Characteristics of Mycoplasma pneumoniae Pneumonia in Romanian Children

Background/Objectives: Mycoplasma pneumoniae (M pneumoniae), traditionally associated with mild community-acquired pneumonia in school-aged children, has experienced a delayed resurgence following the COVID-19 pandemic. The epidemiological and clinical characteristics of M. pneumoniae pneumonia in children within the context of this global resurgence have not been well-established in Romania. Materials and Methods: This retrospective, single-center study analyzed children diagnosed with M pneumoniae pneumonia who were hospitalized in the Pulmonology Department of "Grigore Alexandrescu" Emergency Hospital for Children in Bucharest from March to December 2024. Clinical, laboratory, and radiographic data were extracted from hospital records. M pneumoniae infection was confirmed through polymerase chain reaction (PCR) multiplex panel detection or specific IgM antibody levels ≥10 AU/mL. Results: The final analysis included 63 patients meeting inclusion criteria. The cohort's median age [IQR] was 12.6 [8-15] years, with 11.1% (n=7) under 6 years old. Radiographic findings revealed a predominance of right lung involvement (52.4%, n=33, p=0.03) and a significantly higher prevalence of alveolar infiltrates compared to interstitial patterns (88.9%, n=56, p< 0.001). Antibiotic choice did not significantly affect hospitalization duration. Pleural effusion emerged as a common complication, occurring in 27% (n=17) of patients and associated with elevated admission leukocyte counts (p=0.007). Rare extrapulmonary manifestations included meningoencephalitis (1.6%, n=1) and reactive infectious mucocutaneous eruption (3.2%, n=2). Notably, co-infections with other respiratory pathogens did not extend hospital stays. Conclusion: This study contributes to the evolving global epidemiological profile of M pneumoniae infections in the post-pandemic era. It establishes a foundation for future multi-center analyses aimed at monitoring the changing epidemiology and clinical presentations of M pneumoniae infections in pediatric populations.