{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T18:11:52Z","timestamp":1789150312505,"version":"build-2803163510"},"reference-count":29,"publisher":"American Society for Microbiology","issue":"4","license":[{"start":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T00:00:00Z","timestamp":1712016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T00:00:00Z","timestamp":1712016000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100000057","name":"HHS | NIH | National Institute of General Medical Sciences","doi-asserted-by":"crossref","award":["P20GM121293"],"award-info":[{"award-number":["P20GM121293"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2024,4,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              Non-pharmacologic interventions (NPIs), such as universal masking, implemented during the SARS-CoV-2 pandemic have reduced respiratory infections among children. This study evaluated the impact of NPIs on\n              <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n              infections in children, analyzing data from two hospitals in Arkansas and examining age-related differences and co-infections with other respiratory viruses. The study was approved by the Institutional Review Board and included patients (\u226418 years) with upper respiratory tract symptoms. Data generated from the FilmArray Respiratory Panel were divided into pre-NPI, NPI, and post-NPI periods for analysis. Overall test positivity rate and positivity rate interval changes were evaluated. Statistical differences were determined by Chi-square (\u03c7\n              <jats:sup>2<\/jats:sup>\n              independence) analysis. A total of 100,077 tests were performed, with a statistical increase in testing volume during the NPI and post-NPI periods. The number of positive\n              <jats:italic>M. pneumoniae<\/jats:italic>\n              tests decreased by 77% (77 to 18) during the NPI period, then increased by 50% (18 to 27) during the post-NPI period. Preschool and elementary school age groups had the highest number of positive tests during the study at 59 (48%) and 40 (33%), respectively. Reduced\n              <jats:italic>M. pneumoniae<\/jats:italic>\n              infections were consistent across age groups. Co-infections with other respiratory viruses, particularly human rhinovirus\/enterovirus, were observed at much lower levels. Pediatric\n              <jats:italic>M. pneumoniae<\/jats:italic>\n              infections in Arkansas were temporally associated with implementation and discontinuation of NPIs. Specific viral co-infections still occurred, albeit at lower levels during the SARS-CoV-2 pandemic. Because of the slower growth of this bacterium, we expect\n              <jats:italic>M. pneumoniae<\/jats:italic>\n              infections to return to pre-pandemic levels within approximately 2 years.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>IMPORTANCE<\/jats:title>\n            <jats:p>\n              Non-pharmacologic interventions (NPIs) effectively curtailed the spread of SARS-CoV-2 and, fortuitously, many other aerosol-transmitted respiratory pathogens. This study included the largest data set of symptomatic, pediatric patients from within the United States spanning a period from November 2017 through December 2023, and encompassed individuals residing in both rural and urban settings. We observed a strong correlation between the implementation and cessation of NPIs with the rate of respiratory infections due to\n              <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n              and viral co-infections. These infections are returning to baseline levels approximately 2 years following NPI cessation. This observation was not unexpected since the replication time for viruses is exponentially faster than that of bacteria. The resurgence of\n              <jats:italic>M. pneumoniae<\/jats:italic>\n              and likely other atypical bacterial pathogens is currently in process. Healthcare providers should strongly consider these pathogens in individuals presenting with respiratory tract illnesses.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/spectrum.02908-23","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T16:32:37Z","timestamp":1711557157000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":23,"title":["SARS-CoV-2 pandemic non-pharmacologic interventions temporally associated with reduced pediatric infections due to\n            <i>Mycoplasma pneumoniae<\/i>\n            and co-infecting respiratory viruses in Arkansas"],"prefix":"10.1128","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5665-7357","authenticated-orcid":true,"suffix":"Jr.","given":"Bobby L.","family":"Boyanton","sequence":"first","affiliation":[{"name":"Department of Pathology, Arkansas Children's Hospital, Little Rock, Arkansas, USA"},{"name":"Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel A.","family":"Frenner","sequence":"additional","affiliation":[{"name":"Department of Pathology, Arkansas Children's Hospital, Little Rock, Arkansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashton","family":"Ingold","sequence":"additional","affiliation":[{"name":"Arkansas Children\u2019s Research Institute, Little Rock, Arkansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6242-607X","authenticated-orcid":true,"given":"Lilliam","family":"Ambroggio","sequence":"additional","affiliation":[{"name":"Sections of Emergency Medicine and Hospital Medicine, Children's Hospital Colorado, Aurora, Colorado, USA"},{"name":"Department of Pediatrics, University of Colorado, Aurora, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1919-9051","authenticated-orcid":true,"given":"Joshua L.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Arkansas Children\u2019s Research Institute, Little Rock, Arkansas, USA"},{"name":"Departments of Pediatrics and Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, 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