Mycoplasma pneumoniae among Chinese Outpatient Children with Mild Respiratory Tract Infections during the Coronavirus Disease 2019 Pandemic

Jiande Chen; Jing Zhang; Zhiwei Lu; Yu Chen; Songsong Huang; Hengtao Li; Shuzhu Lin; Jun Yu; Xueqi Zeng; Cuihong Ji; Yuejie Zheng; Fangfang Dai; Wei Dong; Huiting Xu; Weichao Chen; Xiaoqun Jin; Zhen Cui; Jing Qiao; Wei Qin; Hui Chen; Wei Jiang; Xiaoying Zhang; Jingrong Song; Jie Shao; Wen Su; Chao Wang; Fang Liu; Yuhua Zhao; Yingxue Zou; Run Guo; Lei Zhang; Jinhong Wu; Shuhua Yuan; Mingyu Tang; Yufen Wu; Jie Lin; Wenfang Dong; Xing Chen; Xinrong Sun; Yong Yin

doi:10.1128/spectrum.01550-21

Microbiology Spectrum (Feb 2022)

Mycoplasma pneumoniae among Chinese Outpatient Children with Mild Respiratory Tract Infections during the Coronavirus Disease 2019 Pandemic

Jiande Chen,
Jing Zhang,
Zhiwei Lu,
Yu Chen,
Songsong Huang,
Hengtao Li,
Shuzhu Lin,
Jun Yu,
Xueqi Zeng,
Cuihong Ji,
Yuejie Zheng,
Fangfang Dai,
Wei Dong,
Huiting Xu,
Weichao Chen,
Xiaoqun Jin,
Zhen Cui,
Jing Qiao,
Wei Qin,
Hui Chen,
Wei Jiang,
Xiaoying Zhang,
Jingrong Song,
Jie Shao,
Wen Su,
Chao Wang,
Fang Liu,
Yuhua Zhao,
Yingxue Zou,
Run Guo,
Lei Zhang,
Jinhong Wu,
Shuhua Yuan,
Mingyu Tang,
Yufen Wu,
Jie Lin,
Wenfang Dong,
Xing Chen,
Xinrong Sun,
Yong Yin

Affiliations

Jiande Chen: Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Jing Zhang: Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Zhiwei Lu: Department of Respiratory Diseases, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
Yu Chen: Department of Pediatrics, Shanghai Fourth People’s Hospital, Tongji University, Shanghai, China
Songsong Huang: Department of Pediatrics, Shanghai Fourth People’s Hospital, Tongji University, Shanghai, China
Hengtao Li: Department of Pediatrics, Fengcheng Hospital, Shanghai, China
Shuzhu Lin: Department of Pediatrics, Fengcheng Hospital, Shanghai, China
Jun Yu: Department of Pediatrics, Fengxian District Central Hospital, Shanghai, China
Xueqi Zeng: Department of Pediatrics, Fengxian District Central Hospital, Shanghai, China
Cuihong Ji: Department of Pediatrics, Fengxian District Central Hospital, Shanghai, China
Yuejie Zheng: Department of Respiratory Diseases, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
Fangfang Dai: Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
Wei Dong: Department of Pediatrics, Nanxiang Hospital, Shanghai, China
Huiting Xu: Department of Pediatrics, Nanxiang Hospital, Shanghai, China
Weichao Chen: Second Department of Infectious Diseases, Xi’an Children’s Hospital, The Affiliated Children’s Hospital of Xi’an Jiaotong University, Shaanxi, China
Xiaoqun Jin: Department of Pediatrics, Putuo District People’s Hospital, Shanghai, China
Zhen Cui: Department of Pediatrics, Putuo District People’s Hospital, Shanghai, China
Jing Qiao: Department of Pediatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
Wei Qin: Department of Pediatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
Hui Chen: Department of Pediatrics, Dahua Hospital of Shanghai Xuhui District, Shanghai, China
Wei Jiang: Department of Pediatrics, Dahua Hospital of Shanghai Xuhui District, Shanghai, China
Xiaoying Zhang: Department of Pediatrics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Jingrong Song: Department of Pediatrics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Jie Shao: Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Wen Su: Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Chao Wang: Department of Pulmonary, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai, China
Fang Liu: Department of Pediatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
Yuhua Zhao: Department of Pediatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
Yingxue Zou: Department of Respiratory Medicine, Tianjin Children’s Hospital (Children’s Hospital of Tianjin University), Tianjin, China
Run Guo: Department of Respiratory Medicine, Tianjin Children’s Hospital (Children’s Hospital of Tianjin University), Tianjin, China
Lei Zhang: Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Jinhong Wu: Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Shuhua Yuan: Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Mingyu Tang: Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Yufen Wu: Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Jie Lin: Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Wenfang Dong: Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
Xing Chen: Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
Xinrong Sun: Second Department of Infectious Diseases, Xi’an Children’s Hospital, The Affiliated Children’s Hospital of Xi’an Jiaotong University, Shaanxi, China
Yong Yin: Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

