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Volume 48, Number 6, December 2015

Clinical and epidemiological characteristics in children with community-acquired mycoplasma pneumonia in Taiwan: A nationwide surveillance 


Clinical and epidemiological characteristics in children with community-acquired mycoplasma pneumonia in Taiwan: A nationwide surveillance Yun-Ju Ma, Shih-Min Wang, Yu-Hao Cho, Ching-Fen Shen, Ching-Chuan Liu, Hsin Chi, Yi-Chuan Huang, Li-Min Huang, Yhu-Chering Huang, Hsiao-Chuan Lin, Yu-Huai Ho, Jung-Jung Mu, Taiwan Pediatric Infectious Disease Alliance


Received: April 22, 2014    Revised: July 18, 2014    Accepted: August 7, 2014   

 

Corresponding author:

Ching-Chuan Liu
Corresponding author. Department of Pediatrics, National Cheng Kung University Hospital, Number 138, Sheng-Li Road, Tainan City 70403, Taiwan. 



 

Background and purpose: 

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. 



 

Conclusion:

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. 



 

Key words:

Children, Community-acquired pneumonia, Mycoplasma pneumoniae