Frontiers in cellular and infection microbiology · 2026
Clinical characteristics of hospitalized children with mycoplasma pneumoniae pneumonia in Chinese tertiary hospitals during the 2023-2024 post-pandemic period.
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Wang Xiancheng, Zheng Xiaoshun, Wang Longfei, Zhang Lijuan, Xu Yuming, Deng Shuang, Li Lihao, He Jie
Аннотация
BACKGROUNDS: The COVID-19 pandemic and subsequent non-pharmaceutical interventions (NPIs) altered the epidemiological patterns of Mycoplasma pneumoniae (M. pneumoniae) infections. This study aimed to analyze the long-term trends of M. pneumoniae pneumonia (MPP) in children after NPI discontinuation, focusing on epidemiological, clinical and macrolide-resistant characteristics.
METHODS: A retrospective analysis was conducted on 1342 hospitalized children with MPP from January 2023 to December 2024 in Shenzhen Hospital of Southern Medical University, China. MPP, macrolide-unresponsive MPP (MUMPP), and severe MPP (SMPP) were diagnosed according to predefined criteria. Differences between mutated MPP and MUMPP were investigated, and risk factors for MUMPP, SMPP and mixed infection were assessed.
RESULTS: MPP exhibits a bimodal temporal distribution in 2023-2024, with the first peak occurring in November 2023, and the second smaller peak in August 2024. The macrolide resistance gene positive rate was 86.43% (121/140), but only 64.29% (90/140) were clinically unresponsive to macrolides (P < 0.0001). Risk factors for MUMPP included older age, longer hospital stay, and severe cough. Approximately 25% of MPP cases progressed to SMPP, with younger age, prolonged cough, and higher inflammatory markers being associated with severity. Co-pathogen infections were common, and patients with mixed infections had distinct clinical and laboratory profiles compared to those with pure MPP.
CONCLUSIONS: This study highlights the complex epidemiological and clinical landscape of MPP in the post-pandemic era. The discordance between macrolide resistance genes and clinical treatment suggests that macrolides may still be effective in some cases. The identified risk factors and clinical features provide valuable insights for optimizing treatment strategies and managing pediatric MPP in the post-pandemic context.
METHODS: A retrospective analysis was conducted on 1342 hospitalized children with MPP from January 2023 to December 2024 in Shenzhen Hospital of Southern Medical University, China. MPP, macrolide-unresponsive MPP (MUMPP), and severe MPP (SMPP) were diagnosed according to predefined criteria. Differences between mutated MPP and MUMPP were investigated, and risk factors for MUMPP, SMPP and mixed infection were assessed.
RESULTS: MPP exhibits a bimodal temporal distribution in 2023-2024, with the first peak occurring in November 2023, and the second smaller peak in August 2024. The macrolide resistance gene positive rate was 86.43% (121/140), but only 64.29% (90/140) were clinically unresponsive to macrolides (P < 0.0001). Risk factors for MUMPP included older age, longer hospital stay, and severe cough. Approximately 25% of MPP cases progressed to SMPP, with younger age, prolonged cough, and higher inflammatory markers being associated with severity. Co-pathogen infections were common, and patients with mixed infections had distinct clinical and laboratory profiles compared to those with pure MPP.
CONCLUSIONS: This study highlights the complex epidemiological and clinical landscape of MPP in the post-pandemic era. The discordance between macrolide resistance genes and clinical treatment suggests that macrolides may still be effective in some cases. The identified risk factors and clinical features provide valuable insights for optimizing treatment strategies and managing pediatric MPP in the post-pandemic context.