Mycoplasma pneumoniae is the cause of up to 20% of cases of community-acquired pneumonia and has also been implicated in some hospital-based epidemics. Respiratory infection occurs mainly in children and young adults and is often seen in close community settings, such as schools, colleges, nursing homes, and military bases.[3]Jain S, Williams DJ, Arnold SR, et al. Community-acquired pneumonia requiring hospitalization among US children. N Engl J Med. 2015;372:835-45.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4697461
http://www.ncbi.nlm.nih.gov/pubmed/25714161?tool=bestpractice.com
[4]Waites KB, Talkington DF. Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev. 2004 Oct;17(4):697-728.
https://www.doi.org/10.1128/CMR.17.4.697-728.2004
http://www.ncbi.nlm.nih.gov/pubmed/15489344?tool=bestpractice.com
Reports suggest that in certain parts of the world, infants might be the major infected group.[5]Xu YC, Zhu LJ, Xu D, et al. Epidemiological characteristics and meteorological factors of childhood Mycoplasma pneumoniae pneumonia in Hangzhou. World J Pediatr. 2011;7:240-4.
http://www.ncbi.nlm.nih.gov/pubmed/21822990?tool=bestpractice.com
[6]Gadsby NJ, Reynolds AJ, McMenamin J, et al. Increased reports of Mycoplasma pneumoniae from laboratories in Scotland in 2010 and 2011 - impact of the epidemic in infants. Euro Surveill. 2012;17:pii:20110.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20110
http://www.ncbi.nlm.nih.gov/pubmed/22433597?tool=bestpractice.com
M pneumoniae epidemics usually occur at 3- to 5-year intervals and are considered to be polyclonal.[7]Chalker V, Stocki T, Litt D, et al. Increased detection of Mycoplasma pneumoniae infection in children in England and Wales, October 2011 to January 2012. Euro Surveill. 2012;17:pii:20081.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20081
http://www.ncbi.nlm.nih.gov/pubmed/22340973?tool=bestpractice.com
[8]Pereyre S, Charron A, Hidalgo-Grass C, et al. The spread of Mycoplasma pneumoniae is polyclonal in both an endemic setting in France and in an epidemic setting in Israel. PLoS One. 2012;7:38585.
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0038585
http://www.ncbi.nlm.nih.gov/pubmed/22701675?tool=bestpractice.com
[9]Beeton ML, Zhang XS, Uldum SA, et al. Mycoplasma pneumoniae infections, 11 countries in Europe and Israel, 2011 to 2016. Euro Surveill. 2020 Jan;25(2):1900112.
https://www.doi.org/10.2807/1560-7917.ES.2020.25.2.1900112
http://www.ncbi.nlm.nih.gov/pubmed/31964459?tool=bestpractice.com
In some countries there is a relative increase in incidence in the late summer or fall.[5]Xu YC, Zhu LJ, Xu D, et al. Epidemiological characteristics and meteorological factors of childhood Mycoplasma pneumoniae pneumonia in Hangzhou. World J Pediatr. 2011;7:240-4.
http://www.ncbi.nlm.nih.gov/pubmed/21822990?tool=bestpractice.com
[7]Chalker V, Stocki T, Litt D, et al. Increased detection of Mycoplasma pneumoniae infection in children in England and Wales, October 2011 to January 2012. Euro Surveill. 2012;17:pii:20081.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20081
http://www.ncbi.nlm.nih.gov/pubmed/22340973?tool=bestpractice.com
[10]Nir-Paz R, Abutbul A, Moses AE, et al. Ongoing epidemic of Mycoplasma pneumoniae infection in Jerusalem, Israel, 2010 to 2012. Euro Surveill. 2012;17:pii:20095.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20095
http://www.ncbi.nlm.nih.gov/pubmed/22401504?tool=bestpractice.com
[11]Uldum SA, Bangsborg JM, Gahrn-Hansen B, et al. Epidemic of Mycoplasma pneumoniae infection in Denmark, 2010 and 2011. Euro Surveill. 2012;17:pii:20073.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20073
http://www.ncbi.nlm.nih.gov/pubmed/22321137?tool=bestpractice.com
One study suggested a correlation between the time epidemics occur in northern and southern countries.[9]Beeton ML, Zhang XS, Uldum SA, et al. Mycoplasma pneumoniae infections, 11 countries in Europe and Israel, 2011 to 2016. Euro Surveill. 2020 Jan;25(2):1900112.
https://www.doi.org/10.2807/1560-7917.ES.2020.25.2.1900112
http://www.ncbi.nlm.nih.gov/pubmed/31964459?tool=bestpractice.com
Less is known on the exact prevalence of M pneumoniae in upper respiratory infections, although this type of infection is considered to be common.[3]Jain S, Williams DJ, Arnold SR, et al. Community-acquired pneumonia requiring hospitalization among US children. N Engl J Med. 2015;372:835-45.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4697461
http://www.ncbi.nlm.nih.gov/pubmed/25714161?tool=bestpractice.com
[12]Esposito S, Bosis S, Begliatti E, et al. Acute tonsillopharyngitis associated with atypical bacterial infection in children: natural history and impact of macrolide therapy. Clin Infect Dis. 2006;43:206-9.
http://cid.oxfordjournals.org/content/43/2/206.full
http://www.ncbi.nlm.nih.gov/pubmed/16779748?tool=bestpractice.com
A carrier state for this pathogen has been noted and might be more common in the pediatric population.[1]Spuesens EB, Fraaij PL, Visser EG, et al. Carriage of Mycoplasma pneumoniae in the upper respiratory tract of symptomatic and asymptomatic children: an observational study. PLoS Med. 2013;10:e1001444.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3653782
http://www.ncbi.nlm.nih.gov/pubmed/23690754?tool=bestpractice.com
[13]Brown RJ, Nguipdop-Djomo P, Zhao H, et al. Mycoplasma pneumoniae epidemiology in England and Wales: a national perspective. Front Microbiol. 2016;7:157.
https://www.doi.org/10.3389/fmicb.2016.00157
http://www.ncbi.nlm.nih.gov/pubmed/26909073?tool=bestpractice.com
In the setting of a country-wide epidemic an increase of patients admitted to the intensive care unit due to severe M pneumoniae infection should be considered.[14]Ferguson GD, Gadsby NJ, Henderson SS, et al. Clinical outcomes and macrolide resistance in Mycoplasma pneumoniae infection in Scotland, UK. J Med Microbiol. 2013;62:1876-82.
http://www.ncbi.nlm.nih.gov/pubmed/24008501?tool=bestpractice.com
Similarly to other pathogenic bacteria, a global increase in antibiotic resistance has been observed among Mycoplasma. Macrolide-resistant M pneumoniae cases have been reported in the Western Pacific (53.4%), South East Asia (9.8%), the Americas (8.4%), and Europe (5.1%).[15]Kim K, Jung S, Kim M, et al. Global trends in the proportion of macrolide-resistant Mycoplasma pneumoniae infections: a systematic review and meta-analysis. JAMA Netw Open. 2022 Jul 1;5(7):e2220949.
https://www.doi.org/10.1001/jamanetworkopen.2022.20949
http://www.ncbi.nlm.nih.gov/pubmed/35816304?tool=bestpractice.com