BACKGROUND
Mycoplasma pneumoniae is a leading cause of pediatric community-acquired pneumonia. Macrolide-resistant M. pneumoniae (MRMP) emerged in East Asia in the 2000s and was once highly prevalent in Japan. However, its epidemiology in Japan following the coronavirus disease 2019 (COVID-19) pandemic is unclear.
METHODS
The present, single-center, retrospective study, conducted at a tertiary children's hospital in Tokyo, investigated the post-pandemic prevalence of MRMP and compared the clinical features of MRMP and macrolide-susceptible M. pneumoniae (MSMP). Patients aged ≤ 18 years who were positive for M. pneumoniae on polymerase chain reaction (PCR) between April 2020 and March 2025 were enrolled. MRMP was defined by macrolide-resistance mutations detected using a point-of-care, PCR-based assay. The proportion of patients with MRMP and the clinical characteristics of the MRMP and MSMP cohorts were analyzed.
RESULTS
In total, 272 patients had a M. pneumoniae infection, and 191 (70.2%) patients were classified into the MRMP group. A marked resurgence of M. pneumoniae infections, of which MRMP comprised 87% of the cases, was observed in April 2024 and peaked in October 2024. Among hospitalized patient (52/272, 19.1%), MRMP group were more likely to require oxygen (89% vs. 43%, p = 0.0015), and experience respiratory complications (47% vs. 7.1%, p = 0.019) than MSMP group.
CONCLUSION
MRMP reemerged as the predominant strain in Tokyo following the COVID-19 pandemic and may be associated with greater severity and recalcitrance to treatment. Therefore, monitoring its prevalence and adjusting the antibiotic strategy are crucial.
Natsuki Koriyama, Yo Murata, Shoichiro Shirane et al.· Pediatrics International· 0 citations
BACKGROUND
Bordetella parapertussis (BPP) causes a pertussis-like illness that is typically milder than classical pertussis, likely due to the absence of pertussis toxin. However, its clinical spectrum remains insufficiently characterized, partly because viral coinfections are frequently present. This study aimed to investigate the clinical course and management of BPP infections in children, specifically excluding cases with coinfections.
METHODS
We conducted a multicenter retrospective study of patients aged ≤15 years who underwent multiplex polymerase chain reaction testing using the BioFire Respiratory Panel 2.1 at 10 hospitals between April 2023 and March 2024. Cases with confirmed BPP detection were included after excluding cases with coinfections. Clinical data, including demographics, presenting symptoms and antimicrobial use, were reviewed.
RESULTS
Among 139 patients with BPP, 29 patients were included in the analysis after excluding coinfections. The median age was 3 years. Comorbidities were present in 55.2% of cases, and 21 patients (72.4%) were hospitalized. Common symptoms included cough (n = 21), fever (n = 13), vomiting (n = 4), paroxysm (n = 3) and apnea (n = 1). No cases of inspiratory whoop or cyanosis were observed. Antimicrobial therapy was administered in 18 patients (62.1%). There were no fatalities.
CONCLUSION
BPP monoinfection in children presented with a higher frequency of febrile illness compared with classical pertussis. Antibiotics were more frequently prescribed for febrile patients; however, some recovered without antimicrobial treatment. Further studies are warranted to clarify indications for antibiotic use in BPP infection.
Yusuke Isobe, Kenta Ito, Munehiro Furuichi et al.· The Pediatric Infectious Dis...· 0 citations