Table 2.
Clinical Features Among Children Hospitalized for Community-acquired Pneumonia With and Without Mycoplasma pneumoniae (N = 2254)
| Characteristic |
Mycoplasma pneumoniae PCR-Positivea (n = 182) |
Mycoplasma pneumoniae PCR-Negativeb (n = 2072) |
Unadjusted OR |
P Value |
|---|---|---|---|---|
| Clinical presentationc | ||||
| Fever/feverish | 174 (96) | 1885 (91) | 2.2 (1.01–4.5) | .03 |
| Cough | 174 (96) | 1960 (95) | 1.2 (.6–2.6) | .6 |
| Fatigue | 142 (78) | 1425 (63) | 1.6 (1.1–2.3) | <.01 |
| Lack of appetite | 141 (77) | 1542 (68) | 1.2 (.8–1.7) | .4 |
| Dyspnea | 121 (67) | 1479 (71) | 0.8 (.6–1.1) | .2 |
| Chills | 102 (56) | 729 (35) | 2.3 (1.7–3.2) | <.01 |
| Headache | 87 (48) | 425 (21) | 3.5 (2.6–4.8) | <.01 |
| Sore throat | 86 (47) | 582 (28) | 2.3 (1.7–3.1) | <.01 |
| Wheezing | 82 (45) | 1303 (63) | 0.5 (.4–.7) | <.01 |
| Runny nose | 80 (44) | 1484 (72) | 0.3 (.2–.4) | <.01 |
| Abdominal pain | 76 (42) | 427 (21) | 2.7 (2.0–3.8) | <.01 |
| Diarrhea | 64 (35) | 626 (30) | 1.3 (.9–1.7) | .2 |
| Myalgia | 63 (35) | 366 (18) | 2.5 (1.8–3.4) | <.01 |
| Chest pain | 50 (27) | 436 (21) | 1.4 (1.01–2.0) | .04 |
| Chest retraction | 46 (25) | 953 (46) | 0.4 (.3–.6) | <.01 |
| Underlying condition | ||||
| Any condition (≥1 condition) | 83 (46) | 1066 (51) | 0.8 (.6–1.1) | .1 |
| Asthma/reactive airway disease | 55 (30) | 700 (34) | 0.9 (.6–1.2) | .3 |
| Preterm birthd | 6/21 (29) | 201/988 (20) | 1.6 (.6–4.1) | .4e |
| Congenital heart disease | 14 (8) | 147 (7) | 1.1 (.6–1.9) | .8 |
| Neurological disorder | 11 (6) | 180 (9) | 0.7 (.4–1.3) | .2 |
| Chromosomal disorder | 16 (9) | 112 (5) | 1.7 (1.0–2.9) | .06 |
| Examination findings at presentation | ||||
| Decreased breath sounds | 114 (63) | 842 (41) | 2.4 (1.8–3.3) | <.01 |
| Rales | 110 (60) | 814 (39) | 2.4 (1.7–3.2) | <.01 |
| Tachypneaf | 78 (43) | 740 (36) | 1.4 (1.0–1.8) | .05 |
| Documented feverg | 67 (36) | 1003 (48) | 0.6 (.5–.8) | <.01 |
| Hypoxiah | 77 (42) | 768 (37) | 1.3 (.9–1.7) | .2 |
| Chest indrawing | 55 (30) | 1172 (57) | 0.3 (.2–.5) | <.01 |
| Rhonchi | 49 (27) | 855 (41) | 0.5 (.4–.7) | <.01 |
| Wheezing | 48 (26) | 875 (42) | 0.5 (.3–.7) | <.01 |
| Radiographic findingsi | ||||
| Consolidation | 108 (59)j | 1219 (59) | 1.0 (.8–1.4) | .9 |
| Single lobar infiltrate | 59 (32) | 534 (26) | 1.4 (1.0–2.0) | .05 |
| Multilobar infiltrates | 42 (23) | 573 (28) | 0.8 (.5–1.1) | .2 |
| Multilobar infiltrates (unilateral) | 20 (11) | 155 (7) | 1.5 (.9–2.5) | .09 |
| Multilobar infiltrates (bilateral) | 22 (12) | 420 (20) | 0.5 (.3–.9) | <.01 |
| Pleural effusion | 48 (26) | 244 (12) | 2.7 (1.9–3.8) | <.01 |
| Complicated bronchiolitis | 21 (12) | 610 (29) | 0.3 (.2–.5) | <.01 |
| Hilar lymphadenopathy | 18 (10) | 114 (6) | 1.9 (1.1–3.2) | .02 |
| Laboratory findings | ||||
| Abnormal WBC countk | ||||
| Leukopenia | 2/160 (1) | 98/1074 (6) | 0.2 (.05–.8) | .03 |
