Increased rates of intensive care unit admission in patients with Mycoplasma pneumoniae: a retrospective study.
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 2010-13 an epidemic of M. pneumoniae-associated infections was reported and we observed an increase of M. pneumoniae patients admitted to ICU. We analysed the cohort of all M. pneumoniae-positive patients' admissions during 2007 to 2012 at the Hadassah-Hebrew University Medical Centre (a 1100-bed tertiary medical centre). Mycoplasma pneumoniae diagnosis was made routinely using PCR on throat swabs and other respiratory samples. Clinical parameters were retrospectively extracted. We identified 416 M. pneumoniae-infected patients; of which 68 (16.3%) were admitted to ICU. Of these, 48% (173/416) were paediatric patients with ICU admission rate of 4.6% (8/173). In the 19- to 65-year age group ICU admission rate rose to 18% (32/171), and to 38.8% (28/72) for patients older than 65 years. 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. Of the ICU-admitted patients, 54.4% (37/68) 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. Contrary to previous reports, a substantial proportion (16.3%) of our M. pneumoniae-infected patients required ICU admission, especially in the adult population, with significant morbidity and mortality.
Division of Medicine, Hadassah-Hebrew University Medical Centre, Ein Kerem, Jerusalem, Israel.
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Khoury
Medical Intensive Care Unit, Hadassah-Hebrew University Medical Centre, Ein Kerem, Jerusalem, Israel.
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Sviri
Division of Medicine, Hadassah-Hebrew University Medical Centre, Ein Kerem, Jerusalem, Israel.
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Rmeileh
Division of Medicine, Hadassah-Hebrew University Medical Centre, Ein Kerem, Jerusalem, Israel.
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Nubani
Medical Intensive Care Unit, Hadassah-Hebrew University Medical Centre, Ein Kerem, Jerusalem, Israel.
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Abutbul
Division of Medicine, Hadassah-Hebrew University Medical Centre, Ein Kerem, Jerusalem, Israel.
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Hoss
Medical Intensive Care Unit, Hadassah-Hebrew University Medical Centre, Ein Kerem, Jerusalem, Israel.
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van Heerden
Medical Intensive Care Unit, Hadassah-Hebrew University Medical Centre, Ein Kerem, Jerusalem, Israel.
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Bayya
Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Centre, Ein Kerem, Jerusalem, Israel.
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Hidalgo-Grass
Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Centre, Ein Kerem, Jerusalem, Israel.
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Moses
Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Centre, Ein Kerem, Jerusalem, Israel. Electronic address: Ran.nir-paz@mail.huji.ac.il.
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Nir-Paz
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009177:Mycoplasma pneumoniae; D010343:Patient Admission; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D011159:Population Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult
Disease severity; Intensive care unit; Mortality; Mycoplasma pneumoniae; Pneumonia