Scopus
YÖKSİS Eşleşti
Mycoplasma pneumoniae in hospitalised children in the post-COVID era: clinical outcomes from a Turkish multicenter cohort
European Journal of Pediatrics · Kasım 2025
YÖKSİS Kayıtları
Mycoplasma pneumoniae in hospitalised children in the post-COVID era: clinical outcomes from a Turkish multicenter cohort
European Journal of Pediatrics · 2025 SCI-Expanded
DOÇENT MELİKE EMİROĞLU →
Makale Bilgileri
DergiEuropean Journal of Pediatrics
Yayın TarihiKasım 2025
Cilt / Sayfa184 · 775
Scopus ID2-s2.0-105022314979
Özet
Following the COVID-19 pandemic, infections with Mycoplasma pneumoniae (M. pneumoniae) have resurged globally. However, post-pandemic changes in clinical phenotypes, severity, and extrapulmonary manifestations remain poorly characterised in pediatric populations. This study aimed to characterise the clinical spectrum, severity patterns, and phenotypic differences of M. pneumoniae infection in hospitalised children following the COVID-19 pandemic, and to identify risk factors for critical illness in a multicenter cohort. This multicenter retrospective study included 400 hospitalised children with confirmed M. pneumoniae infection across 20 tertiary pediatric centres in Turkey between July 2021 and July 2024. Demographic, clinical, laboratory, and radiologic features were analysed. Groups were compared by age, pulmonary versus extrapulmonary phenotypes, and disease severity. Multivariate logistic regression was used to identify predictors of critical illness. A total of 400 hospitalised children with confirmed M. pneumoniae infection were included in the study, of whom 212 (53%) were male. The median age was 88 months (interquartile range [IQR]: 48-124 months). Underlying conditions were present in 110/400 (27.5%) patients, with asthma/reactive airway disease, neurological disorders, and hematologic/oncologic disorders being the most common comorbidities. Pneumonia was identified in 303/400 (75.8%) patients. Extrapulmonary organ involvement was observed in 79/400 (19.8%) patients, predominantly affecting the hematologic and neurologic systems. Critical illness criteria were met in 216/400 (54%) patients. Oxygen support was required in 145/400 (36.3%), and ICU admission occurred in 36/400 (9%). Children ≥ 5 years were more likely to present with lobar pneumonia, while those < 5 years had higher rates of gastrointestinal symptoms without severe inflammation. Fever, cough, and CRP elevation were strongly associated with pulmonary disease (p < 0.001). Elevated neutrophil count independently predicted critical illness (OR: 1.002; 95% CI: 1.000-1.004; p = 0.046). Treatment varied by phenotype: clarithromycin was used more frequently in pneumonia cases, while azithromycin, corticosteroids, and IVIG were more commonly used in extrapulmonary cases. CONCLUSION: In the post-COVID-19 era, pediatric M. pneumoniae infections show increased severity and clinical diversity. Distinct phenotypes and age-related patterns underscore the need for tailored care. Prospective studies with resistance and immune profiling are needed to inform future management strategies. WHAT IS KNOWN: • The post-COVID era has seen a resurgence and a changing clinical spectrum of Mycoplasma pneumoniae infections in children. WHAT IS NEW: • This study presents the first large-scale, multicenter post-pandemic cohort from Turkey. • In addition to pulmonary and extrapulmonary cases, a distinct critical illness group was identified, in which absolute neutrophil count emerged as an independent but modest risk marker for severity.
Yazarlar (49)
1
Coskun Ekemen
2
Gülhadiye Avcu
3
Esra Cakmak Taskin
4
Mehlika Efendi Kocagoz
5
Nurdan Kayki Aksoy
6
Elif Somuncu
7
Hacer Yakin
8
Mavera Usaklioglu Erol
9
Meryem Cagla Abaci Capar
10
Guldane Dikme
11
Senem Behsat Ulukaya
12
Onur Tekeli
13
Hincal Ozbakir
14
Ayse Gul Yucel
15
Hatice Sinav Utku
16
Esma Tugba Kasikci Mermer
17
Emel Celebi Congur
18
Ulkiye Gungor
19
Merve Nur Kilic
20
Mehmet Emin Menentoglu
21
Asli Arslan
22
Gulben Ozgul Postuk
23
Nahide Gokay
24
Eda Sahin Izci
25
Hatice Burcu Caglar Kizil
26
Ergin Ciftci
27
Halil Ozdemir
28
Gul Arga
29
Zümrüt Şahbudak Bal
30
Emine Hafize Erdeniz
31
Canberk Cinar
32
Hacer Akturk
33
Semra Bayturan Sen
34
Nursen Belet
35
Selim Oncel
36
Melike Emiroglu
ORCID: 0000-0003-1307-0246
37
Aybuke Akaslan Kara
38
Tuğçe Tural Kara
39
Nazan Dalgic Karabulut
40
Edanur Yesil
41
Sevliya Öcal Demir
42
Gülşen Akkoç
43
Ayse Buyukcam
44
Selda Hancerli Torun
45
Yasemin Ozsurekci
46
Kubra Aykac
47
Zeynep Gökçe Gayretli Aydın
48
Ozden Turel
49
Nevin Hatipoglu
Anahtar Kelimeler
Children
Multicenter study
Mycoplasma pneumoniae
Post-COVID-19
Turkey
Kurumlar
Akdeniz University, Faculty of Medicine
Antalya Turkey
Ankara Üniversitesi
Ankara Turkey
Dokuz Eylül Üniversitesi
Izmir Turkey
Ege University Medical School
Izmir Turkey
Hacettepe Üniversitesi
Ankara Turkey
Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital
Istanbul Turkey
Istanbul Medeniyet University
Istanbul Turkey
İstanbul Tıp Fakültesi
Istanbul Turkey
Karadeniz Teknik Üniversitesi Tip Fakültesi
Trabzon Turkey
Kocaeli City Hospital
Kocaeli Turkey
Kocaeli Üniversitesi
İzmit Turkey
Koç Üniversitesi
Istanbul Turkey
Manisa Celâl Bayar Üniversitesi
Manisa Turkey
Marmara Üniversitesi Tip Fakültesi
Istanbul Turkey
Mersin Üniversitesi
Mersin Turkey
Ondokuz Mayis University, Medical School
Samsun Turkey
Selçuk Tip Fakültesi
Konya Turkey
Sisli Hamidiye Etfal Training and Research Hospital
Istanbul Turkey
Trabzon Kanuni Training and Research Hospital
Trabzon Turkey
University of Health Sciences
Istanbul Turkey