Etiology of pediatric community-acquired pneumonia across Mycoplasma pneumoniae epidemic periods
Year: 2026
Type: article
Study design: Observational Study
Abstract: Community-acquired pneumonia (CAP) remains a leading cause of hospitalization and antibiotic use in children, yet etiologic data during Mycoplasma pneumoniae epidemic periods—now resurging globally after the COVID-19 pandemic—remain scarce. We conducted a nationwide prospective surveillance study across 17 hospitals in the Republic of Korea between September 2023 and May 2025, enrolling 740 children with CAP. Etiology was determined using standardized criteria: pyogenic bacteria by culture with central adjudication, atypical bacteria by polymerase chain reaction (PCR) and serology, and viral CAP by PCR (excluding human rhinovirus/enterovirus, bocavirus, and coronavirus, given their uncertain causal role). An etiologic pathogen was identified in 541 children (73.1%), with atypical pathogens predominating (43.6%), followed by viral (26.8%) and pyogenic (2.7%) etiologies. During the M. pneumoniae epidemic period (June–November 2024), atypical CAP accounted for approximately 65% of all enrolled cases, with a 68% reduction in the odds of pyogenic CAP compared with non-epidemic periods (odds ratio, 0.32; 95% confidence interval, 0.12–0.89). Despite its low prevalence, pyogenic CAP was independently associated with prolonged hospitalization, respiratory support, and intensive care unit admission. These findings suggest that routine empirical β-lactam coverage may be less warranted during M. pneumoniae epidemic periods, while early recognition of pyogenic CAP remains essential.
Source: Scientific Reports
Institutions: Chosun University, Chosun University Hospital, CHA University Bundang Medical Center, CHA University, Seoul National University, Seoul National University Bundang Hospital, Konkuk University Medical Center, The Catholic University of Korea Seoul St. Mary's Hospital, Catholic University of Korea, Korea University Anam Hospital, Samsung Medical Center, Sungkyunkwan University, Pusan National University Yangsan Hospital, Kangwon National University, Kangwon National University Hospital, Eulji University, Eulji University Nowon Eulji Medical Center, Gyeongsang National University Changwon Hospital, Inha University, Hallym University Kangnam Sacred Heart Hospital, Inha University Hospital, The Catholic University of Korea Daejeon St. Mary's Hospital, Chungnam National University Sejong Hospital, Jeonbuk National University Hospital, Jeonbuk National University, Pusan National University Hospital, Pusan National University, Seoul National University Children's Hospital
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,690
OpenAlex ID: W7204191114
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