Epidemiology and clinical profiles of neonates with Mycoplasma pneumoniae infection during the post-COVID-19 era in Chengdu.

Background: Data on neonatal Mycoplasma pneumoniae (MP) infection in the post-coronavirus disease 2019 (post-COVID-19) era are scarce, despite MP being a common respiratory pathogen. This study explored the epidemiology and clinical features of hospitalized neonates with MP infection in Chengdu. Methods: A retrospective study was conducted on 61 neonates with MP infections admitted to Chengdu Women's and Children's Central Hospital from January 2023 to April 2025. Demographic, clinical, laboratory, and imaging data were collected from electronic medical records (EMRs). Real-time polymerase chain reaction (PCR) and serological testing confirmed MP infection. Results: MP infections peaked in autumn (44.3%) and winter (27.9%) and were most prevalent in neonates aged ≥22 days (49.2%). Cough (59.0%) and fever (27.9%) were the most common symptoms. Co-infections were observed in 52.5% of cases, predominantly with respiratory syncytial virus (RSV; 13.1%). Multivariate analysis identified fever [adjusted odds ratio (OR) =5.92], multiple pathogens (adjusted OR =5.33), and oxygen therapy (adjusted OR =11.84) as independent risk factors for prolonged hospital stay (>10 days). Symptomatic neonates had higher C-reactive protein (CRP) levels (P=0.01) and longer hospital stays (P=0.009) than asymptomatic ones. Conclusions: During the post-COVID-19 era, neonatal MP infections in Chengdu show autumn-winter predominance and are associated with specific clinical factors affecting hospitalization duration, highlighting the need for targeted management in high-risk neonates.