Dynamic change of Mycoplasma pneumoniae pneumonia in hospitalized children in a general hospital: a 3-year retrospective analysis

BACKGROUND: The epidemiology and economic burden of hospitalized community-acquired pneumonia (CAP) children due to MP is still poorly understood. This study aimed to investigate the dynamic changes of Mycoplasma pneumoniae pneumonia (MPP) in children in a general hospital. METHODS: A total of 2011 CAP children aged 1–16 years hospitalized at Peking University Third Hospital from 2017 to 2019 were enrolled by cross-sectional study for the retrospective analysis of the clinical data mainly including seasonal distribution of MPP, hospital stay, severity, complications, use of flexible bronchoscopy, and hospitalization costs. The dynamic changes of CAP and MPP children within 3 consecutive years and the differences between the MPP group and non-MPP groups were compared. RESULTS: The proportion of CAP children among hospitalized children was 32.4%, 38.5%, and 39.5% in 2017, 2018, and 2019, respectively, showing an upward trend (P<0.05).The prevalence rate of MPP was highest in the third quarter (30.2%) and the fourth quarter (39.2%) and lowest in the second quarter (13.2%) (χ(2)=51.8, P<0.05). Compared with the non-MPP group, the MPP group had significantly higher incidence of severe pneumonia (19.4% vs. 12.0%, χ(2)=20.99), incidence of complications (16.1% vs. 6.5%, χ(2)=48.24), proportion of patients undergoing flexible bronchoscopy (38.4% vs. 9.0%, χ(2)=252.79), and hospitalization costs (all P<0.05), along with significantly longer hospital stay (6 vs. 4 days, z=−11.131). A dynamic comparison of the clinical characteristics of MPP in 3 years showed that the number of children with MPP increased significantly in preschoolers in 2018 (37.3%) and in school-aged or older children in 2019 (53%) (P<0.05). MPP peaks occurred in August 2018 and November 2019. The total hospitalization costs, examination fees, and non-medication treatment costs increased significantly (the z values were 35.24, 46.79, and 9.64, respectively; P<0.05) year by year among MPP children; there was no significant difference in the medication cost over these 3 years (z=4.81, P>0.05). CONCLUSIONS: The proportions of severe pneumonia, complications, and use of flexible bronchoscopy as well as the hospitalization days and costs are higher in MPP children. General hospitals should develop integrated clinical quality control programs for MPP children, so as to optimize the allocation of medical resources.