936. Mycoplasma pneumoniae infection associated with ICU admission: common or emerging disease manifestation?
Session: Poster Abstract Session: Respiratory Infections
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDSA poster 936.pdf (694.8 kB)
  • Background: Mycoplasma pneumoniae (MP) is one of the major pathogens causing respiratory diseases and is generally considered to cause mild respiratory disease. Currently it is suggested that in the ICU setting MP is not a common pathogen. In the last 3 years an epidemic of MP associated infections was noted in Japan, Israel and Europe. Additionally, in several regions a surge in the rate of MP macrolide resistance was reported, presenting a treatment challenge. During this epidemic surge we observed a rise in patients with MP who were admitted to the Intensive Care Unit (ICU).

    Methods: We evaluated all patient-unique MP positive samples during 2007 to 2012 at the Hadassah-Hebrew University medical center. In our institution, which is a tertiary 1000 bed medical center, MP diagnostics are based on PCR testing of throat swabs and other samples as requested by physicians and are done on a daily basis. All patients who were diagnosed during their hospital admission were selected, and their clinical parameters were extracted from the medical records.

    Results: During the study period we identified 406 MP patients of which 16.7% (68 patients) were admitted to the ICU. As expected, the majority of MP patients (48.1%) were pediatric, however only 4% of the pediatric population was admitted to the ICU. ICU admission rose to 19% in ages 19-65, and to 56% for those older than 65. The mean APACHEII score on admission to ICU was 20, with a mean ICU stay of 11 days, and a mean hospital stay of 21 days. 49% of ICU patients were mechanically ventilated. In most patients MP was the sole pathogen identified, but in a substantial proportion of patients (45%) additional pathogens were later identified as secondary pathogens. In up to 20% of the ICU MP patients a cardiac manifestation such as pericarditis, or arrhythmias were observed. The in-hospital mortality rate in the MP ICU patients correlated with the known APACHEII predicted mortality and reached 30%.

    Conclusion: Contrary to common belief, we have found that a substantial proportion (16.7%) of our MP patients required admission to the ICU and it was more frequent in the adult population. Based on our previous work, the ICU admission is probably not related to an epidemic single clone that is spreading in the community, and possibly reflects the rise in MP associated infections in the community.

    Tawfik Khoury, Adi Nubani, Avraham Abutbul, Sara Hoss, Sigal Sviri, Abed El-Raouf Bayya, Carlos Hidalgo-Grass, Allon E. Moses and Ran Nir-Paz, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

    Disclosures:

    T. Khoury, None

    A. Nubani, None

    A. Abutbul, None

    S. Hoss, None

    S. Sviri, None

    A. E. R. Bayya, None

    C. Hidalgo-Grass, None

    A. E. Moses, None

    R. Nir-Paz, None

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