Mycoplasma pneumoniae and Chlamydia spp. infection in community-acquired pneumonia, Germany, 2011-2012

Abstract

Mycoplasma pneumoniae and Chlamydia spp., which are associated with community-acquired pneumonia (CAP), are difficult to propagate, and can cause clinically indistinguishable disease patterns. During 2011-2012, we used molecular methods to test adult patients in Germany with confirmed CAP for infection with these 2 pathogens. Overall, 12.3% (96/783) of samples were positive for M. pneumoniae and 3.9% (31/794) were positive for Chlamydia spp.; C. psittaci (2.1%) was detected more frequently than C. pneumoniae (1.4%). M. pneumoniae P1 type 1 predominated, and levels of macrolide resistance were low (3.1%). Quarterly rates of M. pneumoniae-positive samples ranged from 1.5% to 27.3%, showing a strong epidemic peak for these infections, but of Chlamydia spp. detection was consistent throughout the year. M. pneumoniae-positive patients were younger and more frequently female, had fewer co-occurring conditions, and experienced milder disease than did patients who tested negative. Clinicians should be aware of the epidemiology of these pathogens in CAP.

Figure 1

Results of molecular detection of Mycoplasma pneumoniae from 783 respiratory tract specimens from adult patients with pneumonia, Germany, March 2011–December 2012. A) Quarterly incidence of M. pneumoniae infection. n values indicate number of samples investigated by real-time PCR. B) M. pneumoniae P1 genotypes. C) M. pneumoniae multilocus variable-number tandem-repeat analysis types. Numbers of strains belonging to a given type are indicated in parentheses.

Figure 2

Age and sex distribution of patients with Mycoplasma pneumoniae–positive respiratory tract samples (n = 96), Germany, March 2011–December 2012. Percentage of positive samples for each age group: 18–29 y, 28.1%; 30–39 y, 21.9%; 40–49 y, 22.9%; 50–59 y, 14.6%; >60 y, 13.5%. (Total >100% due to rounding.)