| Background:Respiratory tract infection(RTI)are common and frequently occurring diseases in children.Mycoplasma pneumoniae(MP)is a common and important pathogen of RTI in children.Hainan Province is the tropical region in China,with four distinct seasons,which is significantly different from the mainland.There are many reports of MP infection in mainland China,but few in Hainan Province.Objective: To understand the incidence of MP infection in children with RTI in Hainan Province,and analyze the epidemiological characteristics(season,age,gender,mixed infection and clinical characteristics,etc.)of children with MP infection,and provide evidence-based diagnosis and treatment evidence for prevention and control of MP infection in children in Hainan Province.Methods: From March 2012 to February 2020,35731 children with RTI were hospitalized in a number of grade III A and grade II A hospitals in Hainan(We investigate 50 % grade III A hospitals in Hainan,including Hainan Provincial People’s Hospital,the Second Affiliated Hospital of Hainan Medical College and Sanya Central Hospital,these hospitals locate in the north or south of Hainan Province.And we investigate 33.3 % grade II A hospitals in Hainan,including Wanning people’s Hospital,Tunchang County People’s Hospital,Dongfang people’s Hospital,and Ledong County People’s Hospital,these hospitals locate in the east,middle or west of Hainan Province);serum IgM antibodies of these children against nine pathogens of RTI(MP,Legionella pneumophila,Chlamydia pneumoniae,Adenovirus,Respiratory syncytial virus,Coxiella burnetii,Parainfluenza virus,influenza A virus and influenza B virus)were detected by using indirect immunofluorescence.Serum MP-IgM antibody positive is defined as MP infection.The clinical data and laboratory test data of MP infection cases were retrospectively analyzed.Results: From March 2012 to February 2020,a total of 35731 children with RTI were tested for MP IgM antibody.Among them,13978 cases were MP IgM positive,with a total positive rate of 39.12%.The annual positive rates of MP IgM were 48.39%,56.23%,56.62%,47.04%,29.71%,24.14%,47.55%,36.84% and24.46%,respectively,from 2012 to 2020.The annual positive rates of MP IgM in2013 and 2014 were 56.23% and 56.62%,respectively,which were significantly higher than those in other years(P<0.05).In our data,MP infection in children with RTI occurred all year round.The data of this project showed that the positive rates in summer and spring were higher than those in autumn and winter in Hainan,with the highest positive rate in summer(41.33%)and the lowest positive rate in winter(35.77%),the differences were statistically significant(P<0.05).MP infection was found in all age groups.The positive rates of MP infection in children aged 1-3 years and 4-7 years were 48.31% and 51.80%,respectively,which were significantly higher than those in other age groups.The positive rate of MP infection in children aged<1year was 15.36%,which was the lowest,the difference was statistically significant(P<0.05).In gender distribution,the positive rate of MP IgM in male was 35.83%,which was lower than that in female(44.77%),and the difference was statistically significant(P<0.05).Among the 13978 MP-IgM positive cases,there were 4561 cases with IgM positive to another one pathogen of the nine pathogens(accounting for 32.63%),and 176 cases with IgM positive to another two pathogens of the nine pathogens(accounting for 1.26%),and 43 cases with IgM positive to another three pathogens of the nine pathogens(accounting for 0.31%).MP infection was more common in pneumonia,accounting for 68.73%.The clinical symptoms were mainly cough and fever,accounting for 84.72% and 51.01%,respectively,followed by wheezing,accounting for 3.16%.The level of CRP increased in MP infection children.Among them,the CRP level of the ≥3 years old group was higher than that of the <3years old group,and the difference was statistically significant(P<0.05).The incidence of abnormal liver function in children with MP infection was 8.02%,which was lower than the 14.42% incidence of abnormal liver function in the non-MP infection group,and the difference was statistically significant(P<0.05).Conclusions: 1.The total MP-IgM positive rate of hospitalized children with RTI in Hainan from 2012 to 2020 is 39.12%,and the positive rate of MP IgM fluctuated periodically every year,and there were epidemic trends in 2014 and 2018.2.MP infection occur throughout the year.Hainan Province has high incidences in summer and spring,and low incidences in autumn and winter.3.MP infection were found in all age groups,and there was no positive correlation between infection rate and age.The rates of MP infection in early childhood and preschool age were the highest,and the rate of MP infection in infancy was the lowest.4.In terms of gender,the infection rate of MP in female is higher than that in male,and there are gender differences.5.MP infection is often combined with another one pathogen infection,which is more common in influenza B virus.6.MP infection is more common in pneumonia.The main clinical symptoms are cough and fever,followed by wheezing.7.The level of CRP increased in MP infection in children.8.The incidence of abnormal liver function in children with MP infection was lower than that of children with non-MP infection. |
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