Impact of bacterial and viral coinfection on mycoplasmal pneumonia in childhood community-acquired pneumonia

Background/Purpose: Coinfection of Mycoplasma pneumoniae is not uncommon in children with respiratory syndromes. The purpose of this study was to investigate the impact of bacterial and viral coinfection on mycoplasmal pneumonia in hospitalized children with community-acquired pneumonia (CAP). Methods: Children coinfected with M. pneumoniae in a prospective study of the etiology of CAP at a tertiary pediatric facility Children's Hospital were enrolled and retrospectively reviewed. The data of clinical characteristics, complications, and outcomes of these children were collected and analyzed. Results: A total of 59 children were enrolled and stratified into three groups: M. pneumoniae infection alone (n=31), M. pneumoniae with Streptococcus pneumoniae coinfection (n=9), and M. pneumoniae with virus coinfection (n=19). As compared with children infected with M. pneumoniae alone, coinfection of children with S. pneumoniae was more likely to occur under the age of 5 years with a longer duration of fever and hospital stay. Furthermore, total leukocyte count and serum C-reactive protein level were also significantly higher in these children (p<0.01). However, no significant difference in clinical characteristics, complications, and outcomes was observed between the patients infected with either M. pneumoniae alone or with virus coinfection. Conclusion: In children with CAP, the influence on the clinical outcomes of M. pneumoniae infection may be heavily dependent on the coinfected pathogen. A potential coexistence of M. pneumoniae infection should be considered in children with features suggesting typical bacterial pneumonia.