{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:06:56Z","timestamp":1790348816113,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":228,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n \n Mycoplasma pneumoniae<\/jats:italic>\n <\/jats:styled-content>\n is a leading cause of pediatric community\u2010acquired pneumonia. Macrolide\u2010resistant\n \n M.\u2009pneumoniae<\/jats:italic>\n <\/jats:styled-content>\n (MRMP) emerged in East Asia in the 2000s and was once highly prevalent in Japan. However, its epidemiology in Japan following the coronavirus disease 2019 (COVID\u201019) pandemic is unclear.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n The present, single\u2010center, retrospective study, conducted at a tertiary children's hospital in Tokyo, investigated the post\u2010pandemic prevalence of MRMP and compared the clinical features of MRMP and macrolide\u2010susceptible\n \n M.\u2009pneumoniae<\/jats:italic>\n <\/jats:styled-content>\n (MSMP). Patients aged\u2009\u2264\u200918\u2009years who were positive for\n \n M.\u2009pneumoniae<\/jats:italic>\n <\/jats:styled-content>\n on polymerase chain reaction (PCR) between April 2020 and March 2025 were enrolled. MRMP was defined by macrolide\u2010resistance mutations detected using a point\u2010of\u2010care, PCR\u2010based assay. The proportion of patients with MRMP and the clinical characteristics of the MRMP and MSMP cohorts were analyzed.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In total, 272 patients had a\n \n M.\u2009pneumoniae<\/jats:italic>\n <\/jats:styled-content>\n infection, and 191 (70.2%) patients were classified into the MRMP group. A marked resurgence of\n \n M.\u2009pneumoniae<\/jats:italic>\n <\/jats:styled-content>\n infections, of which MRMP comprised 87% of the cases, was observed in April 2024 and peaked in October 2024. Among hospitalized patient (52\/272, 19.1%), MRMP group were more likely to require oxygen (89% vs. 43%,\n p<\/jats:italic>\n \u2009=\u20090.0015), and experience respiratory complications (47% vs. 7.1%,\n p<\/jats:italic>\n \u2009=\u20090.019) than MSMP group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n MRMP reemerged as the predominant strain in Tokyo following the COVID\u201019 pandemic and may be associated with greater severity and recalcitrance to treatment. Therefore, monitoring its prevalence and adjusting the antibiotic strategy are crucial.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ped.70513","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T08:07:21Z","timestamp":1786954041000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Resurgence of Macrolide\u2010Resistant\n \n Mycoplasma pneumoniae<\/i>\n <\/scp>\n After the\n COVID<\/scp>\n \u201019 Pandemic at a Children's Hospital in Japan"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2559-591X","authenticated-orcid":false,"given":"Natsuki","family":"Koriyama","sequence":"first","affiliation":[{"name":"Department of General Pediatrics Tokyo Metropolitan Children's Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4940-7480","authenticated-orcid":false,"given":"Yo","family":"Murata","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics Tokyo Metropolitan Children's Medical Center Tokyo Japan"},{"name":"Center for Pediatric Infectious Diseases Tokyo Metropolitan Children's Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4948-4902","authenticated-orcid":false,"given":"Shoichiro","family":"Shirane","sequence":"additional","affiliation":[{"name":"Clinical Research Support Center Tokyo Metropolitan Children's Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madoka","family":"Okabe","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics Tokyo Metropolitan Children's Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1768-9927","authenticated-orcid":false,"given":"Shogo","family":"Akahoshi","sequence":"additional","affiliation":[{"name":"Clinical Research Support Center Tokyo Metropolitan Children's Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5875-1024","authenticated-orcid":false,"given":"Yuho","family":"Horikoshi","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics Tokyo Metropolitan Children's Medical Center Tokyo Japan"},{"name":"Center for Pediatric Infectious Diseases Tokyo Metropolitan Children's Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3904-7087","authenticated-orcid":false,"given":"Hiroshi","family":"Sakakibara","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics Tokyo Metropolitan Children's Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1405870"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1128\/cmr.00114\u201016"},{"key":"e_1_2_11_4_1","unstructured":"Japanese Pediatric Society \u201cConcepts for Diagnosis and Treatment ofMycoplasma pneumoniaein Children \u201daccessed May 26 2026 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