Clinical epidemiological characteristics of hospitalized pediatric Mycoplasma pneumoniae pneumonia in China.

BACKGROUND

Mycoplasma pneumoniae pneumonia (MPP) is a leading cause of community-acquired pneumonia in children. The COVID-19 pandemic substantially disrupted the transmission dynamics of M. pneumoniae, yet large-scale, nationwide data characterizing the clinical and epidemiological evolution of pediatric MPP in China across the pandemic period remain scarce.

METHODS

We analyzed 325,781 MPP hospitalizations from 31 tertiary children's hospitals across mainland China between 2016 and 2023, using the FUTURE Database. Temporal trends and demographic differences in disease severity, co-infections, complications, length of stay (LOS), and hospitalization costs were systematically evaluated.

RESULTS

MPP admissions peaked in 2023, accounting for 8.76% of all pediatric hospitalizations. The male-to-female ratio was 1.15:1. children aged 3-6 years accounted for the largest proportion (32.42%), though children aged 6-10 years became predominant in 2023. Severe MPP increased significantly over time (P for trend <0.0001), rising from 3.78% in 2017 to above 13% after 2020. Viral and bacterial co-infection rates rose significantly to 24.13% and 10.09% in 2023, with infants bearing the highest burden. Respiratory complications increased over time to over 10% after 2021, while extrapulmonary complications declined. The median LOS was 7 days (IQR 5-9), and the median cost was 5891.61CNY (IQR 4427.86-8425.95), both decreased significantly from 2016 to 2023. Severe MPP and coinfections were associated with longer LOS and higher costs.

CONCLUSIONS

This nationwide multicenter study reveals a post-pandemic surge in pediatric MPP in China, with rising severity, a shift towards school-aged children, and increasing co-infection rates. Despite improved healthcare efficiency, growing clinical complexity demands enhanced surveillance, risk stratification, and public health preparedness.