| Leukocytosis | 40/160 (25) | 463/1074 (27) | 0.9 (.6–1.3) | .6 |
| Abnormal platelet countl | ||||
| Thrombocytopenia | 6/159 (4) | 73/1681 (4) | 0.9 (.4–2.0) | .7 |
| Thrombocytosis | 15/159 (9) | 182/1681 (11) | 0.9 (.5–1.5) | .6 |
| Hyponatremiam | 12/110 (11) | 125/1352 (9) | 1.2 (.6–2.3) | .6 |
| Severity of illness | ||||
| ICU admission | 21 (12) | 431 (21) | 0.5 (.3–.8) | <.01 |
| Invasive mechanical ventilation | 3 (2) | 143 (7) | 0.2 (.07–.7) | <.01 |
| Length of stay, d, median (IQR) | 2 (2–4) | 3 (2–4) | .1n | |
| Antibiotics | ||||
| Receipt of an outpatient antibiotic | 90 (50) | 482 (23) | 3.2 (2.4–4.4) | <.01 |
| Receipt of antibiotics prior to admission within 5 d | 64 (35) | 338 (16) | 2.8 (2.0–3.9) | <.01 |
| Penicillins | 44/64 (69) | 173/338 (51) | Reference | |
| Cephalosporins | 13/64 (20) | 101/338 (30) | 0.5 (.3–1.0) | .05 |
| Macrolides | 7/64 (11) | 56/338 (17) | 0.5 (.2–1.2) | .1 |
| Inpatient antibiotics | 175 (96) | 1794 (87) | 3.9 (1.8–8.3) | <.01 |
| Macrolideso | 75/175 (43) | 351/1794 (20) | 2.3 (1.6–3.3) | <.01 |
| Penicillins | 72/175 (41) | 776/1794 (43) | Reference | |
| Cephalosporin | 27/175 (15) | 639/1794 (36) | 0.5 (.3–.7) | <.01 |
Data are presented as No. (%) unless otherwise indicated.
Abbreviations: CI, confidence interval; ICU, intensive care unit; IQR, interquartile range; OR, odds ratio; PCR, polymerase chain reaction; WBC, white blood cell.
Radiographically confirmed community-acquired pneumonia (CAP) in a patient enrolled in the Etiology of Pneumonia in the Community (EPIC) study with a positive Mycoplasma pneumoniae PCR result.
Radiographically confirmed CAP in a patient enrolled in the EPIC study with a negative Mycoplasma pneumoniae PCR result.
Clinical presentation is based on patient history.
Only for those children <2 years of age.
Fisher exact test.
Tachypnea: For children <2 months: >60 breaths/minute; 2 months to <12 months: >50 breaths/minute; 12 months to 5 years: >40 breaths/minute; >5 years: >25 breaths/minute were considered as abnormal.
Temperature ≥38.0°C or ≥100.4°F.
Hypoxia: Oxygen saturation rate <92% on admission using pulse oximetry on room air or requirement of supplemental oxygen at the time of presentation.
The radiographic findings are not mutually exclusive and could overlap.
Thirty-two (30%) of the Mycoplasma pneumoniae CAP children with a consolidation had a codetection.
For children <5 years old, WBC count >15 000/μL or <5500/μL and for children ≥5 years old, WBC count >11 000/μL or <3000/μL was considered abnormal.
Platelet count of <150 000 cells/μL or >500 000 cells/μL was considered abnormal.
For children <1 year of age, serum sodium <130 U/L and for those >1 year of age, serum levels of <135 U/L were considered abnormal.
Wilcoxon 2-sample test.
Macrolides received as inpatient treatment: azithromycin 74 (99%); clarithromycin: 1 (1%).