Clinical features of Mycoplasma pneumonia in comparison with viral pneumoina in children: A multicenter, cross-sectional study

Se Hwan An; Hong Je Cho; Hey-Sung Baek; Myong Soon Sung; Jung Won Yoon; Sun Hee Choi; Youn Ho Sheen; Man Yong Han

doi:10.4168/aard.2018.6.3.155

Journal List > Allergy Asthma Respir Dis > v.6(3) > 1095178

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An, Cho, Baek, Sung, Yoon, Choi, Sheen, and Han: Clinical features of Mycoplasma pneumonia in comparison with viral pneumoina in children: A multicenter, cross-sectional study

Original Article

Allergy Asthma Respir Dis 2018;6(3):155-160.

Published online: 5 May 2018

DOI: https://doi.org/10.4168/aard.2018.6.3.155

Clinical features of Mycoplasma pneumonia in comparison with viral pneumoina in children: A multicenter, cross-sectional study

Se Hwan An¹, Hong Je Cho¹, Hey-Sung Baek¹, Myong Soon Sung², Jung Won Yoon³, Sun Hee Choi⁴, Youn Ho Sheen⁵, Man Yong Han⁶

¹Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, Korea

²Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea

³Department of Pediatrics, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea

⁴Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea

⁵Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea

⁶Department of Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea

Correspondence to: Hey-Sung Baek https://orcid.org/0000-0003-0297-9446 Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, 150 Seongan-ro, Gangdong-gu, Seoul 05355, Korea Tel: +82-2-2224-2251, Fax: +82-2-482-8334, E-mail:paviola7@gmail.com

Received 8 September 201729 October 2017 Accepted 31 October 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was conducted to compare clinical features between Mycoplasma pneumonia and viral pneumonia.

Methods

We retrospectively analyzed the medical records of 428 patients requiring hospitalization among children younger than 18 years of age in 5 hospitals in Seoul and Gyeonggi-do. There were 131 patients with M. pneumonia and virus coinfection, 167 patients with M. pneumonia without virus coinfection, and 130 patients with viral pneumonia. All subjects had radiographic evidence of pneumonia with specimens available for both M. pneumonia and viral testing. Virus was identified using the polymerase chain reaction assay in a nasopharyngeal or oropharyngeal swab. M. pneumoniae pneumonia was diagnosed serologically.

Results

Human rhinovirus was detected in 60.3% (79 of 131) of children with M. pneumonia accompanied by virus coinfection. Respiratory syncytial virus (RSV) was detected in 38.2% (50 of 130) of children with viral pneumonia. The mean age was significantly lower in the viral pneumonia group than in the M. pneumonia group with and without virus coinfection. The sex distribution did not differ significantly among the 3 study groups. The procalcitonin level was higher in viral pneumonia and erythrocyte sedimentation rate level was higher in the M. pneumonia group although no significant difference was found in C-reactive protein level between the M. pneumonia and viral pneumonia groups.

Conclusion

Clinical features and inflammatory markers between M. pneumonia and viral pneumonia may be useful for the treatment of community-acquired pneumonia.

Keywords: Mycoplasma pneumonia, Viral pneumonia, Community acquired pneumonia, Child

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Fig. 1.

Distribution of age according to age groups. M. pneumonia, Mycoplasma pneumonia.

Fig. 2.

Number of identified viruses in viral pneumonia and Mycoplasma pneumonia coinfected with virus groups. RSV, respiratory syncytial virus.

Fig. 3.

Identified viruses according to age group. RSV, respiratory syncytial virus.

Fig. 4.

Pathogens detected, according to month in children with pneumonia June, 2015 through May, 2016. RSV, respiratory syncytial virus.

Table 1.

Characteristics of subjects studied

Characteristic	Mycoplasma pneumonia (n=298)		Viral pneumonia (n=130)	P-value∗
Characteristic	Without virus coinfection (n=167)	With virus coinfection (n=131)	Viral pneumonia (n=130)	P-value∗
Age (yr)	5.5±2.9	3.9±2.7	3.4±2.7	<0.001
Age group (yr)				<0.001
<2	27 (16.2)	50 (38.2)	58 (44.6)
2–4	41 (24.6)	36 (27.5)	34 (26.2)
5–9	82 (49.1)	37 (28.2)	35 (26.9)
≥10	17 (10.2)	8 (6.1)	3 (2.3)
Male sex (%)	42.2	56.5	60.6	0.007
Hospitalization
Length of stay (day)	4.29±2.78	4.22±2.83	3.88±2.06	0.362
Invasive mechanical ventilation	1 (0.6)	2 (1.5)	7 (5.4)	0.019

Values are presented as mean±standard deviation or number (%) unless otherwise indicated.

^∗ Chi-square test.

Table 2.

Comparisons of laboratory findings of study subjects

Variable	Mycoplasma pneumonia (n=298)		Viral pneumonia (n=130)	P-value∗
Variable	Without virus coinfection (n=167)	With virus coinfection (n=131)	Viral pneumonia (n=130)	P-value∗
WBC count (×10³/μL)	7,995±3,885^‡,‡	9,991±5,206	9,846±4,405	<0.001
Neutrophil (%)	62.4±13.6^‡	60.2±16.1^‡	54.8±17.2	<0.001
Lymphocyte (%)	27.4±12.4^‡	29.9±14.1^‡	34.9±16.2	<0.001
Monocyte (%)	5.1±2.4^‡	5.5±2.9^‡	6.5±2.9	<0.001
Eosinophil (%)	2.6±2.6^‡	2.4±3.1^‡	1.6±2.0	0.005
Hemoglobin (g/dL)	12.34±0.80	12.40±1.03	12.34±0.97	0.840
Platelet count (×10³/μL)	291±88	299±107	274±93	0.098
Protein (g/dL)	7.0±0.6	6.9±0.3	6.9±0.4	0.974
Albumin (g/dL)	4.3±0.25	4.2±0.2	4.2±0.2	0.773
AST (IU/L)	35.1±7.78	28.7±8.4	40.0±34.3	0.372
ALT (IU/L)	15.7±6.8	14.3±7.6	29.7±70.0	0.456
CRP (mg/dL)	3.3±3.8^‡	2.5±3.2	2.7±2.9	0.121
ESR (mm/hr)	46.6±22.5^‡,‡	40.6±25.5^‡	31.5±19.4	<0.001
Procalcitonin (ng/mL)	0.8±2.8^‡	0.9±2.4^‡	2.1±7.5	<0.001

WBC, white blood cell; AST, aspartate aminotransferase; ALT, alanine aminotransferase; CRP, C-reactive protein; ESR, Erythrocyte sedimentation rate.

^∗ Kruskal-Wallis test.

^† P<0.5 vs. with virus coinfection.

^‡ P<0.5 vs. with viral pneumonia.

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