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Background <p>Mycoplasma pneumoniae (MP) represents a primary etiological agent of pediatric Acute Respiratory Infections (ARIs) in China. However, the epidemiological landscape of MP in coastal regions during the post-COVID-19 era remains poorly characterized. Here, we delineate the epidemiological dynamics of MP—including trends, seasonality, age-specific distribution, and viral co-detection patterns—among children with ARIs in the coastal city of Putian, Southeast China.</p> Methods <p>We retrospectively analyzed a cohort of 10,193 pediatric patients hospitalized with ARIs between December 2022 and November 2024. Oropharyngeal swabs from this cohort were assayed for MP and a panel of other respiratory pathogens using a multiplex reverse transcription-polymerase chain reaction (RT-PCR) platform. Data were stratified by time, season, and age to delineate the epidemiological characteristics of MP positivity.</p> Results <p>Across the surveillance period (Dec 2022–Nov 2024), the overall MP positivity rate was 33.7% (3,437/10,193), with a significant increase from 28.3% in the first year to 37.5% in the second (<i>P</i> &lt; 0.001), signaling a major post-pandemic resurgence. The epidemic pattern shifted from a discrete seasonal wave in the first year to a sustained, high-level plateau of transmission in the second. While school-age children consistently exhibited the highest positivity rates (59.1%), the age distribution of MP cases broadened significantly to include a larger proportion of younger children over the study period. Viral co-detections were identified in 25.5% of MP-positive cases, with the prevalence of co-detection being inversely correlated with age. Although the overall co-detection rate remained stable, MP-HAdV co-detections increased significantly in the second year (<i>P</i> &lt; 0.001). Notably, the rate of co-detection was strongly correlated with the community circulation of other respiratory viruses (<i>R</i> = 0.85, <i>P</i> &lt; 0.001), rather than the prevalence of MP itself.</p> Conclusions <p>Our data indicate that the post-pandemic epidemiology of MP in this coastal Chinese region was characterized by a shift from seasonal outbreaks to prolonged, high-level transmission, and notably, a broadening of the age distribution with expanded susceptibility among younger children. This downward shift deviates from the traditional concentration in school-aged populations and may reflect the evolving epidemiological dynamics of respiratory pathogens in the post-COVID-19 landscape. To the best of our knowledge, our findings offer regional insights that may help inform surveillance efforts and guide the development of age-targeted prevention strategies.</p> Clinical trial number <p>Not applicable.</p>

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Post-pandemic resurgence of Mycoplasma pneumoniae in coastal China: from seasonal waves to sustained transmission and expanded age susceptibility

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月7日

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  • Jinwei Zhu,
  • Suqing Wu,
  • Tianfu Xu,
  • Bijuan Zheng,
  • Yan Chen,
  • Yushan Zhuang

摘要

Background

Mycoplasma pneumoniae (MP) represents a primary etiological agent of pediatric Acute Respiratory Infections (ARIs) in China. However, the epidemiological landscape of MP in coastal regions during the post-COVID-19 era remains poorly characterized. Here, we delineate the epidemiological dynamics of MP—including trends, seasonality, age-specific distribution, and viral co-detection patterns—among children with ARIs in the coastal city of Putian, Southeast China.

Methods

We retrospectively analyzed a cohort of 10,193 pediatric patients hospitalized with ARIs between December 2022 and November 2024. Oropharyngeal swabs from this cohort were assayed for MP and a panel of other respiratory pathogens using a multiplex reverse transcription-polymerase chain reaction (RT-PCR) platform. Data were stratified by time, season, and age to delineate the epidemiological characteristics of MP positivity.

Results

Across the surveillance period (Dec 2022–Nov 2024), the overall MP positivity rate was 33.7% (3,437/10,193), with a significant increase from 28.3% in the first year to 37.5% in the second (P < 0.001), signaling a major post-pandemic resurgence. The epidemic pattern shifted from a discrete seasonal wave in the first year to a sustained, high-level plateau of transmission in the second. While school-age children consistently exhibited the highest positivity rates (59.1%), the age distribution of MP cases broadened significantly to include a larger proportion of younger children over the study period. Viral co-detections were identified in 25.5% of MP-positive cases, with the prevalence of co-detection being inversely correlated with age. Although the overall co-detection rate remained stable, MP-HAdV co-detections increased significantly in the second year (P < 0.001). Notably, the rate of co-detection was strongly correlated with the community circulation of other respiratory viruses (R = 0.85, P < 0.001), rather than the prevalence of MP itself.

Conclusions

Our data indicate that the post-pandemic epidemiology of MP in this coastal Chinese region was characterized by a shift from seasonal outbreaks to prolonged, high-level transmission, and notably, a broadening of the age distribution with expanded susceptibility among younger children. This downward shift deviates from the traditional concentration in school-aged populations and may reflect the evolving epidemiological dynamics of respiratory pathogens in the post-COVID-19 landscape. To the best of our knowledge, our findings offer regional insights that may help inform surveillance efforts and guide the development of age-targeted prevention strategies.

Clinical trial number

Not applicable.