Regional and annual patterns in respiratory virus co-infection etiologies and antibiotic prescriptions for pediatric mycoplasma pneumoniae pneumonia

- OBJECTIVE: Mycoplasma pneu-moniae (M. pneumoniae) pneumonia is the sec-ond-most common cause of community -ac-quired pneumonia (CAP). This study aimed at investigating into the prevalence of macro-lide-resistant M. pneumoniae(MRMP) with respi-ratory virus co-infection and the antibiotic pre-scriptions in children with CAP in four provinces in Korea, and to assess the variations in the find-ings across regions and throughout the year.PATIENTS AND METHODS: This prospective study was conducted in 29 hospitals in Korea between July 2018 and June 2020. Among the enrolled 1,063 children with CAP, all 451 patients with M. pneumoniae underwent PCR assays of M. pneumoniae and respiratory viruses, and the presence of point mutations of residues 2063 and 2064 was evaluated.RESULTS: Gwangju-Honam (88.6%) showed the highest prevalence of MRMP pneumonia, while Daejeon-Chungcheong (71.3%) showed the lowest, although the differences in preva-lence were not significant (p=0.074). Co -infec-tion of M. pneumoniae pneumonia and respira-tory virus was observed in 206 patients (45.4%), and rhinovirus co-infection (101 children; 22.2%) was the most frequent. The prevalence of MRMP pneumonia with respiratory virus co-infection and the antibiotic prescriptions differed signifi-cantly among the four provinces (p < 0.05). The monthly rate of MRMP pneumonia cases among all cases of M. pneumoniae pneumonia and tet-racycline or quinolone prescriptions did not dif-fer significantly among the four regions (trend p > 0.05) during the study period.CONCLUSIONS: The prevalence of M. pneu-moniae pneumonia with virus co-infection and antibiotic prescriptions could differ according to region, although the MRMP pneumonia rate showed no difference within Korea.