Mycoplasma pneumoniae pneumonia (MPP) is the most common form of community-acquired pneumonia, which shows an epidemic interval of 3-7 years. This study was conducted to understand the changing trends in MPP in children hospitalized before and during the coronavirus disease 2019 pandemic and determine adverse outcomes and their influencing factors. This was a retrospective cohort study of children aged 28 days to 14 years hospitalized for MPP at our institution between January 2018 and December 2023. Clinical characteristics, adverse outcomes, and associated factors were analyzed using the chi-square test and multivariable logistic regression. A P < 0.05 was considered statistically significant. A total of 17,505 MPP cases were included, with the highest case number (4,619) in 2023. In 2023, the proportion of severe pneumonia was 44.1%, and bronchoscopy usage was 33.5%, both significantly higher than in 2018-2022. Older age, admission during July-December, co-infection with Epstein-Barr virus, chlamydia, or other bacteria, and complications, including pleural effusion, abnormal liver enzymes, acute respiratory distress syndrome, or atelectasis, were associated with bronchoscopy. Older age, admission during October-December, co-infection with respiratory syncytial virus, adenovirus, Epstein-Barr virus, chlamydia, or other bacteria, and complications, including cardiac failure, abnormal liver enzymes, myocardial damage, or anemia, were associated with severe pneumonia. Cases of MPP, severe pneumonia, and those requiring bronchoscopy increased in 2023 compared with the five previous years. Children with MPP were more susceptible to adverse clinical outcomes, which were associated with age, month of admission, co-infection, and complications.IMPORTANCEMycoplasma pneumoniae pneumonia (MPP) is a leading cause of community-acquired pneumonia in children. This study analyzed 17,505 hospitalized children in Northeast China from 2018 to 2023 to explore MPP trends before, during, and after the coronavirus disease 2019 pandemic. We found a sharp resurgence of MPP in 2023 with higher rates of severe pneumonia, complications, and bronchoscopy use. Key risk factors for adverse outcomes included older age, admission in October-December, viral/bacterial co-infection, and pulmonary or extrapulmonary complications. These findings improve understanding of post-pandemic MPP epidemiology, support early risk stratification, and help optimize clinical management and public health interventions for childhood MPP.

Corticosteroids modulate key inflammatory and fibroproliferative pathways involved in ARDS through genomic and non-genomic glucocorticoid receptor signaling. Advances in ARDS pathophysiology have highlighted the importance of timing, inflammatory burden, and host response in determining treatment efficacy. Clinical evidence supports corticosteroid use in moderate-to-severe ARDS, particularly in COVID-19 ARDS and severe community-acquired pneumonia, with reductions in mortality and duration of mechanical ventilation. However, treatment effects remain heterogeneous across etiologies and biological subphenotypes. Recent identification of hyperinflammatory and hypoinflammatory ARDS phenotypes suggests that corticosteroid responsiveness is not uniform. Hyperinflammatory phenotypes and septic ARDS appear more likely to benefit, whereas evidence remains limited or conflicting in influenza-associated and non-septic ARDS. Long-term effects and adverse outcomes, including metabolic complications and ICU-acquired weakness, remain insufficiently characterized. Future research is increasingly focused on precision medicine approaches integrating biomarkers, adaptive platform trials, and phenotype-guided strategies. Emerging developments include lung-targeted corticosteroid delivery systems and selective glucocorticoid receptor modulators designed to improve efficacy while reducing systemic toxicity. Corticosteroids should therefore be considered a context-dependent therapy whose benefit is influenced by etiology, disease stage, inflammatory phenotype, and timing of administration.

Among 1141 inpatients from Arizona with community-acquired pneumonia, 865 (75.8%) were tested for Coccidioides infection and 85 (9.8%) had positive results. Patients more commonly underwent testing if they had concerning radiographs, fever, dyspnea, or fatigue. Patients with night sweats, rash, headache, or eosinophilia more commonly had positive results.

Enterobacteriaceae are a diverse family of Gram-negative, rod-shaped, facultatively anaerobic bacteria that serve as important indicators of food safety. Many species within this family, including common foodborne pathogens, are major contributors to both community- and hospital-acquired infections. The widespread use of antibiotics in agriculture has facilitated the emergence and dissemination of antimicrobial-resistant bacteria in food products, livestock, and the environment. This study investigated the prevalence and genomic characteristics of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae isolated from food sources in Saudi Arabia. A total of 160 isolates preserved in the Saudi Food and Drug Authority (SFDA) biobank were screened for antimicrobial resistance using indicator β-lactam antibiotics according to CLSI guidelines. Phenotypic screening indicated that Escherichia coli O145, E. coli O157, Klebsiella pneumoniae, and Cronobacter sakazakii isolates were not ESBL producers. In contrast, ESBL production was detected among Salmonella spp. isolates, and 13 confirmed ESBL-producing Salmonella isolates were subsequently subjected to whole-genome sequencing (WGS). Genomic analysis identified the ESBL gene blaCTX-M-65, along with multiple antimicrobial resistance determinants, virulence-associated genes, and plasmid replicons, predominantly belonging to the IncFIB and IncX families. These findings provide important insights into the occurrence of ESBL-producing Enterobacteriaceae in food sources and highlight the value of integrating phenotypic and genomic approaches for antimicrobial resistance surveillance within food safety systems.