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...

Full description

Saved in:
Bibliographic Details
Main Authors: Weiwei Jiao, Jie Wang, Cuidan Li, Peihan Wang, Sihong Xu, Jing Bi, Liya Yue, Fang Liu, Lin Sun, Hui Qi, Tingting Jiang, Xue Tian, He Tang, Xu Li, Min Li, Xuemei Yang, Xiaoxuan Yang, Yuting Sun, Haitao Niu, Wenbao Zhang, Adong Shen, Fei Chen
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:The Lancet Regional Health. Western Pacific
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666606525001154
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
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.
ISSN:2666-6065