Emergence of Novel Macrolide-Resistant Mycoplasma pneumoniae Sequence Type 3 Subclades in Children after COVID-19 Pandemic, Taiwan
Abstract
Post–COVID-19 pandemic Mycoplasma pneumoniae resurgences have occurred globally and have been particularly severe in Taiwan. We conducted a multicenter study to assess M. pneumoniae trends in children. Compared with the 2019 peak, 2024 data revealed a doubling of incidence (546/100,000 population), a 2.2-fold increase in intensive care unit admissions (10.9/100,000 population), and a 13.7-fold surge in central nervous system complications (6.1/100,000 population). In a 2023–2024 prospective cohort (n = 226), intensive care unit admission risk factors were neutrophils >7,000/μL (adjusted odds ratio [aOR] 6.2 [95% CI 1.3–29.9]), platelets >400 × 103/μL (aOR 12.5 [95% CI 2.7–57.9]), pleural effusion (aOR 9.7 [95% CI 1.6–58.1]), and central nervous system involvement (aOR 27.9 [95% CI 4.1–188.3]). Phylogenetic analysis of 698 genomes demonstrated that 4 emerging subclades replaced pre–COVID-19 lineages by mid-2024; 1 subclade was associated with severe outcomes, highlighting evolving resistant, neurotropic lineages and calling for enhanced surveillance.
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BibTeX
@article{hsieh2026emergence,
title = {{Emergence of Novel Macrolide-Resistant Mycoplasma pneumoniae Sequence Type 3 Subclades in Children after COVID-19 Pandemic, Taiwan}},
author = {Yu-Chia Hsieh and Chen-Ching Lin and Jia-Wen Wu and Yi-Hsuan Liu and Yi-Jiun Pan and Tzu-Ya Lo and Shian-Sen Shie and Huey-Ling You and Chong-Wei Huang and Yi-Chuan Huang and Tzu-Ching Huang and Yu-Xin She and Yin-Cheng Chen and Shiao-Wen Li},
journal = {Emerging Infectious Diseases},
year = {2026},
month = oct,
doi = {10.3201/eid3211.260439},
url = {https://doi.org/10.3201/eid3211.260439},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Emergence of Novel Macrolide-Resistant Mycoplasma pneumoniae Sequence Type 3 Subclades in Children after COVID-19 Pandemic, Taiwan
AU - Yu-Chia Hsieh
AU - Chen-Ching Lin
AU - Jia-Wen Wu
AU - Yi-Hsuan Liu
AU - Yi-Jiun Pan
AU - Tzu-Ya Lo
AU - Shian-Sen Shie
AU - Huey-Ling You
AU - Chong-Wei Huang
AU - Yi-Chuan Huang
AU - Tzu-Ching Huang
AU - Yu-Xin She
AU - Yin-Cheng Chen
AU - Shiao-Wen Li
PY - 2026
DA - 2026/10/30
JO - Emerging Infectious Diseases
DO - 10.3201/eid3211.260439
UR - https://doi.org/10.3201/eid3211.260439
AB - Post–COVID-19 pandemic Mycoplasma pneumoniae resurgences have occurred globally and have been particularly severe in Taiwan. We conducted a multicenter study to assess M. pneumoniae trends in children. Compared with the 2019 peak, 2024 data revealed a doubling of incidence (546/100,000 population), a 2.2-fold increase in intensive care unit admissions (10.9/100,000 population), and a 13.7-fold surge in central nervous system complications (6.1/100,000 population). In a 2023–2024 prospective cohort (n = 226), intensive care unit admission risk factors were neutrophils >7,000/μL (adjusted odds ratio [aOR] 6.2 [95% CI 1.3–29.9]), platelets >400 × 103/μL (aOR 12.5 [95% CI 2.7–57.9]), pleural effusion (aOR 9.7 [95% CI 1.6–58.1]), and central nervous system involvement (aOR 27.9 [95% CI 4.1–188.3]). Phylogenetic analysis of 698 genomes demonstrated that 4 emerging subclades replaced pre–COVID-19 lineages by mid-2024; 1 subclade was associated with severe outcomes, highlighting evolving resistant, neurotropic lineages and calling for enhanced surveillance.
SN - 1080-6040
SN - 1080-6059
ER -