Background The epidemiology of Mycoplasma pneumoniae (Mp) among US children (<18 years) hospitalized with community-acquired pneumonia (CAP) is poorly understood. Methods In the Etiology of Pneumonia in the Community study, we prospectively enrolled 2254 children hospitalized with radiographically confirmed pneumonia from January 2010-June 2012 and tested nasopharyngeal/oropharyngeal swabs for Mp using real-time polymerase chain reaction (PCR). Clinical and epidemiological features of Mp PCR-positive and -negative children were compared using logistic regression. Macrolide susceptibility was assessed by genotyping isolates. Results One hundred and eighty two (8%) children were Mp PCR-positive (median age, 7 years); 12% required intensive care and 26% had pleural effusion. No in-hospital deaths occurred. Macrolide resistance was found in 4% (6/169) isolates. Of 178 (98%) Mp PCR-positive children tested for copathogens, 50 (28%) had ≥1 copathogen detected. Variables significantly associated with higher odds of Mp detection included age (10-17 years: adjusted odds ratio [aOR], 10.7 [95% confidence interval {CI}, 5.4-21.1] and 5-9 years: aOR, 6.4 [95% CI, 3.4-12.1] vs 2-4 years), outpatient antibiotics ≤5 days preadmission (aOR, 2.3 [95% CI, 1.5-3.5]), and copathogen detection (aOR, 2.1 [95% CI, 1.3-3.3]). Clinical characteristics were non-specific. Conclusions Usually considered as a mild respiratory infection, Mp was the most commonly detected bacteria among children aged ≥5 years hospitalized with CAP, one-quarter of whom had codetections. Although associated with clinically nonspecific symptoms, there was a need for intensive care in some cases. Mycoplasma pneumoniae should be included in the differential diagnosis for school-aged children hospitalized with CAP.

中文翻译：

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社区获得性肺炎住院儿童的肺炎支原体。

背景：对社区感染性肺炎（CAP）住院的美国儿童（<18岁）的肺炎支原体（Mp）的流行病学知之甚少。方法在“社区研究的肺炎病因学”中，我们前瞻性收集了2010年1月至2012年6月入院的2254例经射线照相确诊为肺炎的儿童，并使用实时聚合酶链反应（PCR）检测了鼻咽/口咽拭子的Mp。使用Logistic回归比较Mp PCR阳性和阴性儿童的临床和流行病学特征。大环内酯的敏感性通过基因分型评估。结果一百八十二（8％）名儿童的Mp PCR阳性（中位年龄为7岁）。12％的患者需要重症监护，而26％的患者有胸腔积液。没有发生院内死亡。在4％（6/169）的分离物中发现了大环内酯类药物的耐药性。在178名（98％）Mp PCR阳性儿童中检测到了同病原菌，其中50名（28％）检出了≥1个同病原菌。与较高的Mp检出几率显着相关的变量包括年龄（10-17岁：调整后的几率[aOR]，10.7 [95％置信区间{CI}，5.4-21.1]和5-9岁：aOR，6.4 [95％ CI，3.4-12.1] vs 2-4岁），入院前≤5天的门诊抗生素（aOR，2.3 [95％CI，1.5-3.5]）和同病原体检测（aOR，2.1 [95％CI，1.3-3.3] ）。临床特征是非特异性的。结论Mp是通常被认为是轻度呼吸道感染的细菌，在CAP住院的≥5岁儿童中，Mp是最常见的细菌，其中四分之一是共同检测出的。尽管与临床非特异性症状相关，但在某些情况下仍需要重症监护。