Genetic factors driving the Mycoplasma pneumoniae outbreak among children post-COVID-19 in China: a whole genome analysisResearch in context
Summary: Background: Mycoplasma pneumoniae (M. pneumoniae) is a leading cause of community-acquired pneumonia in children. Post-COVID-19, a significant resurgence of M. pneumoniae infections has been observed in China, but whole-genome analyses on the genetic mechanisms driving this resurgence rema...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
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| Series: | The Lancet Regional Health. Western Pacific |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666606525001154 |
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| Summary: | Summary: Background: Mycoplasma pneumoniae (M. pneumoniae) is a leading cause of community-acquired pneumonia in children. Post-COVID-19, a significant resurgence of M. pneumoniae infections has been observed in China, but whole-genome analyses on the genetic mechanisms driving this resurgence remain limited. Methods: We performed whole-genome sequencing on 169 M. pneumoniae isolates from Beijing and Baoding, collected before and after COVID-19. All M. pneumoniae genomes from GenBank were included for analysis. Genotypes were identified using multilocus variable-number tandem-repeat analysis (MLVA), multilocus sequence typing (MLST), phylogenetic analysis. Genomic conservation and transmission patterns were assessed via SNP distance. Findings: We identified a post-COVID-19 resurgence of M. pneumoniae infections among children, with infection rates peaking at 60%–70% in late 2023, higher than during the pandemic (10%–20%) and pre-pandemic (∼30%). Genomic analysis revealed distinct genotypes, with T1-2 (4-5-7-2) dominating in Beijing, and both T1-2 and T2-2 (3-5-6-2) prevalent in Baoding. Minimal SNP distances and genomic conservation indicated rapid spread of M. pneumoniae. Genomic analysis uncovered key genetic factors driving the outbreak: near-100% macrolide resistance and increased prevalence of the 4-5-7-2 genotype (enriched in virulence and metabolism-related genes). Interpretation: This study provides a comprehensive genomic analysis of genetic factors driving the outbreak. With near-100% macrolide resistance in China, urgent changes in treatment policies are needed. The rising prevalence of 4-5-7-2 and its functional advantages warrant close monitoring. Our findings offer insights into the outbreak causes and guide future prevention and control strategies. Funding: National Key R&D Program of China; Training Plan for High level Public Health Technical Talents. |
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| ISSN: | 2666-6065 |