Objective To analyze the surveillance results of Mycoplasma pneumoniae infection in hospitalized febrile patients with pneumonia in sentinel hospitals in Guangzhou, Guangdong province from 2009 to 2024 and understand the epidemiological characteristics of M. pneumoniae infection.

Methods M. pneumoniae surveillance information in hospitalized febrile patients with pneumonia in sentinel hospitals in Guangzhou during this period were collected through the Guangzhou Public Health Emergency Surveillance and Early Warning System, and the differences in M. pneumoniae detection rates in the patients in different years, seasons, and age groups were analyzed.

Results From January 2009 to July 2024, a total of 78526 hospitalized febrile patients with pneumonia were surveyed in Guangzhou, in whom 10 491 were M. pneumoniae positive (13.36%). In 29 135 child cases under 14 years old, 7 982 were M. pneumoniae positive (27.40%). In the past 16 years, high incidences of M. pneumoniae infection were recorded for two times in Guangzhou, one was from January 2010 to March 2016, and another one was from March 2023 to April 2024 (in the most months, the M. pneumoniae detection rate exceeded the total detection rate by 13.36%) with peaks in October 2014 (32.20%, 133/413) and November 2023 (36.67%, 242/660), respectively. M. pneumoniae infection mainly occurred in autumn in Guangzhou, and the incidence peak mainly occurred during October-November. M. pneumoniae infection was more common in hospitalized febrile patients with pneumonia under the age of 14 years, and the detection rate of M. pneumoniae increased with age (T=78.000, P=0.011), with the highest detection rate in age group 6−14 years (48.64%, 1697/3489); the detection rate of M. pneumoniae was higher in women than in men (χ²=33.135, P<0.001).

Conclusion The epidemiological characteristics of M. pneumoniae infection in hospitalized febrile patients with pneumonia in Guangzhou changed during 2009−2024. After the high incidence during 2010−2016, the incidence of M. pneumoniae infection was low in the following 6 years, then increased again to a high level during 2023−2024 with increased intensity. M. pneumoniae infection can occur all the year round, but mainly in autumn. The epidemic of M. pneumoniae infection has periodicity at some degree and can last for several years. M. pneumoniae infection mainly occurs in preschool and school-age children, and M. pneumoniae infection in infants and young children still needs attention.