MYCOPLASMA-PNEUMONIAE PNEUMONIA FOLLOWING ASSISTED VENTILATION

BACKGROUND: Mycoplasma pneumoniae pneumonia is regarded as a community -acquired pneumonia, rarely requiring hospitalization, with sporadic c ases car limited outbreaks occurring after close contacts with an infe cted patient. Few reports mention M pneumoniae pneumonia acquired duri ng hospitalization. PATIENTS AND METHODS: M pneumoniae was diagnosed i n patients who developed pneumonia following perioperative and postope rative assisted ventilation by the isolation of M pneumoniae from bron chial washing, the detection of M pneumoniae DNA from bronchial washin g, and serologic testing for the presence of specific immunoglobulin M (IgM) antibodies. RESULTS: Four patients were diagnosed as having M p neumoniae pneumonia following mechanical ventilation over a 1 1/2-year period. They were men, older than 50 years, and were hospitalized for vascular surgery. They developed febrile hypoxemia and intersticial p neumonia. Isolation of M pneumoniae and detection of M pneumoniae DNA were positive in 1 case; specific IgM antibodies were present in 4 cas es. CONCLUSIONS: These observations allow the description of a new cli nical entity and highlight the role of M pneumoniae as an agent of nos ocomial infections. This diagnosis should be considered in any patient with precocious post-assisted ventilation febrile hypoxemia and diffu se interstitial pneumonia, and empiric treatment protocols may include M pneumoniae in their spectrum.