Mycoplasma pneumoniae in pediatric patients: Do macrolide-resistance and/or delayed treatment matter?

Mycoplasma pneumoniae is a common pathogen for pneumonia in children, especially in the post-pneumococcal conjugate vaccination era. Though self-limited disease was found in the majority of the patients, severe diseases occurred occasionally. The emergence of macrolide resistance was reported worldw...

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Published in:Journal of microbiology, immunology and infection immunology and infection, 2019-04, Vol.52 (2), p.329-335
Main Authors: Yang, Tzu-I, Chang, Tu-Hsuan, Lu, Chun-Yi, Chen, Jong-Min, Lee, Ping-Ing, Huang, Li-Min, Chang, Luan-Yin
Format: Article
Language:English
Subjects:
Adolescent
Anti-Bacterial Agents - therapeutic use
Bacterial Load
Child
Child, Preschool
Coinfection
Drug Resistance, Bacterial - genetics
Female
Fever
Hospitals
Humans
Infant
Infant, Newborn
Macrolides - pharmacology
Male
Mycoplasma pneumoniae
Mycoplasma pneumoniae - drug effects
Mycoplasma pneumoniae - pathogenicity
Pneumonia - diagnosis
Pneumonia - drug therapy
Pneumonia - microbiology
Pneumonia, Mycoplasma - diagnosis
Pneumonia, Mycoplasma - drug therapy
Polymerase Chain Reaction
Resistance
Retrospective Studies
Taiwan
Tertiary Care Centers
Time-to-Treatment
Treatment
Treatment Outcome
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Summary:Mycoplasma pneumoniae is a common pathogen for pneumonia in children, especially in the post-pneumococcal conjugate vaccination era. Though self-limited disease was found in the majority of the patients, severe diseases occurred occasionally. The emergence of macrolide resistance was reported worldwide. It is important to delineate whether macrolide resistance or delayed treatment affects outcome. We retrospectively collected pediatric patients with M. pneumoniae infection confirmed by positive PCR in a tertiary medical center in Taiwan from 2010 to 2017. Patients’ clinical characteristics, bacterial load, macrolide resistance and treatment outcome were analyzed. Among 471 children with positive M. pneumoniae PCR, 95% were diagnosed with pneumonia. Seventeen percent of patients had extrapulmonary complications, and 1.5% had respiratory failure. Delayed treatment was associated with prolonged fever after appropriate treatment, fulminant disease, and extrapulmonary manifestations (p 
ISSN:1684-1182
1995-9133
DOI:10.1016/j.jmii.2018.09.009