Mycoplasma pneumoniae Infection Surveillance and Trends

Key points

  • There is no national reporting or surveillance system for Mycoplasma pneumoniae infections.
  • M. pneumoniae infections are common.
  • These infections may occur more often in summer and early fall.
An illustration of generic data

Data sources

A M. pneumoniae infection isn't a nationally notifiable condition. This means that healthcare providers aren't required to report infections to their local public health department. However, CDC can monitor national trends using syndromic and commercial laboratory data collected by the National Syndromic Surveillance Program.

Researchers collect additional data to understand the epidemiology of M. pneumoniae infection:

Studies

M. pneumoniae infections are common in the United States, with an estimated 2 million infections occurring each year12. However, many infections aren't diagnosed, so the actual number is likely higher.

Outbreaks

Outbreaks occur mostly in crowded environments like schools, college residence halls, and nursing homes.

Outbreaks can be prolonged due to the long incubation period of M. pneumoniae.

Trends

The number of M. pneumoniae infections varies over time. There are usually peaks of disease every 3 to 7 years13. Variation in strain types contributes to this pattern. In 2023, M. pneumoniae began to re-emerge globally. This re-emergence occurred after a prolonged period of low incidence of infections since the start of the COVID-19 pandemic.

Increases in 2024‎

So far in 2024, CDC has seen an increase in M. pneumoniae infections, including in young children. This differs from previous years in which most infections were observed among older children and adolescents. CDC continues to monitor these trends in the United States.

Seasonality

M. pneumoniae infections can occur any time of the year. However, they may be more common in summer and early fall3.

Antibiotic resistance

Resistance to macrolides emerged in M. pneumoniae and has been increasing since the early 2000s45. Macrolides are the main type of antibiotic used to treat M. pneumoniae infections.

Current data suggest that the overall global prevalence of macrolide resistance in M. pneumoniae may be around 28%4. However, there's significant geographical variation4:

  • Canada: About 12%
  • China: About 80%
  • Europe: Averages around 5% (highest in Italy: 20%)
  • Japan: More than 50%
  • United States: About 10% with regional variability

CDC monitors macrolide resistance in M. pneumoniae. Monitoring occurs by testing specimens submitted by local and state public health departments and from surveillance systems.

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Content Source:
National Center for Immunization and Respiratory Diseases; Division of Bacterial Diseases
  1. Diaz M, Benitez A, Winchell J. Investigations of Mycoplasma pneumoniae infections in the United States: Trends in molecular typing and macrolide resistance from 2006 to 2013. J Clin Microbiol. 2015;53(1):124–30.
  2. Jain S, Williams D, Arnold S, et al. Community-acquired pneumonia requiring hospitalization among U.S. children. NEJM. 2015;372:835–45.
  3. Foy HM. Infections caused by Mycoplasma pneumoniae and possible carrier state in different populations of patients. Clin Infect Dis. 1993;17(Supplement_1):S37–S46.
  4. Kim K, Jung S, Kim M, et al. Global trends in the proportion of macrolide-resistant Mycoplasma pneumoniae infections: A systematic review and meta-analysis. JAMA Netw Open. 2022;5(7):e2220949.
  5. Rothstein TE, Cunningham SA, Rieke RA, Mainella JM, Mutchler MM, Patel R. Macrolide resistance in Mycoplasma pneumoniae, Midwestern United States, 2014 to 2021. Antimicrob Agents Chemother. 2022;66(4):e0243221.