RISK FACTORS FOR MYCOPLASMA
PNEUMONIAE INFECTION IN CHILDREN WITH ACUTE PHARYNGITIS
Esposito S, Marchisio P, Cavagna R,
Bosis S, Droghetti R, Lambertini L, Principi N
Pediatric Department I, University of Milan,
Italy
Objective: Mycoplasma pneumoniae is an emerging cause of
upper respiratory tract infections in children. Correct identification of
this pathogen can be performed only using complex and time-expensive
laboratory methods. The aims of this study were to define risk factors as
well as clinical and laboratory predictors of M. pneumoniae infection in
children with acute pharyngitis.
Methods: A total of 184 children
aged 0 - 14 years (102 males; median age, 5.33 years) with acute
pharyngitis were enrolled. Exclusion criteria included a throat swab
positive for Streptococcus pyogenes. A diagnosis of M. pneumoniae
infection was defined as a significant antibody response in acute and
convalescent sera and a positive DNA for M. pneumoniae on
nasopharyngeal aspirate. None of the patients was treated with antibiotics
at enrollment. Epidemiological data, clinical characteristics, and
laboratory tests were evaluated in statistical models to identify those
best predicting confirmed M. pneumoniae infection.
Results: M.
pneumoniae infection was diagnosed in 44 subjects (23.9%). The signs
and symptoms as well as white blood cell count, erythrocyte sedimentation
rate, and C-reactive protein overlap broadly between subjects with and
those without M. pneumoniae infection. Children with M.
pneumoniae infection were significantly more likely to have one or more
siblings (75.0% vs 57.8%, p<0.05), a history of recurrent
respiratory tract infections (52.3% vs 2.8%, p<0.001), and a
longer duration of fever (3.64 ± 2.18 vs 2.91 ±
1.96 days, p<0.05).
Conclusion: M.
pneumoniae appears as a common agent of acute pharyngitis in children.
Children with siblings, history of recurrent respiratory tract infections,
and long duration of fever are at higher risk for the infection with this
pathogen. In order to reduce transmission of M. pneumoniae among
household contacts, minimize the risk of recurrences, and shorten the
duration of fever rapid, specific diagnostic methods are needed and, if M.
pneumoniae infection is diagnosed, antimicrobial therapy is recommended.