Waldeck Frederike, Kramer Tobias Siegfried, Boutin Sebastien, Matten Jens, Kramer Jan, Rupp Jan
Infectious Diseases Clinic, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany.
LADR Laborverbund Dr. Kramer & Kollegen, Geesthacht, Germany.
BMC Infect Dis. 2025 Mar 6;25(1):318. doi: 10.1186/s12879-025-10657-4.
Mycoplasma pneumoniae (M. pneumoniae) is a common pathogen of community-acquired pneumonia (CAP). Epidemics occur every 3-7 years especially in pediatric patients. We collected data from a large laboratory network in Germany to define the epidemiological dynamics in the pre- and post-COVID-19 pandemic period.
In this retrospective cohort study we included all patients that obtained targeted or multiplex PCR for M. pneumoniae from nasopharyngeal swabs, sputum or bronchoalveolar fluids from 2015 to 2024. Demographic data (age, sex, place of residence, in- or outpatient status) were compared between M. pneumoniae positive and negative patients and co-infections with bacterial or viral pathogens analyzed.
We screened 38,204 patients for M. pneumoniae. We identified 1448 cases (3.8%) of M. pneumoniae (48.8% females). Pediatric patients ≤ 18 years represented 75.7% of M. pneumoniae patients and 2.3% were ≥ 60 years. Incidence of M. pneumoniae increased in fourth quartile 2015 (16.2%), second quartile 2018 (14.8%) and fourth quartile 2023 (13.4%). No cases were detected during COVID-19 pandemic 2021. Young age (aOR 0.98 95%-CI 0.97-0.98), outpatient status (aOR 0.56 95%-CI 0.43-0.71) and year of testing (OR dependent on year of testing) were predictors of M. pneumoniae detection in multivariate analysis (p < 0.001). We observed a significant increase in outpatients with M. pneumoniae after COVID-19 pandemic (86.7 vs. 96.5%, p = < 0.001, aOR 0.25, 95% CI 0.15-0.4).
Empirical treatment of CAP patients often does not include coverage of M. pneumoniae. A more thorough implementation of available surveillance data into clinical routine, respective therapies could be adapted more quickly during epidemic outbreaks of M. pneumoniae infections.
肺炎支原体是社区获得性肺炎（CAP）的常见病原体。每隔3至7年就会出现疫情，尤其是在儿科患者中。我们收集了德国一个大型实验室网络的数据，以确定新冠疫情前后的流行病学动态。
在这项回顾性队列研究中，我们纳入了2015年至2024年期间所有通过针对肺炎支原体的靶向或多重聚合酶链反应（PCR）检测鼻咽拭子、痰液或支气管肺泡灌洗液的患者。比较了肺炎支原体阳性和阴性患者的人口统计学数据（年龄、性别、居住地点、门诊或住院状态），并分析了与细菌或病毒病原体的合并感染情况。
我们对38204例患者进行了肺炎支原体筛查。我们确定了1448例肺炎支原体病例（占3.8%）（女性占48.8%）。18岁及以下的儿科患者占肺炎支原体患者的75.7%，60岁及以上的患者占2.3%。肺炎支原体的发病率在2015年第四季度（16.2%）、2018年第二季度（14.8%）和2023年第四季度（13.4%）有所上升。2021年新冠疫情期间未检测到病例。在多变量分析中，年轻（调整后比值比[aOR]为0.98，95%置信区间[CI]为0.97 - 0.98）、门诊状态（aOR为0.56，95%CI为0.43 - 0.71）和检测年份（比值比取决于检测年份）是肺炎支原体检测的预测因素（p < 0.001）。我们观察到新冠疫情后门诊肺炎支原体患者显著增加（从86.7%增至96.5%，p = < 0.001，aOR为0.25，95%CI为0.15 - 0.4）。
CAP患者的经验性治疗通常不包括对肺炎支原体的覆盖。将现有监测数据更全面地纳入临床常规，在肺炎支原体感染疫情爆发期间可以更快地调整相应治疗方案。
