Mycoplasma pneumoniae among children hospitalized in a tertiary hospital with community-acquired lower respiratory tract infections.

PURPOSE: In this prospective study incidence of Mycoplasma pneumoniae (M. pneumoniae) infection was investigated in children with community-aquired lower respiratory tract infections (LRTIs) using methods such as serology, nested PCR (polymerase chain reaction), and multiplex PCR analysis.

METHODS

M. pneumoniae infection was investigated among 200 children with LRTIs, ages 2 months to 12 years,. Blood samples were taken for M. pneumoniae antibodies both during admission and four to six weeks following enrollment. Nested and multiplex PCR analysis was performed to identify M. pneumoniae from nasopharyngeal aspirates (NPAs).

RESULTS

Infection due to M. pneumoniae was noted in 29 children (74.35 %) < 5 years of age and in 10 children (25.65 %) aged ≥5 years. The relationship between M. pneumoniae and age was statistically significant in the age group of children under five years [P = 0.004]. No statistically significant difference was seen between male and female children [P = 0.91]. Clinical and radiological results and M pneumoniae infection did not demonstrate any statistically significant correlation with the exception of the presence of statistically significant infiltrates (P = 0.04). In 39 (19.5 %) children, M. pneumoniae was found using a combination of multiplex PCR, nested PCR, and serology. Serology sensitivity was 66.67 %, specificity was 88.56 %, positive and negative predictive values were 36.36 % and 96.41 %, respectively, when using nested PCR as the diagnostic criteria.

CONCLUSIONS

In summary, our research established the critical role of M. pneumoniae infection in community-acquired LRTIs in children particularly in children under five years. There was an association between wheezing and acute M. pneumoniae infection. Multiplex PCR, nested PCR, and serology are used in conjunction to help diagnose M. pneumoniae infection in children with community-acquired LRTIs.