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Mycoplasma pneumoniae Infections Among Children and Adolescents in Korea, 2014-2024
Byung Wook Eun1, Unyeong Go2, Gayoung Chun2
1Department of Pediatrics, Nowon Eulji University Hospital, Seoul, Korea.
Background:
Mycoplasma pneumoniae (MP) is the most common cause of community-acquired bacterial pneumonia in children. Macrolides are used as the first-line treatment for MP infection, but resistance has increased significantly over the past few decades, making treatment difficult. This study examines the prevalence of M. pneumoniae infections and macrolide-resistant M. pneumoniae (MRMP) rates in Korean children across three recent epidemics in Korea between 2014 and 2024.
Methods:
Data from Green Cross Laboratories on M. pneumoniae polymerase chain reaction (PCR) and macrolide-resistance tests were analyzed from January 2014 to March 2024, including 425,079 MP PCR tests and 11,206 resistance tests (macrolide-resistance testing began in 2019). We examined M. pneumoniae-positive rates by age and compared age composition to the epidemic and non-epidemic periods using Cochran-Armitage trend tests and also examined differences in MRMP positive rates by year, epidemic status, sex, age group, and region using the χ² test.
Results:
Three epidemics of M. pneumoniae infection were identified in 2015/16, 2019/20, and 2023/24, with seasonal peaks between the third and fourth quarter of each starting epidemic year and the highest M. pneumoniae-positive rates in children aged 7 to 9 years. There were significant differences in the proportion of children aged 12 years or younger between epidemic and non-epidemic periods (P < 0.001 for two epidemics and 0.027 for one). MRMP PCR positive rates for A2063G and A2064G mutations were 76.6% and 0.7%, respectively, with a notable increase in A2063G rates from 2019/20 to 2023/24, along with a significant decrease as age increased.
Conclusion:
The findings indicate a significant rise in M. pneumoniae infections among Korean children, especially those aged 12 years or younger, suggesting a nationwide epidemic. The increase in A2063G mutation rates underscores the need for monitoring antibiotic resistance and further research into resistance factors for future epidemic responses.
Insights
Mycoplasma pneumoniae infections are rising in Korean children, particularly in those 12 and under, during recent epidemics. Macrolide resistance, especially the A2063G mutation, is increasing, necessitating antibiotic resistance monitoring.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Epidemiology
Background:
- Mycoplasma pneumoniae (MP) is a leading cause of community-acquired pneumonia in children.
- Macrolide antibiotics are first-line treatments, but rising resistance complicates management.
- This study investigates MP and macrolide-resistant MP (MRMP) prevalence in Korean children over three epidemics (2014-2024).
Purpose of the Study:
- To determine the prevalence of Mycoplasma pneumoniae infections in Korean children.
- To assess macrolide-resistant Mycoplasma pneumoniae (MRMP) rates during recent epidemic periods.
- To analyze trends in MP and MRMP by age, epidemic status, and region.
Main Methods:
- Analysis of 425,079 MP PCR tests and 11,206 resistance tests (2014-2024).
- Examination of MP-positive rates by age and comparison between epidemic and non-epidemic periods.
- Statistical analysis (Cochran-Armitage, χ² tests) of MRMP rates by year, sex, age, and region.
Main Results:
- Three MP epidemics identified: 2015/16, 2019/20, 2023/24, peaking in Q3/Q4.
- Highest MP rates observed in children aged 7-9 years; younger children (≤12 years) more prevalent during epidemics.
- Macrolide resistance primarily due to A2063G mutation (76.6%), with increasing rates from 2019/20 to 2023/24.
Conclusions:
- Significant increase in MP infections among Korean children, particularly those ≤12 years, indicating a nationwide epidemic.
- Rising A2063G mutation rates highlight the urgent need for antibiotic resistance surveillance.
- Further research into resistance factors is crucial for effective future epidemic responses.
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