The rate of bacterial infections caused by Mycoplasma pneumoniae among children has been increasing since last spring and remains high, especially among those ages 2-4 years, according to the Centers for Disease Control and Prevention (CDC).
M. pneumoniae is a common cause of mild respiratory illness but also can present as a less severe form of pneumonia known as “walking pneumonia.” Serious complications are uncommon but can include new or worsening asthma, severe pneumonia and encephalitis.
Since M. pneumoniae infection is not a nationally notifiable condition, the CDC monitors trends using syndromic and commercial laboratory data.
National Syndromic Surveillance Program data showed the percentage of pneumonia-associated emergency department visits with a discharge diagnosis of M. pneumoniae increased over the past six months, peaking in late August. From March 31 through Oct. 5, the percentage of cases grew from 1% to 7.2% among children ages 2-4 years and from 3.6% to 7.4% among children ages 5-17 years. Among all ages, cases increased from 0.5% to 2.1%.
The increase among children ages 2-4 years is notable because M. pneumoniae historically hasn’t been recognized as a leading cause of pneumonia in this age group.
The CDC estimates that 2 million M. pneumoniae infections occur each year in the United States.
Bacteria are spread by inhaling respiratory droplets produced when an infected person coughs or sneezes. Outbreaks occur mostly in crowded environments like schools, college residence halls and nursing homes. M. pneumoniae infections can occur at any age but most often occur among children ages 5-17 years and young adults.
Symptom onset typically is gradual and can include fever, cough and sore throat. Younger children also may have symptoms such as diarrhea, wheezing or vomiting.
The CDC recommends the following for health care providers.
- Consider M. pneumoniae in patients with community-acquired pneumonia who aren’t improving clinically on antibiotics that are known to be ineffective against M. pneumoniae, such as beta-lactams.
- Perform laboratory testing when M. pneumoniae infection is suspected, especially among hospitalized children, to ensure appropriate antibiotic therapy is administered.
- Consider swabbing both the throat and the nasopharynx to improve the likelihood of detection in respiratory swab specimens.
- Consider using a second-line antibiotic regimen, such as fluoroquinolones or tetracyclines, to treat patients with suspected or confirmed M. pneumoniae infection who aren’t improving on macrolides.
- Promote frequent handwashing and covering coughs and sneezes to prevent bacteria from spreading.
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