LETTER
Mycoplasma pneumoniae is a leading pathogen of respiratory infection, especially community-acquired pneumonia (CAP), in children and adults worldwide (1). M. pneumoniae can also cause extrapulmonary manifestations (especially cardiovascular, hematologic, and nervous system, as well as skin) and even death. M. pneumoniae can transmit from person to person through aerosolization. Epidemics occur at intervals of 3 to 7 years and may last up to 2 years each time, and M. pneumoniae is responsible for up to 25% of CAP (2, 3). Patients can carry M. pneumoniae from a few days to a few months. M. pneumoniae infection can result in great economic loss and social impact in families, schools, and militaries—even a whole society. Increasing scientists around the world have joined in the research on M. pneumoniae in recent years.
From 1977 to the present (about 38 years), we have been continuously monitoring M. pneumoniae infections in children in Beijing, China. A total of seven epidemics were documented in seven different periods of time in 1979, 1983, 1990, 1995, 2002, 2007, and 2012 (Fig. 1). This epidemic trend is in line with that found in Japan, England, Finland, and many other countries in Europe and Asia (4, 5). Several reports from different countries have shown that the last notable increase of infection caused by M. pneumoniae was during 2010 to 2012; the initial report of such increase was made from Denmark in 2010 (6).
FIG 1.
Epidemiological surveillance of Mycoplasma pneumoniae infections in children in Beijing, China from 1977 to 2014.
A large number of clinical specimens (n = 656) were collected from pediatric patients who were diagnosed with pneumonia or respiratory tract infection in the Affiliated Children's Hospital of the Capital Institute of Pediatrics, Beijing, China, from January to December 2015. The specimens consisted of throat swab, bronchoalveolar lavage fluid, and sputum; one specimen was collected from each patient. DNA of the specimen was extracted using the QIAamp DNA minikit (Qiagen) according to the manufacturer's instructions. The DNA was immediately used to detect M. pneumoniae by real-time PCR as previously described (7).
During the study period, the number of patients in each month fluctuated slightly, ranging from 50 to 60, whereas the detection rate of M. pneumoniae increased rapidly from May (30%), and peaked in December, up to 56.8% (Fig. 2). It seemed that an epidemic outbreak of M. pneumoniae infection started occurring in Beijing, China, from mid-2015. Based on the available epidemiological pattern of M. pneumoniae, we postulated that this epidemic outbreak may continue further into 2016 or even later. We will continue to monitor the status of M. pneumoniae infections and to molecularly characterize the M. pneumoniae isolates from this epidemic to find the relationship between M. pneumoniae in the current epidemic outbreak in Beijing and the previous epidemic outbreaks from different places at different periods of time in our future work. At this moment, however, we intend to predict that the sudden increase of M. pneumoniae infections found in Beijing from the mid-2015 might be the beginning of a new epidemic outbreak and may soon occur in other places in China and even in other countries in Asia. Because M. pneumoniae has no cell wall, macrolides are usually the first choices of drugs for treatment of M. pneumoniae infections, especially in children. More importantly, the infections caused by M. pneumoniae are more likely to relapse. Therefore, it is important for doctors (both outpatient and inpatient) to pay substantial attention to the diagnoses of infections caused by M. pneumoniae in order to give the appropriate treatments for the diseases.
FIG 2.
Positive rate of M. pneumoniae detection in 2015 by real-time PCR of specimens collected from patients.
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