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Volume 32, Number 11—November 2026

Research

Emergence of Novel Macrolide-Resistant Mycoplasma pneumoniae Sequence Type 3 Subclades in Children after COVID-19 Pandemic, Taiwan

Yu-Chia Hsieh, Chen-Ching Lin, Jia-Wen Wu, Yi-Hsuan Liu, Yi-Jiun Pan, Tzu-Ya Lo, Shian-Sen Shie, Huey-Ling You, Chong-Wei Huang, Yi-Chuan Huang, Tzu-Ching Huang, Yu-Xin She, Yin-Cheng Chen1, and Shiao-Wen Li1Comments to Author 
Author affiliation: Chang Gung Children’s Hospital, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan (Y.-C. Hsieh, J.-W. Wu, Y.-H. Liu, T.-Y. Lo); School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (C.-C. Lin, Y.-C. Chen); School of Medicine, College of Medicine, People’s Republic of China Medical University, Taichung, Taiwan (Y.-J. Pan); Chang Gung Memorial Hospital, Taoyuan (S.-S. Shie); Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (H.-L. You); Keelung Chang Gung Memorial Hospital, Keelung, Taiwan (C.-W. Huang, Y.-C. Huang); School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei (T.-C. Huang); College of Science Department of Life Sciences, National University of Kaohsiung, Kaohsiung (Y.-X. She, S.-W. Li)

Main Article

Table 1

Mycoplasma pneumoniae–related hospitalizations, ICU admissions, and CNS complications among children <18 years of age in study of emergence of novel macrolide-resistant M. pneumoniae sequence type 3 subclades in children after COVID-19 pandemic, Taiwan, 2017–2024 (n = 2,340)*

Age group, y
 Incidence per 100,000 (no. cases)
2017 vs. 2019
2019 vs. 2024
2017
 2018
 2019
 2020
 2021
 2022
 2023
 2024
IRR (95% CI)
 p value
IRR (95% CI)
 p value
M. pneumoniae incidence
<18 87 (206) 90 (204) 284 (635) 55 (112) 0 0 12.8 (28) 546 (1,155) 3.25 (2.78–3.81) <0.0001 1.92 (1.74–2.11) <0.0001
0–4 117 (72) 117 (71) 348 (205) 90 (47) 0 0 14.0 (7) 470 (219) 2.99 (2.29–3.91) <0.0001 1.4 (1.11–1.63) 0.002
5–9 173 (105) 157 (95) 535 (329) 73 (44) 0 0 21.3 (14) 986 (616) 3.09 (2.48–3.85) <0.0001 1.84 (1.61–2.11) <0.0001
10–17
 26 (29)
 36 (38)
 98 (101)
 23 (21)
 0
 0
 6.8 (7)
 313 (320)
3.83 (2.54–5.80)
 <0.0001
3.2 (2.55–3.98)
 <0.0001
M. pneumoniae–related hospitalization
<18 82 (194) 86 (197) 268 (599) 53 (108) 0 0 12.3 (27) 348 (735) 3.26 (2.77–3.83) <0.0001 1.30 (1.16–1.44) <0.0001
0–4 107 (66) 115 (70) 323 (190) 86 (45) 0 0 14.0 (7) 341 (159) 3.02 (2.28–4.00) <0.0001 1.07 (0.86–1.30) 0.6
5–9 167 (101) 154 (93) 513 (315) 71 (43) 0 0 19.8 (13) 608 (380) 3.07 (2.46–3.85) <0.0001 1.19 (1.02–1.38) 0.03
10–17
 24 (27)
 32 (34)
 91 (94)
 22 (20)
 0
0
6.8 (7)
 191 (196)
3.83 (2.50–5.88)
 <0.0001
2.10 (1.64–2.68)
 <0.0001
M. pneumoniae–related ICU admission
<18 0.8 (2) 1.3 (3) 4.9 (11) 2.4 (5) 0 0 0 10.9 (23) 5.8 (1.29–26.2) 0.02 2.2 (1.08–4.53) 0.03
0–4 1.6 (1) 0 8.5 (5) 7.6 (4) 0 0 0 6.4 (3) 5.25 (0.61–44.93) 0.13 0.76 (0.18–3.17) 0.7
5–9 0 3.3 (2) 8.1 (5) 0 0 0 0 19.2 (12) ND ND 2.36 (0.83–6.7) 0.11
10–17
 0.9 (1)
 0.9 (1)
 1.0 (1)
 1.1 (1)
 0
 0
0
 7.8 (8)
1.1 (0.07–17.6)
 0.95
8.04 (1.01–64.3)
 0.05
M. pneumoniae–related CNS complications
<18 0.8 (2) 0 0.4 (1) 0 0 0 0 6.1 (13) 0.53 (0.05–5.82) 0.6 13.7 (1.80–104.90) 0.01
0–4 1.6 (1) 0 0 0 0 0 0 0 ND ND ND ND
5–9 0 0 0 0 0 0 0 11.2 (7) ND ND ND ND
10–17 0.9 (1) 0 0 0 0 0 0 5.9 (6) 1.1 (0.07–17.6) 0.95 6.03 (0.73–50.10) 0.1

*ICU, intensive care unit; IRR, incidence rate ratio; CNS, central nervous system; ND, not done.

Main Article

1These senior authors contributed equally to this article.

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