Epidemiology, Characteristics, and Treatment Outcomes of Mycoplasma pneumoniae Pneumonia in Hospitalized Adults: A 5-Year Retrospective Cohort Study - Report - MDSpire
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Epidemiology, Characteristics, and Treatment Outcomes of Mycoplasma pneumoniae Pneumonia in Hospitalized Adults: A 5-Year Retrospective Cohort Study
Clinical Report: 5-Year Analysis of Mycoplasma pneumoniae Pneumonia in Hospitalized Adults
Overview
This retrospective study of 747 adults hospitalized with Mycoplasma pneumoniae pneumonia in Stockholm County from 2013 to 2017 found an incidence rate of 8.5 cases per 100,000 person-years, peaking in 2016. Tetracycline treatment was associated with shorter hospital stays and fever duration compared to macrolides and fluoroquinolones, suggesting it as a preferred first-line therapy.
Background
Mycoplasma pneumoniae is a common cause of community-acquired pneumonia with epidemic peaks approximately every 4 years. Diagnosis has shifted from serology to nucleic acid amplification tests, improving detection accuracy. Macrolides are widely used as first-line treatment but face challenges due to rising resistance. Alternative antibiotics include tetracyclines and fluoroquinolones, though comparative effectiveness data are limited.
Data Highlights
Parameter
Value
Number of patients
747
Median age (IQR)
42 (33–55) years
Male patients
55% (385/747)
Incidence rate
8.5 cases per 100,000 person-years
Incidence peak year
2016 (14.1 per 100,000 person-years)
Common symptoms
Cough (95%), Fever (92%)
Hypoxemia at admission
71%
In-hospital mortality
0.4%
ICU admission
6%
Median length of stay
4 days (IQR 2–6)
Length of stay increase with macrolides
+1.0 days (P < .001)
Length of stay increase with fluoroquinolones
+0.8 days (P = .03)
Fever duration increase with fluoroquinolones
+0.3 days (P = .02)
Key Findings
The incidence of hospitalized M pneumoniae pneumonia was 8.5 per 100,000 person-years, with a peak in 2016.
Patients were predominantly middle-aged adults (median 42 years) with a slight male predominance (55%).
Cough and fever were the most common presenting symptoms; 71% were hypoxemic at admission.
In-hospital mortality was low (0.4%), and 6% required ICU care.
Tetracycline treatment was associated with shorter hospital stays and fever duration compared to macrolides and fluoroquinolones.
Longer symptom duration before admission correlated with more severe disease.
Clinical Implications
Clinicians should consider tetracyclines as a first-line treatment option for hospitalized adults with M pneumoniae pneumonia due to their association with better clinical outcomes. Awareness of the epidemiological peak periods can aid in timely diagnosis. Given the low mortality but notable hypoxemia and ICU admission rates, close monitoring remains essential.
Conclusion
This study underscores the epidemiological trends and clinical profiles of M pneumoniae pneumonia in adults and highlights tetracyclines as an effective treatment option associated with improved outcomes. Optimizing antibiotic choice may reduce hospital stay and fever duration.
References
Study Authors/Stockholm County Study/2023 -- A 5-Year Retrospective Analysis of Mycoplasma pneumoniae Pneumonia in Hospitalized Adults
