Respiratory pathogen analysis in pediatric inpatients unraveled the infection pattern of Mycoplasma pneumoniae post the COVID-19 pandemic

Front Public Health. 2024 Oct 9:12:1437508. doi: 10.3389/fpubh.2024.1437508. eCollection 2024.

Authors

Qihong Chen^#^{1

2}, Ruizhi Xu^#³, Ying Gu^#³, Jie Peng^#^{1

2}, Chiyuan Ma³, Dubin Su³, Shuai Liu³, Dandan Ge^{1

2}, Yungang Yang^{1

2}, Wanshan Ning³

Affiliations

¹ Department of Pediatrics, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.
² Department of Pediatrics, Pediatric Key Laboratory of Xiamen, the First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China.
³ Institute for Clinical Medical Research, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.

^# Contributed equally.

Abstract

Background: To counteract the COVID-19 pandemic, nonpharmaceutical interventions (NPIs) were implemented globally, exerting a profound influence on a wide spectrum of infectious diseases, encompassing respiratory tract infections (RTIs). Subsequent to the easing of NPIs, China experienced a significant outbreak of Mycoplasma pneumoniae (MP).

Methods: Over a decade from 2015 to 2024, our study scrutinized 12 common infectious diseases among pediatric children. Etiologically diagnostic data and clinical outcome metrics of children with RTIs, tested for 13 pathogens, were analyzed to evaluate changes during and after the pandemic compared to pre-pandemic periods, with a notable emphasis on age profile and coinfection patterns of MP.

Results: Among 57,471 hospitalized children, 23,178 were diagnosed with infectious diseases. Under NPIs, most respiratory infections declined compared to pre-pandemic levels, rebounding by 69.64% in 2023. While the infection rate of common respiratory pathogens decreased, cases of respiratory syncytial virus increased during the period of extensive NPI implementation. In 2023, pediatric intensive care unit durations for these pathogens increased, suggesting greater severity of illness compared to 2019. MP exhibited the highest infection rate (31.38% average), with a notable outbreak post-pandemic due to severity increase in <3 year olds and rise among older children. NPIs reduced MP coinfections and mitigated their severity, while exerting a significant influence on bacterial coinfections with MP over the span of 5 years, in contrast to their impact on viral pathogens.

Conclusion: NPIs effectively curb transmission of respiratory infections by most pathogens, resulting in increased average age of MP infections and altered patterns of coinfection post-pandemic.

Keywords: COVID-19 pandemic; Mycoplasma pneumoniae; children; nonpharmaceutical interventions; respiratory pathogens.

MeSH terms

Adolescent
COVID-19* / epidemiology
Child
Child, Preschool
China / epidemiology
Coinfection* / epidemiology
Female
Hospitalization / statistics & numerical data
Humans
Infant
Inpatients / statistics & numerical data
Male
Mycoplasma pneumoniae* / isolation & purification
Pandemics
Pneumonia, Mycoplasma* / epidemiology
Respiratory Tract Infections* / epidemiology
Respiratory Tract Infections* / microbiology
SARS-CoV-2

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National Key R & D Program of China [2021ZD0201300 and 2022YFC2704300]. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.