Molecular Detection of Bacterial Agents of Atypical Pneumonia: Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila in Suez Canal region

Background: Atypical bacterial infections played an important role in community-acquired pneumonia (CAP). It is difficult to detect atypical pathogens by conventional microbiological diagnostic methods. Atypical bacteria do not respond to beta-lactam antibiotics. The use of multiplex polymerase chain reaction (PCR) methods enables rapid and simultaneous detection of many pathogens in a single analysis. Aim: detecting the prevalence of atypical bacterial pathogens as etiologic agents of atypical pneumonia, in the Suez Canal region.
Materials and Methods: This cross-sectional descriptive study was conducted throughout 18 months, from October 2018 to April 2020. It included 84 Egyptians suffered from CA atypical pneumonic patients of all age groups from Suez-Canal region, Egypt. Sputum samples were collected for identification of Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophilia by using multiplex PCR.
Results: Among the 84 atypical pneumonia patients, L. pneumophila were detected in 12 (14%) patients. M. pneumoniae and C. pneumoniae were not detected in our samples. Compared with L. pneumophila -negative cases, L. pneumophila -positive cases were more prevalent in middle aged males, smokers, COPD, diabetic and asthmatic patients (P values = 0.048). Persistent cough, elevated levels of C-reactive protein (C-RP), bilateral pulmonary infiltration are significant clues for predicting L. pneumophila pneumonia.
Conclusions: L. pneumophila incidence is not low in our geographical region in atypical pneumonia patients. Clinicians should consider atypical bacterial pathogens while prescribing antimicrobial management plan.
Keywords: Atypical pneumonia, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella pneumophilia, multiplex-PCR.