Epidemiology and clinical features of segmental/lobar pattern Mycoplasma pneumoniae pneumonia: A ten-year retrospective clinical study

Gao,Jian; Yue,Baozhu; Li,Haitao; Chen,Rong; Wu,Chunlian; Xiao,Mili

doi:10.3892/etm.2015.2818

Epidemiology and clinical features of segmental/lobar pattern Mycoplasma pneumoniae pneumonia: A ten-year retrospective clinical study

Authors:
- Jian Gao
- Baozhu Yue
- Haitao Li
- Rong Chen
- Chunlian Wu
- Mili Xiao
View Affiliations

Affiliations: Department of Pediatrics, Weifang Maternal and Child Health Hospital, Weifang, Shandong 261011, P.R. China, Pulmonary Department, Weifang Chest Hospital, Weifang, Shandong 261011, P.R. China, Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, P.R. China
Published online on: October 19, 2015 https://doi.org/10.3892/etm.2015.2818
Pages: 2337-2344

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Mycoplasma pneumoniae plays an important role in community-acquired pneumonia. However, epidemiological and clinical studies on the segmental/lobar pattern (S/L) radiographic‑pathologic subtype of pediatric Mycoplasma pneumoniae pneumonia (MPP) are rare. The current study retrospectively analyzed the epidemiological and clinical characteristics of pediatric MPP patients. A total of 1,933 children with MPP received treatment at a single hospital between 2000 and 2009, of which 684 (35.4%) were diagnosed with S/L‑MPP. The annual incidence of S/L‑MPP in children with MPP increased throughout the duration of this study (from 6.4 to 59.6%, P<0.001), which was particularly evident after 2003. S/L‑MPP was predominantly found in pre‑school‑aged children (4‑6 years old; 56.6%). Compared with non‑S/L‑MPP, S/L‑MPP was more closely associated with severe manifestations, including higher rates of fever (90.2 vs. 83.3%), pleural effusion (3.9 vs. 1.3%), extrapulmonary manifestations (26.2 vs. 21.2%), abnormal white blood cell counts (65.5 vs. 55.2%), abnormal C‑reactive protein levels (30.9 vs. 23.7%) and bacterial co‑infection (32.0 vs. 24.9%), as well as longer durations of fever (4.13±4.28 vs. 3.02±2.22 days) and hospitalization (12.70±4.54 vs. 9.22±5.12 days). Older S/L‑MPP patients showed higher rates and longer durations of fever and cough; however, they also displayed a lower rate of extrapulmonary manifestations when compared with younger patients. In conclusion, the annual incidence of S/L‑MPP has increased in recent years. Pre-school-aged children (4‑6 years) with MPP are more likely to display a segmental/lobar pattern, which is associated with more severe clinical manifestations than other MPP infection patterns.

