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Mycoplasma


BMC Infectious Diseases 2009, 9:62doi:10.1186/1471-2334-9-62


Research article

Mycoplasma pneumoniae pneumonia revisited within the German Competence Network for Community-acquired pneumonia (CAPNETZ)

 

Heike von Baum 1, Tobias Welte 2 , Reinhard Marre 3 , Norbert Suttorp 4 , Christian Lück 5 and Santiago Ewig 6

 

  1. Institute. for Medical Microbiology and Hygiene, Ulm University Hospital, Ulm, Germany
  2. Department of Pneumonology, Hannover University Hospital, Hannover, Germany
  3. Hospital Administration, Ulm University Hospital, Ulm, Germany
  4. Department of Infectious Diseases and Pulmonary Medicine, Charité, Berlin, Germany
  5. Institute of Med. Microbiology and Hygiene, Dresden University Hospital, Dresden, Germany
  6. Department of Pneumonology, Thoraxzentrum Ruhrgebiet, Herne und Bochum, Germany

 

The electronic version of this article is the complete one and can be found online at:
http://www.biomedcentral.com/1471-2334/9/62

 

Published: 13 May 2009

 

© 2009 von Baum et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

 

Background

Currently, broad empiric antimicrobial treatment including atypical coverage is recommended for patients with mild to moderate community-acquired pneumonia (CAP). Therefore, the relative impact of each atypical pathogen, particularly Mycoplasma pneumoniae deserves renewed attention.

Methods

Based on prospective data from 4532 patients with CAP included in the German CAP-Competence Network (CAPNETZ), we studied the incidence, clinical characteristics, and outcome of patients with Mycoplasma pneumoniae pneumonia (MPP). The diagnosis of MPP was based on a positive PCR from respiratory samples and/or a positive IgM-titer from an acute phase serum sample.

Results

307 patients (6.8%) had definite MPP (148 with positive PCR, 204 with positive IgM, 46 with positive PCR and IgM). Compared to patients with other definite and unknown etiologies, patients with MPP were significantly younger (41 ± 16 versus 62 ± 17 and 61 ± 18 years), had fewer co-morbidities, presented with a less severe disease, showed a lower inflammatory response in terms of leukocyte counts (median 8850 versus 13200 and 11000 μL) and CRP values (60 versus 173 and 73 mg/L), and had better outcomes, including a shorter length of hospitalization (9 ± 5 versus 14 ± 11 and 12 ± 9 days), fewer patients requiring mechanical ventilation (0.3 versus 4.5 and 2.1%), and a minimal mortality (0.7 versus 8.7 and 6.5%).

Conclusion

In this large series of patients with definite MPP according to very strict criteria, MPP appears as a condition with a high incidence, quite specific clinical presentation, and a largely benign course. In view of a widely favorable clinical outcome, recent recommendations including regular coverage of atypical pathogens in patients with mild to moderate CAP might be reconsidered for patients in Germany as well as in other countries with comparable epidemiological settings.

 

Full Text article at : http://www.biomedcentral.com/1471-2334/9/62

 

Also available as PDF document

 

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