Paediatric PM came back with a vengeance after COVID pandemic: study

The clinical presentation of paediatric Mycoplasma pneumoniae (MP) in 2024 shows a stark difference when compared with prior epidemics, marked by an increase in severe pneumonia among older children, reveals a study.

In this retrospective cohort study, investigators analysed demographic, clinical, and treatment data from paediatric patients (0–17 years of age) with PCR-confirmed MP. Daily reports in 2024 updated physicians on positive cases. Data in 2024 (221 patients) was compared with that from 2007 to 2017 (352 patients) and initial epidemic years (2012, 2015; 139 patients).

In the 2024 epidemic, the investigators noted an increased median age (8.0 vs 5.8 years; p=0.0002), higher female prevalence (56 percent vs 44 percent; p=0.007), and altered clinical manifestations: increased cough (78 percent vs 63 percent; p=0.0002), fever (79 percent vs 64 percent; p=0.0004), consolidation on radiograph (48 percent vs 39 percent; p=0.0244), and pleural effusions (5 percent vs 0 percent; p<0.0001). Furthermore, the incidence of rash decreased (8 percent vs 16 percent; p=0.0031).

These differences in age, sex, pleural effusions, and rash persisted in comparisons with initial epidemic years.

In 2024, early emergency department diagnosis also rose from 43 percent to 80 percent, while the hospitalization rate dropped from 70 percent to 30 percent and was lower than 2007–2017 overall (81 percent; p<0.001).

“Enhanced awareness facilitated rapid diagnostics, reducing hospital admissions, unnecessary tests, and inappropriate antibiotic use,” the investigators said.

“MP is a prevalent bacterial respiratory pathogen known for cyclic epidemics every 3–5 years, potentially linked to waning immunity,” they said. “Following the global decline postcoronavirus disease 2019, MP has re-emerged since late 2023.”