View Figures

View References

1	Foy HM: Infections caused by Mycoplasma pneumoniae and possible carrier state in different populations of patients. Clin Infect Dis. 17(Suppl 1): S37–S46. 1993. View Article : Google Scholar : PubMed/NCBI
2	Marston BJ, Plouffe JF, File TM Jr, Hackman BA, Salstrom SJ, Lipman HB, Kolczak MS and Breiman RF: The Community-based Pneumonia Incidence Study Group: Incidence of community-acquired pneumonia requiring hospitalization: Results of a population-based active surveillance study in Ohio. Arch Intern Med. 157:1709–1718. 1997. View Article : Google Scholar : PubMed/NCBI
3	Waites KB and Talkington DF: Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev. 17:697–728. 2004. View Article : Google Scholar : PubMed/NCBI
4	Liu G, Talkington DF, Fields BS, Levine OS, Yang Y and Tondella ML: Chlamydia pneumoniae and Mycoplasma pneumoniae in young children from China with community-acquired pneumonia. Diagn Microbiol Infect Dis. 52:7–14. 2005. View Article : Google Scholar : PubMed/NCBI
5	Heiskanen-Kosma T, Korppi M, Jokinen C, Kurki S, Heiskanen L, Juvonen H, Kallinen S, Stén M, Tarkiainen A, Rönnberg PR, et al: Etiology of childhood pneumonia: Serologic results of a prospective, population-based study. Pediatr Infect Dis J. 17:986–991. 1998. View Article : Google Scholar : PubMed/NCBI
6	Phares CR, Wangroongsarb P, Chantra S, Paveenkitiporn W, Tondella ML, Benson RF, Thacker WL, Fields BS, Moore MR, Fischer J, et al: Epidemiology of severe pneumonia caused by Legionella longbeachae, Mycoplasma pneumoniae and Chlamydia pneumoniae: 1-year, population-based surveillance for severe pneumonia in Thailand. Clin Infect Dis. 45:e147–e155. 2007. View Article : Google Scholar : PubMed/NCBI
7	Korppi M, Heiskanen-Kosma T and Kleemola M: Incidence of community-acquired pneumonia in children caused by Mycoplasma pneumoniae: Serological results of a prospective, population-based study in primary health care. Respirology. 9:109–114. 2004. View Article : Google Scholar : PubMed/NCBI
8	Layani-Milon MP, Gras I, Valette M, Luciani J, Stagnara J, Aymard M and Lina B: Incidence of upper respiratory tract Mycoplasma pneumoniae infections among outpatients in Rône-Alpes, France, during five successive winter periods. J Clin Microbiol. 37:1721–1726. 1999.PubMed/NCBI
9	Principi N and Esposito S: Emerging role of Mycoplasma pneumoniae and Chlamydia pneumoniae in paediatric respiratory-tract infections. Lancet Infect Dis. 1:334–344. 2001. View Article : Google Scholar : PubMed/NCBI
10	John SD, Ramanathan J and Swischuk LE: Spectrum of clinical and radiographic findings in pediatric mycoplasma pneumonia. Radiographics. 21:121–131. 2001. View Article : Google Scholar : PubMed/NCBI
11	Nambu A, Saito A, Araki T, Ozawa K, Hiejima Y, Akao M, Ohki Z and Yamaguchi H: Chlamydia pneumoniae: Comparison with findings of Mycoplasma pneumoniae and Streptococcus pneumoniae at thin-section CT. Radiology. 238:330–338. 2006. View Article : Google Scholar : PubMed/NCBI
12	Reittner P, Muller NL, Heyneman L, Johkoh T, Park JS, Lee KS, Honda O and Tomiyama N: Mycoplasma pneumoniae pneumonia: Radiographic and high-resolution CT features in 28 patients. AJR Am J Roentgenol. 174:37–41. 2000. View Article : Google Scholar : PubMed/NCBI
13	Lee I, Kim TS and Yoon HK: Mycoplasma pneumoniae pneumonia: CT features in 16 patients. Eur Radiol. 16:719–725. 2006. View Article : Google Scholar : PubMed/NCBI
14	George RB, Weill H, Rasch JR, Mogabgab WJ and Ziskind MM: Roentgenographic appearance of viral and mycoplasmal pneumonias. Am Rev Respir Dis. 96:1144–1150. 1967.PubMed/NCBI
15	Murray HW, Masur H, Senterfit LB and Roberts RB: The protean manifestations of Mycoplasma pneumoniae infection in adults. Am J Med. 58:229–242. 1975. View Article : Google Scholar : PubMed/NCBI
16	Brolin I and Wernstedt L: Radiographic appearance of mycoplasmal pneumonia. Scand J Respir Dis. 59:179–189. 1978.PubMed/NCBI
17	Defilippi A, Silvestri M, Tacchella A, Giacchino R, Melioli G, Di Marco E, Cirillo C, Di Pietro P and Rossi GA: Epidemiology and clinical features of Mycoplasma pneumoniae infection in children. Respir Med. 102:1762–1768. 2008. View Article : Google Scholar : PubMed/NCBI
