CDC Addresses Rebound of Mycoplasma Pneumonia in Kids

In the fall of 2023, emergency department (ED)-related visits for Mycoplasma pneumoniae in children rebounded somewhat from a lull during the COVID-19 pandemic, but the numbers were still not as high as before the pandemic, according to an analysis of CDC data.

The percentage of M. pneumoniae diagnoses among pneumonia-related ED visits fell from 1.15% before the pandemic to just 0.35% during the pandemic, and then increased to 0.89% in the post-pandemic period, Chris Edens, PhD, of the CDC’s National Center for Immunization and Respiratory Diseases in Atlanta, and colleagues detailed in Morbidity and Mortality Weekly Report.

Also, the percentage of M. pneumoniae-positive test results decreased from 1.2% during the study’s prepandemic period (January 2018 to April 2020) to 0.04% during the pandemic period (May 2020 to August 2023), before then increasing to 0.53% during the study’s post-pandemic period (September 2023 to December 2023).

Thirteen out of 14 positive specimens collected at four different sites from September 2023 to January 2024 and analyzed at the CDC were found to be susceptible to macrolides. “Despite ongoing concerns regarding antimicrobial resistance, macrolides remain the recommended first-line treatment for M. pneumoniae infections in the United States,” wrote Edens and co-authors.

The study results are somewhat reassuring, given concerns over a potential surge in pediatric M. pneumoniae reported around the world late last year. In November 2023, cases of M. pneumoniae reached epidemic levels in one Ohio county and increases in pediatric cases and hospitalizations were also reported in six European countries, Korea, and in China. However, on December 1, the CDC announced that, overall, rates of pneumonia from all causes among children were in line with previous years.

M. pneumoniae often causes so-called “walking pneumonia,” and is particularly common in school-age children. While most infections are mild, some children develop severe pneumonia and may require hospitalization. Significant cyclical increases in M. pneumoniae infections are often seen every 3 to 5 years, likely because of changes in the predominant circulating strain, Edens and colleagues explained.

The analysis used data from the CDC’s National Syndromic Surveillance Program that included diagnostic codes from more than 6,500 ED and urgent care departments in the U.S. to determine the percentage of M. pneumoniae-related diagnoses before, during, and after the COVID-19 pandemic. Data from the New Vaccine Surveillance Network were used to determine the percentage of positive M. pneumoniae laboratory test results during the same time periods.

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