Mycoplasma Pneumoniae in Pediatric Patients–14 Years of Experience at a Tertiary Center and Most Recent Impressions

Background: Mycoplasma pneumoniae is a well-established pathogen that affects both the upper and lower respiratory tracts in children and adolescents. It can also affect the skin, mucous membranes, central nervous system, and other tissues. Epidemics occur every 3 to 5 years and by the end of 2023, a resurgence of cases was reported, suggesting a new epidemic. This study aimed to characterize the pediatric M. pneumoniae cases over the past 14 years. Methods: We reviewed medical records of patients aged 0 to 18, evaluated in the emergency department or hospitalized, with a positive PCR result for M. pneumoniae from respiratory specimens between 2011 and 2024. Results: A total of 270 patients with a positive PCR for M. pneumoniae were included. Three outbreaks were identified: 2015 to 2016, 2018 to 2019, and 2024, with the latter being the most significant, comprising 40.3% of the study population. The median age at presentation was 7 years (IQR: 3.8 to 11), with 37% of patients under 5 years; 25% aged 2 to 5 years, and 12% were under 2 years old. Seventy-four patients (27.4%) had a history of severe comorbidities. Two hundred five patients (76%) presented with pneumonia, 78 (29%) with asthma exacerbations, and 45 (16.7%) with extrapulmonary manifestations. Fourteen patients (5.2%) required pediatric intensive care, and only 22 of them required mechanical ventilation. No mortalities occurred. Conclusion: Our data highlights a substantial burden of M. pneumoniae in children under 5 years old. This underscores the importance of maintaining a high index of suspicion and considering this pathogen in young children during outbreaks, ensuring timely diagnosis and appropriate management.