Advertisement

Infection

pp 1–4 | Cite as

M. pneumoniae and C. pneumoniae are no relevant pathogens in critically ill patients with hospital-acquired respiratory tract infections

  • Stefan HagelEmail author
  • Svenja Schmitt
  • Miriam Kesselmeier
  • Michael Baier
  • Tobias Welte
  • Santiago Ewig
  • Mathias W. Pletz
Brief Report
  • 56 Downloads

Abstract

Purpose

To assess the incidence of Mycoplasma pneumoniae and Chlamydia pneumoniae in the pathogenesis of hospital-acquired respiratory tract infections (RTIs) in critically ill patients.

Methods

This is a retrospective cohort study of all ICU-patients ≥ 18 years with RTI who underwent conventional culture techniques and PCR testing for both M. pneumoniae and C. pneumoniae from respiratory tract specimens (bronchoalveolar lavage or tracheobronchial aspirates) between January 2013 to May 2017 at the Jena University Hospital.

Results

In total, 314 patients were included in the analysis. Of these, 210 (66.9%) patients were diagnosed with HAP, 65 (20.7%) with VAP and 39 (12.4%) with VAT. Overall, 73 (30.7%) patients were on mechanical ventilation on the day of microbiological examination. PCR-testing for M. pneumoniae was positive in two patients (0.6%) and for C. pneumoniae in zero patients.

Conclusions

Our study shows that the incidence of M. pneumoniae and C. pneumoniae in the pathogenesis of hospital-acquired RTIs in critically ill patients is negligible. The results support the recommendations of the guidelines not to perform empiric therapy covering these pathogens.

Keywords

Hospital-acquired pneumonia (HAP) Ventilator-associated pneumonia (VAP) Ventilator-associated tracheobronchitis (VAT) Mycoplasma pneumoniae Chlamydia pneumoniae 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests relevant to the manuscript.

References

  1. 1.
    Torres A, Niederman MS, Chastre J, et al. International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia: guidelines for the management of hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) of the European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Asociación Latinoamericana del Tórax (ALAT). Eur Respir J. 2017;50:1700582.CrossRefGoogle Scholar
  2. 2.
    Kalil AC, Metersky ML, Klompas M, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016;63:e61–111.CrossRefGoogle Scholar
  3. 3.
    Dalhoff K, Abele-Horn M, Andreas S, et al. Epidemiologie, diagnostik und therapie erwachsener patienten mit nosokomialer pneumonie—update 2017. Pneumologie. 2018;72:15–63.CrossRefGoogle Scholar
  4. 4.
    Dumke R, Schnee C, Pletz MW, et al. Mycoplasma pneumoniae and Chlamydia spp. infection in community-acquired pneumonia, Germany, 2011–2012. Emerg Infect Dis. 2015;21:426–34.CrossRefGoogle Scholar
  5. 5.
    Leroy O, Giradie P, Yazdanpanah Y, et al. Hospital-acquired pneumonia: microbiological data and potential adequacy of antimicrobial regimens. Eur Respir J. 2002;20:432–9.CrossRefGoogle Scholar
  6. 6.
    Park DR. The microbiology of ventilator-associated pneumonia. Respir Care. 2005;50:742–63 (discussion 763–5).Google Scholar
  7. 7.
    Casalta JP, Piquet P, Alazia M, et al. Mycoplasma pneumoniae pneumonia following assisted ventilation. Am J Med. 1996;101:165–9.CrossRefGoogle Scholar
  8. 8.
    Louie M, Dyck B, Parker S, et al.: Nosocomial pneumonia in a Canadian tertiary care center: a prospective surveillance study. Infect. Control Hosp. Epidemiol. 1991;12:356–63.Google Scholar
  9. 9.
    Ewig S, Höffken G, Kern WV, et al. Management of adult community-acquired pneumonia and prevention—update 2016. Pneumologie. 2016;70:151–200.CrossRefGoogle Scholar
  10. 10.
    Apfalter P, Stoiser B, Barousch W, et al. Community-acquired bacteria frequently detected by means of quantitative polymerase chain reaction in nosocomial early-onset ventilator-associated pneumonia. Crit Care Med. 2005;33:1492–8.CrossRefGoogle Scholar
  11. 11.
    Nilsson AC, Björkman P, Persson K. Polymerase chain reaction is superior to serology for the diagnosis of acute Mycoplasma pneumoniae infection and reveals a high rate of persistent infection. BMC Microbiol. 2008;8:93.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Institute for Infectious Diseases and Infection ControlJena University HospitalJenaGermany
  2. 2.Research Group Clinical Epidemiology, Center for Sepsis Control and Care (CSCC)University HospitalJenaGermany
  3. 3.Institute of Medical MicrobiologyJena University HospitalJenaGermany
  4. 4.Department of Respiratory MedicineHannover Medical SchoolHannoverGermany
  5. 5.Department of Respiratory Medicine and Infectious Diseases, Thorax Centre in the Ruhr AreaEvangelic Hospital in Herne and Augusta Hospital in BochumBochumGermany

Personalised recommendations