Table 2. Mycoplasma pneumoniae testing and detection rates per year, April 2017–March 2021 (n = 631,104).

UN region and country	City or region	Test method	April 2017–March 2018			April 2018–March 2019			April 2019–March 2020			April 2020–March 2021 (COVID-19 pandemic)			Difference in detection rate (%) pre-pandemic vs COVID-19 pandemica	Pb
			Total tests (N)	Positive tests (n)	Detection rate (%)	Total tests (N)	Positive tests (n)	Detection rate (%)	Total tests (N)	Positive tests (n)	Detection rate (%)	Total tests (N)	Positive test (n)	Detection rate (%)
Europe
Western Europe
France	Bordeaux	PCR	619	16	2.58	625	22	3.52	530	41	7.74	466	4	0.86	–80.72	<0.01
Switzerland	Geneva	PCR	1,347	30	2.23	1,622	76	4.69	2,119	76	3.59	1,193	7	0.59	–83.60	<0.01
	Lausanne	PCR	388	6	1.55	406	4	0.99	592	20	3.38	246	0	0.00	–100.00	0.02
	Bernc	PCR	134	17	12.69	175	43	24.57	191	29	15.18	41	0	0.00	–100.00	<0.01
	Lucernec	PCR	NA	7	NA	229	10	4.37	215	21	9.77	129	1	0.78	–88.90	<0.01
	Bellinzona	PCR	701	10	1.43	1,104	76	6.88	1,540	43	2.79	804	0	0.00	–100.00	<0.01
	Zurich (A)	PCR	1,067	17	1.59	1,361	41	3.01	1,620	50	3.09	1,823	11	0.60	–77.38	<0.01
	Zurich (B)c	PCR	104	21	20.19	123	22	17.89	201	54	26.87	1,659	6	0.36	–98.40	<0.01
	St. Gallenc	PCR	20	7	35.00	18	5	27.78	19	6	31.58	8	1	12.50	–60.42	0.42
	Aarau	PCR	1,431	36	2.52	1,586	55	3.47	1,955	77	3.94	1,601	10	0.62	–81.51	<0.01
		IgM ELISA	220	14	6.36	229	19	8.30	191	23	12.04	183	13	7.10	–18.81	0.55
		IgG ELISA	220	43	19.55	229	50	21.83	191	48	25.13	183	46	25.14	+ 14.10	0.37
	Basel (A)	PCR	1,535	9	0.59	2,212	12	0.54	5,028	53	1.05	3,061	2	0.07	–92.25	<0.01
	Basel (B)c	PCR	870	10	1.15	845	6	0.71	1,050	19	1.81	634	6	0.95	–25.24	0.69
Germany	Homburg	PCR	2,321	10	0.43	2,395	19	0.79	2,773	17	0.61	2,570	1	0.04	–93.67	<0.01
		IgM ELISA	486	67	13.79	492	70	14.23	544	71	13.05	588	70	11.90	–12.89	0.31
		IgG ELISA	486	277	57.00	492	291	59.15	544	341	62.68	588	331	56.29	–5.75	0.15
	Düsseldorf	PCR	1,515	27	1.78	1,530	18	1.18	1,283	16	1.25	1,011	12	1.19	–15.79	0.65
		IgM ELISA	398	18	4.52	446	78	17.49	585	148	25.30	538	134	24.91	+ 45.87	<0.01
		IgG ELISA	530	298	56.23	491	288	58.66	561	307	54.72	522	315	60.34	+ 6.90	0.13
		IgA ELISAd	NA	NA	NA	241	95	39.42	560	195	34.82	521	142	27.26	–24.72	<0.01
	Saxony	PCR or serologye	NA	2,013	NA	NA	1,044	NA	NA	927	NA	NA	303	NA	NA	NA
Belgium	Antwerp, Leuven (national reference laboratory)	PCR	2,698	30	1.11	1,150	15	1.30	1220	32	2.62	864	3	0.35	–77.15	<0.01
	National surveillance	Direct test methods (different techniques)	NA	1,151	NA	NA	548	NA	NA	833	NA	NA	230	NA	NA	NA
The Netherlands	Rotterdam	PCR	NA	NA	NA	240	36	15.00	407	56	13.76	444	36	8.11	–42.98	<0.01
Northern Europe
England	National reference laboratoryf	PCR	138	19	13.77	110	11	10.00	263	118	44.87	155	10	6.45	–77.72	<0.01
Denmark	National surveillance	PCR	100,257	5,303	5.29	80,965	1,371	1.69	100,879	4,383	4.34	58,716	177	0.30	–92.31	< 0.01
Finland	Turku	PCR or serologye	NA	NA	NA	NA	NA	NA	5,413	211	3.90	3,462	70	2.02	–48.13	<0.01
	National surveillance	PCR or serologye	NA	2,420	NA	NA	1,728	NA	NA	1,312	NA	NA	455	NA	NA	NA