18	Esposito S, Blasi F, Bellini F, Allegra L and Principi N: Mowgli Study Group: Mycoplasma pneumoniae and Chlamydia pneumoniae infections in children with pneumonia. Eur Respir J. 17:241–245. 2001. View Article : Google Scholar : PubMed/NCBI
19	Foy HM, Kenny GE, McMahan R, Mansy AM and Grayston JT: Mycoplasma pneumoniae pneumonia in an urban area. Five years of surveillance. JAMA. 214:1666–1672. 1970. View Article : Google Scholar : PubMed/NCBI
20	Youn YS, Lee KY, Hwang JY, Rhim JW, Kang JH, Lee JS and Kim JC: Difference of clinical features in childhood Mycoplasma pneumoniae pneumonia. BMC Pediatr. 10:482010. View Article : Google Scholar : PubMed/NCBI
21	World Health Organization Pneumonia Vaccine Trial Investigators' Group. Standardization of interpretation of chest radiographs for the diagnosis of pneumonia in children. http://apps.who.int/iris/bitstream/10665/66956/1/WHO_V_and_B_01.35.pdfAccessed. November 29–2011
22	Daxboeck F, Bauer CC, Assadian O and Stanek G: An unrecognized epidemic of Mycoplasma pneumoniae infection in Vienna. Wien Klin Wochenschr. 118:208–211. 2006. View Article : Google Scholar : PubMed/NCBI
23	Musatovova O, Kannan TR and Baseman JB: Genomic analysis reveals Mycoplasma pneumoniae repetitive element 1-mediated recombination in a clinical isolate. Infect Immun. 76:1639–1648. 2008. View Article : Google Scholar : PubMed/NCBI
24	Nolevaux G, Bessaci-Kabouya K, Villenet N, Andrèoletti L, Laplanche D, Carquin J, Abély M, De Champs C and Motte J: Epidemiological and clinical study of Mycoplasma pneumoniae respiratory infections in children hospitalized in a pediatric ward between 1999 and 2005 at the Reims University Hospital. Arch Pediatr. 15:1630–1636. 2008.(In French). View Article : Google Scholar : PubMed/NCBI
25	Hong JY, Nah SG, Nam SG, Choi EH, Park JY and Lee HJ: Occurrence of Mycoplasma pneumoniae pneumonia in Seoul, Korea, from 1986–1995. Korean J Pediatr. 40:607–613. 1997.
26	Kang KS and Woo HO: Pattern of occurrence of Mycoplasma pneumoniae pneumonia in admitted children, southern central Korea, from 1989 to 2002. Korean J Pediatr. 46:474–479. 2003.
27	Principi N, Esposito S, Blasi F and Allegra L: Mowgli Study Group: Role of Mycoplasma pneumoniae and Chlamydia pneumoniae in children with community-acquired lower respiratory tract infections. Clin Infect Dis. 32:1281–1289. 2001. View Article : Google Scholar : PubMed/NCBI
28	Xu YC, Zhu LJ, Xu D, Tao XF, Li SX, Tang LF and Chen ZM: Epidemiological characteristics and meteorological factors of childhood Mycoplasma pneumoniae pneumonia in Hangzhou. World J Pediatr. 7:240–244. 2011. View Article : Google Scholar : PubMed/NCBI
29	Marrie TJ: Pneumococcal pneumonia: Epidemiology and clinical features. Semin Respir Infec. 14:227–236. 1999.
30	Toikka P, Juvén T, Virkki R, Leinonen M, Mertsola J and Ruuskanen O: Streptococcus pneumoniae and Mycoplasma pneumoniae coinfection in community acquired pneumonia. Arch Dis Child. 83:413–414. 2000. View Article : Google Scholar : PubMed/NCBI
31	Liu Y, Ye X, Zhang H, Xu X, Li W, Zhu D and Wang M: Antimicrobial susceptibility of Mycoplasma pneumoniae isolates and molecular analysis of macrolide-resistant strains from Shanghai, China. Antimicrob Agents Chemother. 53:2160–2162. 2009. View Article : Google Scholar : PubMed/NCBI
32	Liu Y, Ye X, Zhang H, Xu X, Li W, Zhu D and Wang M: Characterization of macrolide resistance in Mycoplasma pneumoniae isolated from children in Shanghai, China. Diagn Microbiol Infect Dis. 67:355–358. 2010. View Article : Google Scholar : PubMed/NCBI
33	Ito I, Ishida T, Osawa M, Arita M, Hashimoto T, Hongo T and Mishima M: Culturally verified Mycoplasma pneumoniae pneumonia in Japan: A long-term observation from 1979–99. Epidemiol Infect. 127:365–367. 2001.PubMed/NCBI
34	Othman N, Isaacs D and Kesson A: Mycoplasma pneumoniae infections in Australian children. J Paediatr Child Health. 41:671–676. 2005. View Article : Google Scholar : PubMed/NCBI
35	Wu PS, Huang LM, Chang IS, Lu CY, Shao PL, Tsai FY and Chang LY: The epidemiology of hospitalized children with pneumococcal/lobar pneumonia and empyema from 1997 to 2004 in Taiwan. Eur J Pediatr. 169:861–866. 2010. View Article : Google Scholar : PubMed/NCBI
36	Cockcroft DW and Stilwell GA: Lobar pneumonia caused by Mycoplasma pneumoniae. Can Med Assoc J. 124:1463–1468. 1981.PubMed/NCBI