% (173/416) were paediatric patients with ICU admission rate of 4.6% (8/173). In the 19- to 65-year age group ICU admission rate rose to 18% (32/171), and to 38.8% (28/72) for patients older than 65 years. The mean APACHE II score on ICU admission was 20, with a median ICU stay of 7 days, and median hospital stay of 11.5 days. Of the ICU-admitted patients, 54.4% (37/68) were mechanically ventilated upon ICU admission. In 38.2% (26/68), additional pathogens were identified mostly later as secondary pathogens. A concomitant cardiac manifestation occurred in up to 36.8% (25/68) of patients. The in-hospital mortality was 29.4% (20/68) and correlated with APACHE II score. Contrary to previous reports, a substantial proportion (16.3%) of our M. pneumoniae -infected patients required ICU admission, especially in the adult population, with significant morbidity and mortality.