Table 3.
Pathogen Detection in Upper Respiratory Tract of Mycoplasma pneumoniae–Positive Community-acquired Pneumonia (CAP) Versus M. pneumoniae–Negative CAP in Children
| Pathogen | Mp-Positive CAP (n = 29) | Mp-Negative CAP (n = 34) | OR (95% CI) | P Value |
|---|---|---|---|---|
| Pathogen | ||||
| Any pathogen | 29 (100) | 29 (85) | NA | .06 |
| ≥2 pathogens | 20 (69) | 13 (38) | 3.5 (1.1–11.7) | .02 |
| ≥3 pathogens | 7 (24) | 5 (15) | 1.8 (.4–8.4) | .52 |
| Bacteria | ||||
| Any bacteria | 29 (100) | 26 (76) | NA | < .01 |
| Mp | 29 (100) | 3 (9) | NA | < .01 |
| Sp | 18 (62) | 26 (76)a | 0.5 (.1–1.7) | .27 |
| Chlamydophila pneumoniae | 0 (0) | 1 (3) | NA | 1.00 |
| Legionella pneumophila | 0 (0) | 0 (0) | NA | 1.00 |
| Bordetella pertussis | 0 (0) | 0 (0) | NA | 1.00 |
| Viruses | ||||
| Any virus | 9 (32) | 15 (45) | 0.6 (.2–1.8) | .31 |
| RSV | 0 (0) | 8 (24)b | NA | < .01 |
| A | … | 2 | … | |
| B | … | 3 | … | |
| Influenza virus | 0 (0) | 2 (6) | NA | .50 |
| A | … | 2 | … | |
| A(H1) | … | 0 | … | |
| A(2009 H1N1) | … | 0 | … | |
| A(H3) | … | 1 | … | |
| B | … | 0 | … | |
| Parainfluenza virus | 0 (0) | 2 (6) | NA | .50 |
| 1 | … | 0 | … | |
| 2 | … | 2 | … | |
| 3 | … | 0 | … | |
| 4 | … | 0 | … | |
| Human rhinovirus/enterovirusc | 3 (11) | 4 (12) | 0.9 (.1–5.7) | 1.00 |
| Adenovirus | 5 (18) | 3 (9) | 2.1 (.4–15.3) | .45 |
| Human metapneumovirus | 0 (0) | 0 (0) | NA | 1.00 |
| Coronavirus | 0 (0) | 1 (3) | NA | 1.00 |
| 229E | … | 0 | … | |
| HKU1 | … | 0 | … | |
| NL63 | … | 0 | … | |
| OC43 | … | 1 | … | |
| MERS coronavirus | … | 0 | … | |
| Human bocavirus | 1 (4) | 1 (3) | 1.2 (.0–95.8) | 1.00 |
Data are presented as no. or no. (%). Differences between proportions were determined by the Fisher exact test. P values <.05 are indicated in bold. Pharyngeal samples were tested in all patients by real-time polymerase chain reaction (PCR) for Mp [14] and Sp [15], and for other bacterial and viral pathogens by the ePlex respiratory panel [17] in 28 of 29 Mp-positive CAP and 33 of 34 Mp-negative CAP patients with residual respiratory samples. Blood cultures were performed in 14 (48%) Mp-positive CAP and 20 (59%) Mp-negative CAP patients during routine clinical care and all were negative. Routine PCR testing for Mp [14] as part of clinical care was positive in 8 of 8 Mp-positive CAP and 0 of 11 Mp-negative CAP patients.
Abbreviations: CAP, community-acquired pneumonia; CI, confidence interval; MERS, Middle East respiratory syndrome; Mp, Mycoplasma pneumoniae; NA, not available; OR, odds ratio; RSV, respiratory syncytial virus; Sp, Streptococcus pneumoniae.
aTwo patients had Sp detected in both upper respiratory tract (URT) and pleural fluid samples (pleural puncture performed during routine clinical care). They had no other pathogens detected in the URT apart from Sp.
bRSV was additionally detected in nasopharyngeal samples of 3 patients by rapid antigen detection test (Sofia, Quidel, San Diego, California) during routine clinical care.
cNo differentiation possible between rhinovirus and enterovirus [17].