Norway	Trondheim	PCR	3,306	230	6.96	2,330	56	2.40	2,014	48	2.38	1,263	0	0.00	–100.00	<0.01
Southern Europe
Portugal	Coimbrac	PCR	803	5	0.62	924	90	9.74	1,084	19	1.75	161	0	0.00	–100.00	<0.01
Greece	Athens (A)c	IgM ELISA	212	19	8.96	236	51	21.61	250	65	26.00	167	35	20.96	+ 8.36	0.66
		IgG ELISA	212	44	20.75	236	29	12.29	250	37	14.80	167	41	24.55	+ 55.79	<0.01
	Athens (B)c	IgM ELISA	185	9	4.86	181	15	8.29	231	27	11.69	172	14	8.14	–4.72	1.00
		IgG ELISA	185	59	31.89	181	88	48.62	231	92	39.83	172	44	25.58	–36.10	<0.01
Slovenia	Ljubljana	PCR	1,604	22	1.37	1,887	153	8.11	2,639	495	18.76	1,241	20	1.61	–85.26	<0.01
Asia
Western Asia
Israel	Jerusalem	PCR	1,364	45	3.30	1,299	62	4.77	1,637	53	3.24	666	0	0.00	–100.00	<0.01
Eastern Asia
Japan	Kurashiki City (Okayama)c	PCR	30	4	13.33	64	14	21.88	34	3	8.82	5	0	0.00	–100.00	1.00
	Tokyof	Rapid antigen test	346	56	16.18	140	36	25.71	600	36	6.00	120	4	3.33	–71.72	<0.01
Taiwan	Taoyuanc	PCR	116	20	17.24	159	63	39.62	204	131	64.22	44	5	11.36	–74.56	<0.01
South-eastern Asia
Singapore	Singaporec	PCR	4,212	387	9.19	8,765	307	3.50	15,860	613	3.87	8,835	33	0.37	–91.76	<0.01
South Asia
India	New Delhi	IgM ELISA	245	19	7.76	320	18	5.63	205	19	9.27	153	16	10.46	+ 43.79	0.19
America
Northern America
United States	Chicagoc	PCR	4,221	10	0.24	4,199	25	0.60	4,990	42	0.84	1,695	2	0.12	–79.45	0.01
Caribbean
Cuba	National surveillance	PCR	902	18	2.00	62	4	6.45	844	20	2.37	4	0	0.00	–100.00	1.00
Oceania
Australia	Darlinghurst (Sydney)	PCR	15,751	60	0.38	12,187	55	0.45	21,086	168	0.80	70,807	19	0.03	–95.35	<0.01
New Zealand	Auckland	PCR	543	21	3.87	993	26	2.62	858	41	4.78	2,723	4	0.15	–96.00	<0.01
Total (global, participating countries)g		Direct test methods (PCR or rapid antigen test considered only)	148,343	6,453	4.35	129,705	2,733	2.11	173,735	6,780	3.90	162,989	374	0.23	–93.51	<0.01
		Indirect test methods (IgM considered only)	1,746	146	8.36	1,904	251	13.18	2,006	353	17.60	1,801	282	15.66	+ 18.08	0.01

COVID-19: coronavirus disease; ELISA: enzyme-linked immunosorbent assay; Ig: immunoglobulin; NA: not available; UN: United Nations.

^a Difference in detection rate between April 2017 and March 2020 (mean positive/total tests across the 3 years) and between April 2020 and March 2021 (absolute number positive/total tests). Percentages showing a reduction in detection rate are indicated in bold.

^b Proportions of positive/total tests from April 2020 to March 2021 were compared with total numbers from April 2017 to March 2020 by Fisher's exact test. p values < 0.05 are indicated in bold.

^c ≥ 90% of data are from children and adolescents < 18 years of age.

^d IgA ELISA introduced in November 2018.

^e Data from combined serology and PCR tests (no distinction possible between detection methods; Table 1).

^f Period of enhanced surveillance from 1 October 2019 to 30 March 2020.

^g These numbers include only data from PCR or rapid antigen test (for direct test methods) and IgM serology (for indirect test methods).

Entries in italics signify serological data (± PCR).