2337. Clinical characteristics of children infected with Macrolide resistant Mycoplasma Pneumonia in Central Ohio – Preliminary data
Session: Poster Abstract Session: Pediatric Bacterial Infections
Saturday, October 6, 2018
Room: S Poster Hall
Posters
  • Mariana M Lanata _ poster ID WEEK 2018-converted (1).pdf (264.2 kB)
  • Background: Macrolide-resistant Mycoplasma pneumoniae (MRMp) has emerged in the last 2 decades, with rates as high as 93% in Asia. Rates in the United Stated vary from 3.5-13.2%. By sequencing we identified our local resistance rate of 1.8% (9/477) in isolates collected from Oct 2015-Dec 2017. Previous reports described increased morbidity in patients with MRMp. We evaluated the clinical characteristics of children infected with MRMp in Central Ohio.

    Methods: Of the 9 MRMp isolates identified, clinical data was available in 7 cases. We performed a case-control (1:3) analysis, where Mp patients were matched by month and year of presentation. Retrospective analysis of electronic health records (HER) was performed to identify clinical and treatment characteristics. Continuous variables are shown as medians and inter-quartile ranges (IQR), and categorical variables as percentages. For comparisons T, Mann-Whitney U, and Fisher’s exact tests were used as appropriate.

    Results: Both groups had similar demographics with no differences in age and gender. Median age (IQR) was 8.5 yrs (6-17) for the MRMp and 8 (IQR 3.5-11.5) for the Macrolide-susceptible Mp (MSMp). Duration of symptoms at presentation was similar, median (IQR) of 11 (4-14) days for MRMp, and 8 (6.25-13.25) days for MSMp (p=0.7). All patients with MRMp had fever compared to 17 (81%) of the MSMp (p=0.07). Tmax was similar in both groups (p=0.11). All patients (100%) had cough. There were no differences in the frequency of oxygen requirement, fatigue, shortness of breath, sore throat, nasal congestion, rash, headache and chest radiographic findings. There were similar rates of hospitalization with 4 (57%) in the MRMp and 8 (38%) in the MSMp (p=0.42). Among hospitalized children, there were no differences in duration hospitalization, median (IQR) 6 (1.25-21.25) days for MRMp and 2 (1-2.75) for MSMp (p=0.31). None required invasive ventilation. One MRMp patient had encephalitis; this was the only patient requiring intensive care compared to none MSMp (p=0.25). All patients were initially treated with azithromycin, but 2 (12%) of the MRMp were switched to levofloxacin (p=0.06).

    Conclusion: We did not identify significant differences in clinical characteristics between patients with MRMp and MSMp. This could be related to our low local rate of MRMp.

    Mariana Lanata Piazzon, MD1, Huanyu Wang, PhD2, Kathy Everhart, B.S.3, Octavio Ramilo, MD, FPIDS4 and Amy Leber, PhD3, (1)Pediatrics, Section of Infectious Diseases, Nationwide Children's Hospital, Columbus, OH, (2)Nationwide Children's Hospital, Columbus, OH, (3)Department of Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, (4)Pediatrics, Nationwide Children's Hospital, Columbus, OH

    Disclosures:

    M. Lanata Piazzon, None

    H. Wang, None

    K. Everhart, None

    O. Ramilo, Janssen Scientific Affairs, LLC: Consultant , Consulting fee . Sanofi: Scientific Advisor , Consulting fee . Merck: Scientific Advisor , Consulting fee and Speaker honorarium . Janssen: Grant Investigator and Scientific Advisor , Consulting fee , Grant recipient and Speaker honorarium . Pfizer: Consultant , Consulting fee and Speaker honorarium .

    A. Leber, Nationwide Children's Hospital: Research Contractor , Research support .

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.