Increased rates of Intensive Care Unit admission in patients with Mycoplasma pneumoniae: a retrospective study.
Clin Microbiol Infect. 2016 Jun 10;
Authors: Khoury T, Sviri S, Abu Rmeileh A, Nubani A, Abutbul A, Hoss S, van Heerden PV, El-Raouf Bayya A, Hidalgo-Grass C, Moses AE, Nir-Paz R
OBJECTIVES: 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 2010-2013 an epidemic of M. pneumoniae-associated infections was reported and we observed an increase of M. pneumoniae patients admitted to ICU.
METHODS: We analyzed the cohort of all M. pneumoniae positive patients' admissions during 2007 to 2012 at the Hadassah-Hebrew University medical center (a 1000 bed tertiary medical center). M. pneumoniae diagnosis was done routinely using PCR on throat swabs and other respiratory samples. Clinical parameters were retrospectively extracted.
RESULTS: We identified 416 M. pneumoniae patients; of which 68 (16.3%) were ICU admitted. 48% (173/416) were pediatric patients with ICU admission rate of 4.6% (8/173). In the 19-65 age group ICU admission rate rose to 18% (32/171), and to 38.8% (28/72) in older than 65. 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. 54.4% (37/68) of ICU patients 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.
CONCLUSION: Contrary to previous reports, a substantial proportion (16.3%) of our M. pneumoniae patients' required ICU admission, especially in the adult population with significant morbidity and mortality.
PMID: 27297319 [PubMed - as supplied by publisher]