Uzma Hasan, MD
Division Director, Pediatric Infectious Diseases
Cooperman Barnabas Medical Center
Mycoplasma pneumoniae is an atypical fastidious organism typically implicated in causing “walking pneumonia”. Bacteria are spread via respiratory droplet inhalation. Infection typically occurs in summer and early fall, but can occur year around. Incubation period is between 1 and 4 weeks. It can also cause ear infections (bullous myringitis), and lead to asthma exacerbations. Mycoplasma is also implicated in extrapulmonary infections including mucocutaneous disease (reactive infectious mucocutaneous eruption), autoimmune hemolytic anemia, neurological disease including meningoencephalitis, acute disseminated encephalomyelitis, Guillain-barre syndrome, transverse myelitis, and cranial nerve palsies. An estimated 2 million infections occur each year in the United States. Outbreaks occur in crowded dwellings, schools, colleges, residence halls and nursing homes.
Typically Mycoplasma pneumonia is seen in school aged children. However the CDC recently put out an advisory showing increase in emergency room visits for Pneumonia caused by Mycoplasma pneumonia. An increase in illness was reported in all age groups, notably highest among children in the time period March 31, 2024 through October 5, 2024. The percentage grew from 1% to 7.2% among children ages 2-4 years. An increase in Mycoplasma triggered pneumonia was also noted from 3.6% to 7.4% among children ages 5–17 years in that time frame. The increase in Mycoplasma illness in 0–1 year olds and 2–4 year olds is notable as typically infection is seen in older children.
Mycoplasma resistance to Macrolides remains below 10% in the United States. Resistance to macrolides is rising since the 2000s. Global prevalence of macrolide resistance is around 28%. Higher rates of resistance to macrolides are reported from China (80%) and Japan (50%). Fluoroquinolones and tetracyclines are alternative options to macrolides for treatment.
The ASP, representing pediatric providers, including pediatric infectious disease specialists and pharmacists, exchange ideas, discuss case management strategies and develop and implement guidelines to be shared system wide, as well as serve as a resource for community physicians.
For more educational information, research and best practices from the Children’s Health Network at RWJBarnabas Health, visit rwjbh.org/childrenshealthresearch.