Mycoplasma pneumoniae among Chinese Outpatient Children with Mild Respiratory Tract Infections during the Coronavirus Disease 2019 Pandemic
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 w...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
American Society for Microbiology
2022-02-01
|
| Series: | Microbiology Spectrum |
| Subjects: | |
| Online Access: | https://journals.asm.org/doi/10.1128/spectrum.01550-21 |
| _version_ | 1819326750093475840 |
|---|---|
| author | 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 |
| author_facet | 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 |
| author_sort | Jiande Chen |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-24T12:59:54Z |
| format | Article |
| id | doaj.art-4dcbce517b98441d9a2c982b9e6b3f86 |
| institution | Directory Open Access Journal |
| issn | 2165-0497 |
| language | English |
| last_indexed | 2024-12-24T12:59:54Z |
| publishDate | 2022-02-01 |
| publisher | American Society for Microbiology |
| record_format | Article |
| series | Microbiology Spectrum |
| spelling | doaj.art-4dcbce517b98441d9a2c982b9e6b3f862022-12-21T16:54:10ZengAmerican Society for MicrobiologyMicrobiology Spectrum2165-04972022-02-0110110.1128/spectrum.01550-21Mycoplasma pneumoniae among Chinese Outpatient Children with Mild Respiratory Tract Infections during the Coronavirus Disease 2019 PandemicJiande Chen0Jing Zhang1Zhiwei Lu2Yu Chen3Songsong Huang4Hengtao Li5Shuzhu Lin6Jun Yu7Xueqi Zeng8Cuihong Ji9Yuejie Zheng10Fangfang Dai11Wei Dong12Huiting Xu13Weichao Chen14Xiaoqun Jin15Zhen Cui16Jing Qiao17Wei Qin18Hui Chen19Wei Jiang20Xiaoying Zhang21Jingrong Song22Jie Shao23Wen Su24Chao Wang25Fang Liu26Yuhua Zhao27Yingxue Zou28Run Guo29Lei Zhang30Jinhong Wu31Shuhua Yuan32Mingyu Tang33Yufen Wu34Jie Lin35Wenfang Dong36Xing Chen37Xinrong Sun38Yong Yin39Department of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Respiratory Diseases, Shenzhen Children’s Hospital, Shenzhen, Guangdong, ChinaDepartment of Pediatrics, Shanghai Fourth People’s Hospital, Tongji University, Shanghai, ChinaDepartment of Pediatrics, Shanghai Fourth People’s Hospital, Tongji University, Shanghai, ChinaDepartment of Pediatrics, Fengcheng Hospital, Shanghai, ChinaDepartment of Pediatrics, Fengcheng Hospital, Shanghai, ChinaDepartment of Pediatrics, Fengxian District Central Hospital, Shanghai, ChinaDepartment of Pediatrics, Fengxian District Central Hospital, Shanghai, ChinaDepartment of Pediatrics, Fengxian District Central Hospital, Shanghai, ChinaDepartment of Respiratory Diseases, Shenzhen Children’s Hospital, Shenzhen, Guangdong, ChinaDepartment of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, ChinaDepartment of Pediatrics, Nanxiang Hospital, Shanghai, ChinaDepartment of Pediatrics, Nanxiang Hospital, Shanghai, ChinaSecond Department of Infectious Diseases, Xi’an Children’s Hospital, The Affiliated Children’s Hospital of Xi’an Jiaotong University, Shaanxi, ChinaDepartment of Pediatrics, Putuo District People’s Hospital, Shanghai, ChinaDepartment of Pediatrics, Putuo District People’s Hospital, Shanghai, ChinaDepartment of Pediatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Pediatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Pediatrics, Dahua Hospital of Shanghai Xuhui District, Shanghai, ChinaDepartment of Pediatrics, Dahua Hospital of Shanghai Xuhui District, Shanghai, ChinaDepartment of Pediatrics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Pediatrics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Pulmonary, Shanghai Children’s Hospital, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Pediatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Pediatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Respiratory Medicine, Tianjin Children’s Hospital (Children’s Hospital of Tianjin University), Tianjin, ChinaDepartment of Respiratory Medicine, Tianjin Children’s Hospital (Children’s Hospital of Tianjin University), Tianjin, ChinaDepartment of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, ChinaSecond Department of Infectious Diseases, Xi’an Children’s Hospital, The Affiliated Children’s Hospital of Xi’an Jiaotong University, Shaanxi, ChinaDepartment of Respiratory Medicine, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaABSTRACT 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.https://journals.asm.org/doi/10.1128/spectrum.01550-21Mycoplasma pneumoniaechildrenmacrolideoutpatientCOVID-19 |
| spellingShingle | 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 Mycoplasma pneumoniae among Chinese Outpatient Children with Mild Respiratory Tract Infections during the Coronavirus Disease 2019 Pandemic Microbiology Spectrum Mycoplasma pneumoniae children macrolide outpatient COVID-19 |
| title | Mycoplasma pneumoniae among Chinese Outpatient Children with Mild Respiratory Tract Infections during the Coronavirus Disease 2019 Pandemic |
| title_full | Mycoplasma pneumoniae among Chinese Outpatient Children with Mild Respiratory Tract Infections during the Coronavirus Disease 2019 Pandemic |
| title_fullStr | Mycoplasma pneumoniae among Chinese Outpatient Children with Mild Respiratory Tract Infections during the Coronavirus Disease 2019 Pandemic |
| title_full_unstemmed | Mycoplasma pneumoniae among Chinese Outpatient Children with Mild Respiratory Tract Infections during the Coronavirus Disease 2019 Pandemic |
| title_short | Mycoplasma pneumoniae among Chinese Outpatient Children with Mild Respiratory Tract Infections during the Coronavirus Disease 2019 Pandemic |
| title_sort | mycoplasma pneumoniae among chinese outpatient children with mild respiratory tract infections during the coronavirus disease 2019 pandemic |
| topic | Mycoplasma pneumoniae children macrolide outpatient COVID-19 |
| url | https://journals.asm.org/doi/10.1128/spectrum.01550-21 |
| work_keys_str_mv | AT jiandechen mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT jingzhang mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT zhiweilu mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT yuchen mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT songsonghuang mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT hengtaoli mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT shuzhulin mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT junyu mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT xueqizeng mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT cuihongji mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT yuejiezheng mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT fangfangdai mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT weidong mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT huitingxu mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT weichaochen mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT xiaoqunjin mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT zhencui mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT jingqiao mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT weiqin mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT huichen mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT weijiang mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT xiaoyingzhang mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT jingrongsong mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT jieshao mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT wensu mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT chaowang mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT fangliu mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT yuhuazhao mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT yingxuezou mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT runguo mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT leizhang mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT jinhongwu mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT shuhuayuan mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT mingyutang mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT yufenwu mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT jielin mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT wenfangdong mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT xingchen mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT xinrongsun mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic AT yongyin mycoplasmapneumoniaeamongchineseoutpatientchildrenwithmildrespiratorytractinfectionsduringthecoronavirusdisease2019pandemic |