Epidemiology and Clinical Impact of Mycoplasma pneumoniae in an Italian Pediatric Center: An Observational Study from 2017 to 2024
Marco Bianchi, Mara Pisani, Lara Ricotta, Carmen D’Amore, Anna Chiara Vittucci, Sebastian Cristaldi, Anna Maria Musolino, Paola Bernaschi, Velia Chiara Di Maio, Venere Cortazzo, Claudio Cherchi, Renato Cutrera, Federica Pellizzoni, Alessia Arduini, María Antonietta Barbieri, Andrea Campana, Martina Di Giuseppe, Umberto Raucci, Laura Lancella, Marta Luisa Ciofi degli Atti, Carlo Federico Perno, Alberto Villani
Abstract
BACKGROUND: Mycoplasma pneumoniae (MP) is a common cause of lower respiratory tract infections in children. During the COVID-19 pandemic, a marked decline in MP infections was observed, with a delayed resurgence reported in some European countries. This study aimed to assess the epidemiologic trends and clinical features of MP infections in a pediatric tertiary care academic hospital in Italy from 2017 to 2024. METHODS: We conducted a retrospective, single-center study including immunocompetent patients 30 days to 17 years of age, hospitalized with confirmed MP infection. Clinical, laboratory, and radiologic data were analyzed across 3 periods: prepandemic (2017-2019), pandemic (2020-2022) and postpandemic (2023-2024). Statistical analyses were performed to compare incidence and clinical characteristics over time. RESULTS: Of 303 included patients, 130 were hospitalized prepandemic and 148 postpandemics. The proportion of MP among acute respiratory infection hospitalizations nearly doubled, from 3.2% in 2019 to 6.1% in 2024. Despite the higher incidence, the need for respiratory support remained stable (25.7% overall; P = 0.3), the pediatric intensive care admissions were rare and unchanged (2.0% vs. 2.0%, P = 1.0) and median hospital stay was consistent across both periods (5 days, interquartile range 4-8; P = 0.803). CONCLUSIONS: MP incidence increased significantly postpandemic, and clinical severity remained comparable to prepandemic levels. Ongoing epidemiologic surveillance is essential to better understand infection dynamics and to guide effective clinical management strategies.