Epidemiological analysis of Mycoplasma pneumoniae infection in hospitalized children with community-acquired pneumonia in Hunan from 2013 to 2021 / 中华微生物学和免疫学杂志

ABSTRACT

Objective:To analyze the epidemiological characteristics of Mycoplasma pneumoniae ( Mp) infection in hospitalized children with community-acquired pneumonia in Hunan Province and to provide a theoretical basis for clinical diagnosis and treatment. Methods:The epidemiological characteristics of Mp infection in children hospitalized for community-acquired pneumonia in the Children′s Medical Center of the First Affiliated Hospital of Hunan Normal University (Hunan Provincial People′s Hospital) from January 1, 2013 to December 31, 2021 were retrospectively analyzed. Results:A total of 55 681 children with community-acquired pneumonia were enrolled during the study period, of whom 27.24% (15 170/55 681) were tested positive for Mp. The positive rate was lower in boys than in girls (23.39% vs 33.39%, χ 2=665.998, P<0.001). The positive rate of Mp infection increased with age with the highest rate in children who were 5-14 years old (67.92%) and the lowest in infants less than one year old (6.38%). The detection rates of Mp infection varied between years with the highest rate in 2019 (38.31%). The positive rates of Mp infection during the COVID-19 epidemic in 2020-2021 were similar to those in 2013-2018. Among the children hospitalized for community-acquired pneumonia, the detection rate of Mp was significantly higher in summer and autumn than in winter and spring (χ 2=648.753, P<0.001), with the highest detection rate reaching to 56.91% in the summer of 2019. In contrast, the detection rates of Mp in the spring and summer of 2020 were 15.60% and 17.44%, respectively, being the lowest detection rates ever for spring and summer, while the detection rates in the autumn and winter rebounded (31.22% and 28.48%). During the Mp epidemic in 2019, the age at onset, the proportion of severe pneumonia and the cost of treatment were higher as compared with those in other years. In 2020, the number of cases positive for Mp was the lowest on record, as was the proportion of severe pneumonia and admission rate to PICU ( P<0.001). Conclusions:In hospitalized children with community-acquired pneumonia, there were gender, age and season differences in Mp infection. In the summer of 2019, there was a Mp epidemic in Hunan Province, which increased the proportion of severe pneumonia and the cost of treatment. After the outbreak of COVID-19, the rate of Mp infection dropped significantly in the spring of in 2020 as well as in the summer, but rebounded in the autumn and winter. This might be due to the strict restrictive measures taken early during the COVID-19 pandemic that effectively controlled the spread of Mp.