Outcomes of M. pneumoniae pneumonia with co-infection
Abstract
Background: Mycoplasma pneumoniae pneumonia (MPP) is often complicated
with co-infections that worsen the prognosis, but the outcomes in
pediatric cases are unclear. The aim of this study is to investigate the
association of co-infection and outcomes in severe MPP that occurs in
childhood. Methods: This retrospective study included 184 pediatric
cases of severe MPP that were managed at our hospital (between January
2014 and December 2017). The cohort was divided into the single
Mycoplasma pneumoniae infection, co-infection with a noxa other than M.
pneumoniae, and co-infection with two or more noxae other than M.
pneumoniae groups. The demographic and clinical information of the
patients was compared via statistical analysis. Results: The incidence
of co-infections was high at 64.1%. Cytomegalovirus and Epstein-Barr
virus were the most common causes of co-infection. According to the
findings of binary logistic regression analysis, the presence of more
than one pathogen (other than M. pneumoniae) was positively associated
with the score determined from Pediatric Risk of Mortality III (β =
0.760, odds ratio [OR] = 2.139, 95% confidence interval [CI] =
1.391–2.390, P = 0.001), Pediatric Critical Illness Score (β = 1.203,
OR = 3.328, 95% CI = 1.723–6.731, P = 0.000), and total length of
hospital stay (β = 0.730, OR = 2.075, 95% CI = 1.404–3.066, P =
0.000). Conclusion: Viral and bacterial co-infection in pediatric cases
of severe MPP is positively associated with hospitalization period and
disease severity, and ultimately, may increase the chances of severe
illness and death among children.