DOI: https://doi.org/10.1128/spectrum.01550-21
Journal volume & issue: Vol. 10, no. 1

Abstract

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ABSTRACT Mycoplasma pneumoniae is a common pathogen causing respiratory disease in children. We sought to investigate the epidemiology of M. pneumoniae among outpatient children with mild respiratory tract infections (RTIs) during the coronavirus disease 2019 (COVID-19) pandemic. Eligible patients were prospectively enrolled from January 2020 to June 2021. Throat swabs were tested for M. pneumoniae RNA. M. pneumoniae IgM was tested by a colloidal gold assay. Macrolide resistance and the effect of the COVID-19 countermeasures on M. pneumoniae prevalence were assessed. Symptom scores, treatments, and outcomes were evaluated. Eight hundred sixty-two eligible children at 15 centers in China were enrolled. M. pneumoniae was detected in 78 (9.0%) patients. Seasonally, M. pneumoniae peaked in the first spring and dropped dramatically to extremely low levels over time until the next summer. Decreases in COVID-19 prevalence were significantly associated with decreases in M. pneumoniae prevalence (r = 0.76, P = 0.001). The macrolide resistance rate was 7.7%. The overall sensitivity and specificity of the colloidal gold assay used in determining M. pneumoniae infection were 32.1% and 77.9%, respectively. No more benefits for improving the severity of symptoms and outcomes were observed in M. pneumoniae-infected patients treated with a macrolide than in those not treated with a macrolide during follow-up. The prevalences of M. pneumoniae and macrolide resistance in outpatient children with mild RTIs were at low levels in the early stage of the COVID-19 pandemic but may have rebounded recently. The colloidal gold assay for M. pneumoniae IgM may be not appropriate for diagnosis of M. pneumoniae infection. Macrolides should be used with caution among outpatients with mild RTIs. IMPORTANCE This is the first and largest prospective, multicenter, active, population-based surveillance study of the epidemiology of Mycoplasma pneumoniae among outpatient children with mild respiratory tract infections (RTIs) during the COVID-19 pandemic. Nationwide measures like strict face mask wearing and restrictions on population movement implemented to prevent the spread of COVID-19 might also effectively prevent the spread of M. pneumoniae. The prevalence of M. pneumoniae and the proportion of drug-resistant M. pneumoniae isolates in outpatient children with mild RTIs were at low levels in the early stage of the COVID-19 pandemic but may have rebounded recently. The colloidal gold assay for M. pneumoniae IgM may be not appropriate for screening and diagnosis of M. pneumoniae infection. Macrolides should be used with caution among outpatients with mild RTIs.

Published in Microbiology Spectrum

ISSN: 2165-0497 (Online)
Publisher: American Society for Microbiology
Country of publisher: United States
LCC subjects: Science: Microbiology
Website: https://journals.asm.org/journal/spectrum

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