Effect of COVID-19 on childhood 
      <i>Mycoplasma pneumoniae</i> infection in Chengdu, China

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Abstract

Background

Following the outbreak of the COVID-19 pandemic, a change in the incidence and transmission of respiratory pathogens was observed. Here, we retrospectively analyzed the impact of COVID-19 on the epidemiologic characteristics of Mycoplasma pneumoniae infection among children in Chengdu, one of the largest cities of western China.

Method

M. pneumoniae infection was diagnosed in 33,345 pediatric patients with respiratory symptoms at the Chengdu Women’s & Children’s Central Hospital between January 2017 and December 2020, based on a serum antibody titer of ≥1:160 measured by the passive agglutination assay. Differences in infection rates were examined by sex, age, and temporal distribution.

Results

Two epidemic outbreaks occurred between October-December 2017 and April-December 2019, and two infection peaks were detected in the second and fourth quarters of 2017, 2018, and 2019. Due to the public health response to COVID-19, the number of positive M. pneumoniae cases significantly decreased in the second quarter of 2020. The number of M. pneumoniae infection among children aged 3–6 years was higher than that in other age groups.

Conclusions

Preschool children are more susceptible to M. pneumoniae infection and close contact appears to be the predominant factor favoring pathogen transmission. The public health response to COVID-19 can effectively control the transmission of M. pneumoniae.

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Most cited references 30

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Mycoplasma pneumoniae from the Respiratory Tract and Beyond.

Ken B Waites, Li Ying Xiao, Yang Liu … (2017)

Mycoplasma pneumoniae is an important cause of respiratory tract infections in children as well as adults that can range in severity from mild to life-threatening. Over the past several years there has been much new information published concerning infections caused by this organism. New molecular-based tests for M. pneumoniae detection are now commercially available in the United States, and advances in molecular typing systems have enhanced understanding of the epidemiology of infections. More strains have had their entire genome sequences published, providing additional insights into pathogenic mechanisms. Clinically significant acquired macrolide resistance has emerged worldwide and is now complicating treatment. In vitro susceptibility testing methods have been standardized, and several new drugs that may be effective against this organism are undergoing development. This review focuses on the many new developments that have occurred over the past several years that enhance our understanding of this microbe, which is among the smallest bacterial pathogens but one of great clinical importance.

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Antimicrobial therapy of macrolide-resistant Mycoplasma pneumoniae pneumonia in children.

Ki Wook Yun, Eun Hwa Choi, Hoan Lee … (2018)

Mycoplasma pneumoniae is an important cause of community-acquired pneumonia in children and young adolescents. Macrolides are recommended as the first-line therapy however, macrolide resistance rates in M. pneumoniae among children have been increasing substantially. Areas covered: This review focused on clinical characteristics and treatment of macrolide-resistant M. pneumoniae pneumonia in children. Expert commentary: Antibiotic choice should be based on in vitro activity, clinical efficacy and in consideration of potential adverse events. Macrolide resistance did not contribute to the clinical severity of M. pneumoniae pneumonia, but resistance may be an aggravating factor. Antibiotics may not be required for treatment in mild cases due to the self-resolving nature of M. pneumonia infection, regardless of macrolide resistance. In contrast, antibiotic treatment of severe cases of M. pneumoniae pneumonia is complicated. The clinical benefit of tetracyclines and fluoroquinolones has been shown in terms of shortening duration of symptoms and rapid defervescence in some reports. However, due to safety concerns regarding these two alternative antibiotics, clinicians should weigh the risks and benefits when choosing treatment options. Alternative antibiotics may be considered when patients remain febrile or when chest x-rays show deterioration at least 48-72 hours after macrolide treatment.

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Epidemiology and clinical features of Mycoplasma pneumoniae infection in children.

Michela Silvestri, E. Di Marco, Annacarla Defilippi … (2008)

Mycoplasma pneumoniae (MP) is, considered to affect rarely children less than 5 yrs of age. This study was performed to describe the epidemiology and the clinical features of MP lower respiratory tract infection (LRTI) in children, presenting to a tertiary children hospital. Eleven month-longitudinal study of LRTI due to MP, diagnosed by polymerase chain reaction (PCR) on throat swab specimen, was performed. Out of 866 children with LRTI admitted to the Gaslini Pediatric Institute in Genoa, 102 had a positive PCR for MP. We found 39 preschool-aged children, 42 school-aged children and 21 young adolescent [6.20 (3.81) yrs old]. Interestingly, eight MP+ infants had <8 months of age. The commonest presentations were cough and/or fever (76.5%). Tachypnoea, upper respiratory tract involvement, diarrhoea and vomiting were more common in the <5 yr Gr as compared to the other groups. Chest X-ray was found abnormal in 76 children: consolidations were the commonest finding. Laboratory test showed that the preschool-aged children had a higher number of lymphocytes (p<0.0001) and monocytes (p=0.009). Thrombocytosis was found in 35.7% of children and was more frequent in the preschool-aged children (p=0.013). MP infection is common in preschool-aged children, including young infants, and may have different clinical presentation, as compared to older children.

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Author and article information

Contributors

Hanmin Liu: liuhm@scu.edu.cn

Journal

Journal ID (nlm-ta): BMC Pediatr

Journal ID (iso-abbrev): BMC Pediatr

Title: BMC Pediatrics

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2431

Publication date (Electronic): 28 April 2021

Publication date PMC-release: 28 April 2021

Publication date Collection: 2021

Volume: 21

Electronic Location Identifier: 202

Affiliations

[1 ]GRID grid.13291.38, ISNI 0000 0001 0807 1581, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), West China Second University Hospital, Ministry of Education, , Sichuan University, ; No.20 section3 South Renmin Road, Sichuan Province 610041 Chengdu, China

[2 ]GRID grid.54549.39, ISNI 0000 0004 0369 4060, Children respiratory department,Chengdu Women’s and Children’s Central Hospital, School of Medicine, , University of Electronic Science and Technology of China, ; 611731 Chengdu, China

Article

Publisher ID: 2679

DOI: 10.1186/s12887-021-02679-z

PMC ID: 8079841

PubMed ID: 33910509

SO-VID: 0afd1225-ef73-42c0-bb35-1de0d059a734

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 31 December 2020

Date accepted : 20 April 2021

Custom metadata

ScienceOpen disciplines: Pediatrics

Keywords: mycoplasma pneumoniae,covid-19 pandemic,children,western china

Data availability:

ScienceOpen disciplines: Pediatrics

Keywords: mycoplasma pneumoniae, covid-19 pandemic, children, western china

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Effect of COVID-19 on childhood Mycoplasma pneumoniae infection in Chengdu, China

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Abstract

Background

Method

Results

Conclusions

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Novel Coronavirus Disease COVID-19

Most cited references 30

Mycoplasma pneumoniae from the Respiratory Tract and Beyond.

Antimicrobial therapy of macrolide-resistant Mycoplasma pneumoniae pneumonia in children.

Epidemiology and clinical features of Mycoplasma pneumoniae infection in children.

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Cited by 20

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