Impact of bacterial and viral coinfection on mycoplasmal pneumonia in childhood community-acquired pneumonia.
OBJECTIVE
Coinfection of Mycoplasma pneumoniae is not uncommon in children with respiratory syndromes. The purpose of this study was to investigate the impact of bacterial and viral coinfection on mycoplasmal pneumonia in hospitalized children with community-acquired pneumonia (CAP).


METHODS
Children coinfected with M. pneumoniae in a prospective study of the etiology of CAP at a tertiary pediatric facility Children's Hospital were enrolled and retrospectively reviewed. The data of clinical characteristics, complications, and outcomes of these children were collected and analyzed.


RESULTS
A total of 59 children were enrolled and stratified into three groups: M. pneumoniae infection alone (n = 31), M. pneumoniae with Streptococcus pneumoniae coinfection (n = 9), and M. pneumoniae with virus coinfection (n = 19). As compared with children infected with M. pneumoniae alone, coinfection of children with S. pneumoniae was more likely to occur under the age of 5 years with a longer duration of fever and hospital stay. Furthermore, total leukocyte count and serum C-reactive protein level were also significantly higher in these children (p < 0.01). However, no significant difference in clinical characteristics, complications, and outcomes was observed between the patients infected with either M. pneumoniae alone or with virus coinfection.


CONCLUSIONS
In children with CAP, the influence on the clinical outcomes of M. pneumoniae infection may be heavily dependent on the coinfected pathogen. A potential coexistence of M. pneumoniae infection should be considered in children with features suggesting typical bacterial pneumonia.
Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Pediatric Pulmonology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Chih-Yung
CY
Chiu
Division of Pediatric Infectious Diseases, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Chih-Jung
CJ
Chen
Division of Pediatric Pulmonology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Kin-Sun
KS
Wong
Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan; Division of Pediatric Infectious Diseases, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Ming-Han
MH
Tsai
Division of Pediatric Infectious Diseases, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Cheng-Hsun
CH
Chiu
Division of Pediatric Infectious Diseases, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: ychuang@adm.cgmh.org.tw.
Yhu-Chering
YC
Huang
D001419:Bacteria / Q000145:classification / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D017714:Community-Acquired Infections / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011019:Pneumonia, Mycoplasma / Q000453:epidemiology*; D011446:Prospective Studies; D013296:Streptococcus pneumoniae; D016896:Treatment Outcome; D014777:Virus Diseases / Q000453:epidemiology* / Q000821:virology; D014780:Viruses / Q000145:classification / Q000302:isolation & purification*
Coinfection; Mycoplasma pneumoniae; Outcomes