Le infezioni in medicina · 2026
Clinical characteristics of community acquired pneumonia due to Mycoplasma pneumoniae: experience from an outbreak.
СтатьяНазвание и аннотация: Перевод в очереди
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Nair Aparna Anil, Niyas Vettakara Kandy Muhammed, Ananthanarayanan Rajalakshmi, Durai Shijukumar Chella, Jose Divakar, Padmanabhan Arjun
Аннотация
BACKGROUND: Mycoplasma pneumoniae is a major cause of Community-Acquired Pneumonia (CAP) but often remains underrecognized because it requires molecular or serologic testing for diagnosis. In late 2024, an increase in cases with poor response to macrolides was noted at a tertiary hospital in Thiruvananthapuram, Kerala. This study describes the clinical profile, treatment, and outcomes of patients affected during this outbreak.
METHODS: This retrospective study included all patients admitted with M. pneumoniae pneumonia between January 2024 and August 2025. Diagnosis was confirmed by PCR or IgM serology. Clinical features, laboratory parameters, radiologic findings, treatment, and outcomes were collected from records and analyzed using Jamovi (version 2.6.45).
RESULTS: A total of 124 patients were included; 79.8% were <18 years (median age 9 years, IQR 6-14). Diagnosis was PCR-based in 97.6%. Cough (97.6%) and fever (95.2%) were the most common symptoms. Nineteen patients (15.3%) required supplemental oxygen, three (2.4%) non-invasive ventilation, and five (4.0%) invasive mechanical ventilation. Pleural effusion was noted in 24.2%. Extrapulmonary complications were rare, including one case each of encephalitis and pericardial effusion. Definitive therapy included doxycycline in 76.6%, azithromycin in 17.7%, and levofloxacin in 3.2%. One-third of patients initially started on macrolides required a change to alternative agents. Corticosteroids were used in 18.5%, and 33.0% required ICU care. Three patients (2.4%) died, all with significant comorbidities.
CONCLUSIONS: During the 2024-2025 outbreak, M. pneumoniae caused predominantly paediatric CAP but occasionally severe disease requiring intensive care. The frequent need to switch from macrolides suggests emerging resistance. Early recognition and use of alternative agents such as doxycycline or fluoroquinolones may improve outcomes.
METHODS: This retrospective study included all patients admitted with M. pneumoniae pneumonia between January 2024 and August 2025. Diagnosis was confirmed by PCR or IgM serology. Clinical features, laboratory parameters, radiologic findings, treatment, and outcomes were collected from records and analyzed using Jamovi (version 2.6.45).
RESULTS: A total of 124 patients were included; 79.8% were <18 years (median age 9 years, IQR 6-14). Diagnosis was PCR-based in 97.6%. Cough (97.6%) and fever (95.2%) were the most common symptoms. Nineteen patients (15.3%) required supplemental oxygen, three (2.4%) non-invasive ventilation, and five (4.0%) invasive mechanical ventilation. Pleural effusion was noted in 24.2%. Extrapulmonary complications were rare, including one case each of encephalitis and pericardial effusion. Definitive therapy included doxycycline in 76.6%, azithromycin in 17.7%, and levofloxacin in 3.2%. One-third of patients initially started on macrolides required a change to alternative agents. Corticosteroids were used in 18.5%, and 33.0% required ICU care. Three patients (2.4%) died, all with significant comorbidities.
CONCLUSIONS: During the 2024-2025 outbreak, M. pneumoniae caused predominantly paediatric CAP but occasionally severe disease requiring intensive care. The frequent need to switch from macrolides suggests emerging resistance. Early recognition and use of alternative agents such as doxycycline or fluoroquinolones may improve outcomes.