Microbiol Spectr. 2026 Aug 14:e0035426. doi: 10.1128/spectrum.00354-26. Online ahead of print.
ABSTRACT
Mycoplasma pneumoniae pneumonia (MPP) is the most common form of community-acquired pneumonia, which shows an epidemic interval of 3-7 years. This study was conducted to understand the changing trends in MPP in children hospitalized before and during the coronavirus disease 2019 pandemic and determine adverse outcomes and their influencing factors. This was a retrospective cohort study of children aged 28 days to 14 years hospitalized for MPP at our institution between January 2018 and December 2023. Clinical characteristics, adverse outcomes, and associated factors were analyzed using the chi-square test and multivariable logistic regression. A P < 0.05 was considered statistically significant. A total of 17,505 MPP cases were included, with the highest case number (4,619) in 2023. In 2023, the proportion of severe pneumonia was 44.1%, and bronchoscopy usage was 33.5%, both significantly higher than in 2018-2022. Older age, admission during July-December, co-infection with Epstein-Barr virus, chlamydia, or other bacteria, and complications, including pleural effusion, abnormal liver enzymes, acute respiratory distress syndrome, or atelectasis, were associated with bronchoscopy. Older age, admission during October-December, co-infection with respiratory syncytial virus, adenovirus, Epstein-Barr virus, chlamydia, or other bacteria, and complications, including cardiac failure, abnormal liver enzymes, myocardial damage, or anemia, were associated with severe pneumonia. Cases of MPP, severe pneumonia, and those requiring bronchoscopy increased in 2023 compared with the five previous years. Children with MPP were more susceptible to adverse clinical outcomes, which were associated with age, month of admission, co-infection, and complications.IMPORTANCEMycoplasma pneumoniae pneumonia (MPP) is a leading cause of community-acquired pneumonia in children. This study analyzed 17,505 hospitalized children in Northeast China from 2018 to 2023 to explore MPP trends before, during, and after the coronavirus disease 2019 pandemic. We found a sharp resurgence of MPP in 2023 with higher rates of severe pneumonia, complications, and bronchoscopy use. Key risk factors for adverse outcomes included older age, admission in October-December, viral/bacterial co-infection, and pulmonary or extrapulmonary complications. These findings improve understanding of post-pandemic MPP epidemiology, support early risk stratification, and help optimize clinical management and public health interventions for childhood MPP.
PMID:42599103 | DOI:10.1128/spectrum.00354-26
