title: Clinical and epidemiological characteristics in children with community-acquired mycoplasma pneumonia in Taiwan: A nationwide surveillance.
abstract: BACKGROUND
  Community-acquired pneumonia (CAP) is the leading cause of hospitalization of children. Mycoplasma pneumoniae is one of the most common pathogens. The disease severity is diverse, and the diagnosis remains a challenge to clinical pediatricians. The aims of this study are to provide a nationwide surveillance of the epidemiology and clinical manifestations of community-acquired mycoplasma pneumonia (CAMP) in children in Taiwan.
  
  
  METHODS
  The medical records of children enrolled by the Taiwan Pediatric Infectious Disease Alliance (TPIDA) project during 2010-2011 were reviewed. Hospitalized children with segmental or lobar pneumonia were included. The demographic, clinical, laboratory and radiographic data were analyzed. Nasopharyngeal swabs, pleural effusion, and serum were collected for multiplex viral and bacterial polymerase chain reaction (PCR), mycoplasma immunoglobulin M (IgM), or paired immunoglobulin G (IgG) titer.
  
  
  RESULTS
  There were overall 127 children with CAMP. Among them, 16 (12.6%) children had PCR and IgM positivity, 74 (58.3%) children had a positive serologic study, 34 (27.8%) children had positive PCR detection, and three (2.4%) children had paired IgG above a four-fold increase. Enrolled patients were divided into two groups before and after the age of 5 years. Children younger than 5 years or younger had a significantly longer hospitalization, higher intensive care unit (ICU) admission rates, and more complications. They were more frequent to receive oxygen supplementation and even surgical intervention. The white blood cell counts and C-reactive protein levels were higher in children 5 years old or younger.
  
  
  CONCLUSIONS
  Mycoplasma pneumoniae is an important etiology of CAP in children 5 years or younger. They had a longer length of hospitalization, higher inflammatory responses, and more complications, compared to children older than 5 years.
authors.affiliation: Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan.
authors.forename: Yun-Ju
authors.initials: YJ
authors.lastname: Ma
authors.affiliation: Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan; Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan City, Taiwan; Taiwan Pediatric Infectious Disease Alliance, Taiwan.
authors.forename: Shih-Min
authors.initials: SM
authors.lastname: Wang
authors.affiliation: Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan.
authors.forename: Yu-Hao
authors.initials: YH
authors.lastname: Cho
authors.affiliation: Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan; Taiwan Pediatric Infectious Disease Alliance, Taiwan.
authors.forename: Ching-Fen
authors.initials: CF
authors.lastname: Shen
authors.affiliation: Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan; Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan City, Taiwan; Taiwan Pediatric Infectious Disease Alliance, Taiwan. Electronic address: liucc@mail.ncku.edu.tw.
authors.forename: Ching-Chuan
authors.initials: CC
authors.lastname: Liu
authors.affiliation: Taiwan Pediatric Infectious Disease Alliance, Taiwan; Department of Pediatrics, Mackay Memorial Hospital, Taipei City, Taiwan.
authors.forename: Hsin
authors.initials: H
authors.lastname: Chi
authors.affiliation: Taiwan Pediatric Infectious Disease Alliance, Taiwan; Division of Infectious Diseases, Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan.
authors.forename: Yi-Chuan
authors.initials: YC
authors.lastname: Huang
authors.affiliation: Taiwan Pediatric Infectious Disease Alliance, Taiwan; Department of Pediatrics, National Taiwan University and Hospital, Taipei City, Taiwan.
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Huang
authors.affiliation: Taiwan Pediatric Infectious Disease Alliance, Taiwan; Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Yhu-Chering
authors.initials: YC
authors.lastname: Huang
authors.affiliation: Taiwan Pediatric Infectious Disease Alliance, Taiwan; School of Medicine, China Medical University, Taichung City, Taiwan; Department of Pediatrics, China Medical University Hospital, Taichung City, Taiwan.
authors.forename: Hsiao-Chuan
authors.initials: HC
authors.lastname: Lin
authors.affiliation: Taiwan Pediatric Infectious Disease Alliance, Taiwan; Division of Infectious Disease, Department of Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
authors.forename: Yu-Huai
authors.initials: YH
authors.lastname: Ho
authors.affiliation: Taiwan Pediatric Infectious Disease Alliance, Taiwan; Centers for Disease Control, Taiwan.
authors.forename: Jung-Jung
authors.initials: JJ
authors.lastname: Mu
mesh_terms: D000293:Adolescent; D000907:Antibodies, Bacterial / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology / Q000382:microbiology / Q000821:virology; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology; D007223:Infant; D007958:Leukocyte Count; D008168:Lung / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D008297:Male; D009177:Mycoplasma pneumoniae / Q000276:immunology / Q000302:isolation & purification*; D011019:Pneumonia, Mycoplasma / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000382:microbiology; D016133:Polymerase Chain Reaction; D011859:Radiography; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D002097:C-Reactive Protein
keywords: Children; Community-acquired pneumonia; Mycoplasma pneumoniae