Epidemiological surveillance of Mycoplasma pneumoniae in targeted next-generation sequencing analysis in Southern...

Mycoplasma pneumoniae (M. pneumoniae) is a prevalent cause of respiratory infections, and the emergence of macrolide-resistant strains presents a public health concern. We aimed to investigate the epidemiological patterns and macrolide resistance of M. pneumoniae infections in Southern Chinese populations using targeted next-generation sequencing (tNGS).

This study analysed tNGS samples collected from multiple medical centres in Southern China from January to December 2023. Data of demographics, specimen types, macrolide resistance genes, and respiratory virus co-infections were analysed.

Of the 58,415 specimens, 9,218 (15.78%) tested positive for M. pneumoniae. It revealed significant gender- and age-dependent differences in M. pneumoniae infection rates (both P < 0.001). Females demonstrated notably higher positivity rates compared to males (19.06% vs 13.70%, P < 0.001), and children (28.75%) exhibited significantly higher infection rates than adults (12.45%) and elderly individuals (5.00%) (P < 0.001). School-aged children (5-9 years) were the most affected, with a positivity rate of 48.28%. The incidence of M. pneumoniae infections demonstrated seasonal variation, with a peak during the winter months (25.88%). Age-dependent patterns were observed in macrolide resistance, with children demonstrating the highest detection rate of resistance genes (53.38%), predominantly the A2063G mutation. Co-infections with respiratory viruses (influenza, adenovirus, and respiratory syncytial virus) were more prevalent in children.

This study offers valuable insights regarding demographic and seasonal trends, along with age-related macrolide resistance characteristics. The implications are crucial for surveillance measures to mitigate the impact of M. pneumoniae infections and antibacterial management strategies.