Details:

Alternative Title:
Pediatr Infect Dis J
Personal Author:
Francois Watkins, Louise K. ; Olson, Daniel ; Diaz, Maureen H. ; Lin, Xia ; Demirjian, Alicia ; ... More +
Francois Watkins, Louise K. ; Olson, Daniel ; Diaz, Maureen H. ; Lin, Xia ; Demirjian, Alicia ; Benitez, Alvaro J. ; Winchell, Jonas M. ; Robinson, Christine C. ; Bol, Kirk A. ; Glodé, Mary P. ; Dominguez, Samuel R. ; Miller, Lisa A. ; Kutty, Preeta K. Less -
Description:
Background

An increase in Mycoplasma pneumoniae-associated Stevens-Johnson syndrome (SJS) cases at a Colorado pediatric hospital led to an outbreak investigation. We describe the epidemiologic and molecular characteristics of M. pneumoniae among SJS case-patients and surrounding community members during the outbreak.

Methods

M. pneumoniae polymerase chain reaction-positive respiratory specimens from 5 Colorado hospitals and 4 referral laboratories underwent confirmatory polymerase chain reaction testing; positive specimens then underwent multilocus variable-number tandem-repeat analysis (MLVA) and macrolide resistance testing. Three SJS-M. pneumoniae case-patient households were surveyed using a standardized questionnaire, and nasopharyngeal/oropharyngeal swabs were obtained from all consenting/assenting household contacts. International Classification of Diseases, 9th revision codes were used to identify pneumonia cases among Colorado patients 5–21 years of age from January 2009 to March 2014.

Results

Three different M. pneumoniae MLVA types were identified among the 5 SJS case-patients with confirmed infection; MLVA type 3-X-6-2 was seen more commonly in SJS case-patients (60%) than in 69 non-SJS community specimens (29%). Macrolide resistance was identified in 7% of community specimens but not among SJS case-patients. Of 15 household contacts, 5 (33%) were M. pneumoniae positive; all MLVA types were identical to those of the corresponding SJS case-patient, although the specimen from 1 contact was macrolide resistant. Overall pneumonia cases as well as those caused by M. pneumoniae specifically peaked in October 2013, coinciding with the SJS outbreak.

Conclusions

The outbreak of M. pneumoniae-associated SJS may have been associated with a community outbreak of M. pneumoniae; clinicians should be aware of the M. pneumoniae–SJS relationship. Household transmission of M. pneumoniae was common within the households investigated.


Subject:
[+]
Adolescent
Adult
Anti-Bacterial Agents
Article
Child
Child, Preschool
Community-Acquired Infections
Contact Tracing
Disease Outbreaks
Female
Hospitals, Pediatric
Humans
Infant
Macrolides
Male
Microbial Sensitivity Tests
Middle Aged
Molecular Epidemiology
Pneumonia, Mycoplasma
Stevens-Johnson Syndrome
Young Adult

Source:
Pediatr Infect Dis J. 36(6):564-571
Pubmed ID:
28060039
Pubmed Central ID:
PMC5893500
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Place as Subject:
Colorado
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:492f45305800b14883ceb2189ff156da46798f2f96bcc07330dd2b8e96dd817a
File Type:

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