Disease Trends and Reporting

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There is no national reporting or surveillance system for Mycoplasma pneumoniae infections.

Estimated incidence

M. pneumoniae infections are common in the United States, with an estimated 2 million cases occurring each year1,2. However, many infections are not diagnosed, so the actual number is likely higher.

Trends over time

The number of M. pneumoniae infections varies over time. There are usually peaks of disease every 3 to 7 years1,3. Variation in strain types contributes to this periodicity.

Seasonality

M. pneumoniae infections can happen any time of the year. However, they may be more common in summer and early fall3.

Outbreaks

Outbreaks occur mostly in crowded environments like schools, college residence halls, and nursing homes. Outbreaks can be prolonged due to the long incubation period of M. pneumoniae.

Antibiotic resistance

Resistance to macrolides emerged in M. pneumoniae and has been increasing since the 2000s4,5.

Current data suggest that the overall global prevalence of macrolide resistance in M. pneumoniae may be around 28%4. However, there is significant geographical variation4:

  • Canada: About 12%
  • China: About 80%
  • Europe: Averages around 5% (highest in Italy: 20%)
  • Japan: More than 50%
  • United States: About 10% with regional variability
  1. Diaz M, Benitez A, Winchell J. Investigations of Mycoplasma pneumoniae infections in the United States: Trends in molecular typing and macrolide resistance from 2006 to 2013. J Clin Microbiol. 2015;53(1):124–30.
  2. Jain S, Williams D, Arnold S, et al. Community-acquired pneumonia requiring hospitalization among U.S. children. NEJM. 2015;372:835–45.
  3. Foy HM. Infections caused by Mycoplasma pneumoniae and possible carrier state in different populations of patients. Clin Infect Dis. 1993;17(Supplement_1):S37–S46.
  4. Kim K, Jung S, Kim M, et al. Global trends in the proportion of macrolide-resistant Mycoplasma pneumoniae infections: A systematic review and meta-analysis. JAMA Netw Open. 2022;5(7):e2220949.
  5. Rothstein TE, Cunningham SA, Rieke RA, Mainella JM, Mutchler MM, Patel R. Macrolide resistance in Mycoplasma pneumoniae, Midwestern United States, 2014 to 2021. Antimicrob Agents Chemother. 2022;66(4):e0243221.