[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-458897-105":59,"doc-detail-458897-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","macrolide-resistant-mycoplasma-pneumoniae-in-children-ohio-usa-research-letter","Macrolide-Resistant Mycoplasma pneumoniae in Children, Ohio, USA - Research letter","","Macrolide-resistant Mycoplasma pneumoniae reemerged among children in Ohio, USA after the COVID-19 pandemic waned. Monthly macrolide-resistance rates fluctuated from 0% to 8.7%, tracking the azithromycin prescribing rate. From September 2023 to May 2025, patients under 21 with positive tests were analyzed using electronic medical charts and surveillance data. Resistance mutations were identified by sequencing, showing increased monthly rates peaking in October, with co-detection of respiratory viruses and higher hospitalization rates among resistant cases.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/macrolide-resistant-mycoplasma-pneumoniae-in-children-ohio-usa-research-letter/458897/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/macrolide-resistant-mycoplasma-pneumoniae-in-children-ohio-usa-research-letter/458897.png","ImageObject",300,407,{"name":92,"@type":93},"Indoniesian Boy","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-08","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":19},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the observed pattern of macrolide-resistant M. pneumoniae rates over time in Ohio children?","Question",{"text":112,"@type":113},"Monthly macrolide-resistance rates fluctuated between 0% and 8.7%, increasing over time and peaking in October.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were children selected for the study and what diagnostic testing was used?",{"text":117,"@type":113},"Patients under 21 were identified from positive M. pneumoniae tests using multiplex respiratory molecular panels or laboratory-developed PCR. Demographics, laboratory results, testing location, and hospitalization status were extracted from electronic medical charts.",{"name":119,"@type":110,"acceptedAnswer":120},"How did azithromycin prescribing relate to resistance and M. pneumoniae positivity rates?",{"text":121,"@type":113},"Azithromycin prescribing rates rose alongside both M. pneumoniae–positive rates and macrolide-resistance rates, and decreased as M. pneumoniae activity declined.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},458897,1790754714,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":19,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":129,"read_time":39,"preview_page_count":4},962090760608,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","RESEARCH LETTERS  \nMacrolide-Resistant Mycoplasma pneumoniae in Children, Ohio, USA  \nHuanyu Wang, Tori Embry, Kathy Everhart, Morgan Szekely, Jeanette Taveras, Sophonie J. Oyeniran, Amy L. Leber  \nAuthor affiliations: Nationwide Children’s Hospital, Columbus, Ohio, USA (H. Wang, T. Embry, K. Everhart, M. Szekely,  \nJ. Taveras, S.J. Oyeniran, A. L. Leber); The Ohio State University, Columbus (H. Wang, J. Taveras, S.J. Oyeniran, A. L. Leber)  \nDOI: [https://doi.org/10.3201/eid3112.251008](https://doi.org/10.3201/eid3112.251008)  \nAs the COVID-19 pandemic waned, Mycoplasma pneumoniae reemerged in the pediatric population in Ohio, USA. The rate of macrolide-resistant M. pneumoniae fluctuated by month, ranging from 0 to 8.7%, and mirrored the azithromycin prescribing rate. Real-time surveillance for macrolide-resistant M. pneumoniae provides accurate information for management of children with these infections.  \nMycopsociasma pted winethucmoniae isommunitay-macqajoruirepatd rogspienrataosryinfections in school-age children. Cyclic epidemics occur every few years (1) . As the COVID-19 pandemic waned, M. pneumoniae reemerged in a patient population in Ohio, USA, in September 2023. Activity peaked in summer 2024. This elevated activity persisted through winter 2024–25 and declined in the spring 2025, resulting in the largest M. pneumoniae outbreak in central Ohio in a decade.  \nMacrolides are the first-line treatment for M. pneumoniae infections (2) . We previously reported an average of 2.4% macrolide-resistant M. pneumoniae (MRMp) rate during September 2023–September 2024, which showed resistance increasing over time (3) . Here, we describe an overview of the entire outbreak and changes in MRMp rates during that period.  \nDuring September 1, 2023–May 27, 2025, we identified patients \u003C21 years of age who had positive M. pneumoniae tests by multiplex respiratory molecular panel (RP2.1; BioFire Diagnostics, [https://www](https://www). [biofiredx.com](biofiredx.com)) or laboratory-developed PCR (MPNPCR) . We tested a subset of remnant specimens for macrolide resistance (3) . We extracted demographic information, laboratory findings, testing location, and hospitalization status from electronic medical charts. We obtained azithromycin prescription data from records of patients seen at Nationwide  \nChildren’s Hospital urgent care centers. We conducted data analyses by using GraphPad Software ([https://www.graphpad.com](https://www.graphpad.com)).  \nDuring the study period, 45,320 M. pneumoniae tests were performed. We identified 7,969 (17.6%) positive results from 7,649 unique patients during 7,740 medical encounters (Table; Appendix Figure, [https://wwwnc.cdc.gov/EID/article/31/12/25-](https://wwwnc.cdc.gov/EID/article/31/12/25-)[ ](https://wwwnc.cdc.gov/EID/article/31/12/25-)[1008-App.pdf](1008-App.pdf)) . Positive test percentages began increasing in June 2024, peaked at 31% in July, and remained >20% until January 2025. The median age of patients with positive tests was 8.9 years (interquartile range [IQR] 5.8–12.0 years); 4,037 (52.8%) were male and 3,612 (47.2%) female. A total of 657 (8.5%) patients were hospitalized; 153 (2.0%) required intensive care unit (ICU) admission. Among the 795 patients with positive M. pneumoniae tests who had RP2.1 testing, 340 (42.8%) had co-detection of other respiratory viruses on the panel. We conducted an age-stratified analysis of resistance rates, testing location, hospitalization, ICU admission, and co-detection (Appendix Table 1) .  \nAmong positive M. pneumoniae tests, we successfully sequenced 2,014 (25.0%) samples (Appendix Table 2) . Resistance mutations occurred in 90 (4.5%) samples; 84 were A2063G, 5 were A2064G, and 1 was A2064T. Monthly resistance rates increased over time, peaking in October (8.7%) (Table; Figure) . We detected no resistance mutations among 26 (36.1%) samples collected during March–May 2025. The resistance rate of the entire outbreak was higher than we previously repor","cbCaivf3TusH7X8M","https://ap.wps.com/l/cbCaivf3TusH7X8M","pdf",564740,"English","# Overview\n## Background and clinical significance\n## Surveillance period and methods\n## Testing volume and positive rates\n## Sequencing and resistance mutations\n## Clinical outcomes and prescribing correlations","[{\"question\":\"What was the observed pattern of macrolide-resistant M. pneumoniae rates over time in Ohio children?\",\"answer\":\"Monthly macrolide-resistance rates fluctuated between 0% and 8.7%, increasing over time and peaking in October.\"},{\"question\":\"How were children selected for the study and what diagnostic testing was used?\",\"answer\":\"Patients under 21 were identified from positive M. pneumoniae tests using multiplex respiratory molecular panels or laboratory-developed PCR. Demographics, laboratory results, testing location, and hospitalization status were extracted from electronic medical charts.\"},{\"question\":\"How did azithromycin prescribing relate to resistance and M. pneumoniae positivity rates?\",\"answer\":\"Azithromycin prescribing rates rose alongside both M. pneumoniae–positive rates and macrolide-resistance rates, and decreased as M. pneumoniae activity declined.\"}]","Macrolide-Resistant Mycoplasma pneumoniae in Children, Ohio, USA - Research letter | PDF"]