Mycoplasma pneumoniae infection in adult inpatients during the 2023–24 outbreak in France (MYCADO): a national, retrospective, observational study
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CCSD ; New York, NY : Elsevier Science ; The Lancet Pub. Group, 2001- -
International audience.
Background. An epidemic of Mycoplasma pneumoniae infection has been observed in France since the fall of 2023. We aimed to: i) describe the characteristics of adults hospitalized for M. pneumoniae infection and ii) identify factors associated with severe outcomes of infection (i.e., intensive care unit [ICU)] admission or in-hospital death).
Methods. MYCADO is a retrospective observational study including adults hospitalized for ≥24 hours in 76 French hospitals for a M. pneumoniae infection between 1 September 2023 and 29 February 2024. Clinical, laboratory and imaging data were collected from medical records.
We identified factors associated with severe outcomes of infection, defined as need for ICU or in-hospital death, using multivariable logistic regression.
Findings. Overall, 1309 patients with M. pneumoniae infection were included: 718 (54.9%) males; median age 43 years (IQR 31-63); 288 (22.0%) with chronic respiratory failure; 423 (32.3%) with cardiovascular comorbidities; 95 (7.3%) with immunosuppression. The most common symptoms were: cough (n=1098, 83.9%), fever (n=1023, 78.2%), dyspnoea (n=948, 72.4%), fatigue (n=550, 42.0%), headache (n=211, 16.1%), arthromyalgia (n=253, 19.3%), vomiting (n=132, 10.1%); 156 (11.9%) patients had extra-respiratory manifestations, including 36 (2.8%) erythema multiforme, 19 (1.5%) meningoencephalitis, 44 (3.4%) autoimmune haemolytic anaemia and 17 (1.3%) myocarditis. The median hospital stay duration was 8 days (IQR 6-11); 415 (31.7%) patients were admitted to ICU and 28 (2.1%) died at hospital. Men, patients with hypertension, obesity, respiratory or liver chronic failure, extra-respiratory manifestations, bilateral lung damage or consolidation on computed tomography scan, elevated inflammatory syndrome, lymphopenia, and those who did not receive any active antibiotic against M. pneumoniae prior to admission, were more likely to present with severe outcomes of infection.
Interpretation. This national, observational study highlights unexpected, atypical radiologic presentations, a high proportion of transfers to ICU, and an association between severity and delayed administration of effective antibiotics.
