1459. The Scope of Mycoplasma Pneumoniae Pneumonia Diagnosed by Multiplex Polymerase Chain Reaction Respiratory Viral Panel in Pediatric Patients in Hawaii

BACKGROUND: Mycoplasma pneumoniae pneumonia (MPP) is classically associated with an infection in older children with mild virulence in younger children. The multiplex polymerase chain reaction (PCR) respiratory viral panel (RVP) allows for diagnosis of multiple viruses and bacteria. METHODS: A retrospective study was performed in patients 0–18 years old with positive MPP RVP from January 1, 2013 to June 30, 2017. Clinical cases of patients hospitalized with positive MPP testing by RVP PCR were reviewed for clinical, radiologic and laboratory data. RESULTS: A total of 3,621 RVPs were tested with 49 positive for MPP. In regard to age of patients, 27/49 (incidence 2.7%) positive for MPP were under 5 years old as compared with 22/49 (incidence 1%) between 5–18 years old. 75% of RVPs obtained were in patients under 5 years of age. Cough and fever were present for a mean of 8.3 and 7.6 days, respectively prior to RVP. Of the MPP positive patients, 21/49 patients (43%) were treated with scheduled although only 16 had a history of wheezing. Of the MPP positive patients, 38/48 patients had radiological findings of a pulmonary infiltrate (not perihilar) with 30/38 patients (79%) had bilateral infiltrates. Admission antimicrobial therapy was the following: 8 on no antibiotic, 21 on nonmacrolide, 11 macrolide and nonmacrolide, and 9 on macrolide therapy alone. Pediatric intensive care unit (PICU) admission occurred in 8 patients: 4 direct PICU admissions and 4 patients transferred from wards to PICU. All four PICU transfers had initially nonmacrolide therapy; 3 of 4 were under 5 years of age. CONCLUSION: Over half of Pediatric MPP was diagnosed by rapid molecular diagnostics in patients under 5 years of age. Bilateral pulmonary infiltrates and new onset wheezing responsive to β agonists were commonly noted in patients who had MPP. A small subset of those younger patients required higher level of care after initial therapy with nonmacrolide therapy. While MPP has a lower incidence among younger children, the infection is not rare and can have a significant clinical impact. MPP should be considered in all patients, especially younger patients who are nonresponsive to treatment of community acquired pneumonia. DISCLOSURES: All authors: No reported disclosures.