http://www.sudoc.fr/29728620X fre FR Difficultés d’accès au diagnostic d’infection à Mycoplasma pneumoniae en situation épidémique chez les médecins libéraux : une étude qualitative auprès de 19 médecins généralistes, pédiatres et biologistes : thèse présentée pour le diplôme d'Etat de docteur en médecine : diplôme d'Etat mention médecine générale Thèse d'exercice Médecine (médecine générale) 2026-06-30 Introduction : Lower respiratory tract infections, particularly community-acquired pneumonia (CAP), represent a major public health concern in France and remain the leading cause of infectionrelated mortality. Among the bacterial pathogens responsible for CAP, Mycoplasma pneumoniae plays an important role and ranks second after Streptococcus pneumoniae. In late November 2025, an unusual increase in Mycoplasma pneumoniae infections was reported in France after more than three years of low circulation, in the context of public health measures implemented during the COVID-19 pandemic. Objective : This study aimed to describe diagnostic practices for Mycoplasma pneumoniae infections in primary care and to assess the role of microbiology in this process. Secondary objectives were to identify difficulties reported by clinical microbiologists, general practitioners, and pediatricians during this epidemic context, and to explore interactions between community laboratories and prescribing physicians. Methods : A qualitative study was conducted using individual semi-structured interviews with 19 healthcare professionals (general practitioners, pediatricians, and clinical microbiologists) practicing in the Alsace region between February and September 2025. Results : Participants reported difficulties in the diagnostic approach to Mycoplasma pneumoniae infections, associated with non-specific clinical presentations and variable use of additional diagnostic tests. Molecular diagnostic techniques were identified as relevant tools, although their accessibility in primary care was described as limited. In this context of diagnostic uncertainty, practices appeared heterogeneous and the use of existing guidelines varied among practitioners. Participants also reported adaptations in clinical practice and difficulties in antibiotic supply during the epidemic period. Conclusion : This study describes the diagnostic and organizational challenges encountered during the epidemic of Mycoplasma pneumoniae infections. The findings highlight the involvement of general practitioners, pediatricians, and microbiologists, as well as institutional stakeholders, in the management of the epidemic. The results suggest the potential benefit of strengthening collaboration between the different actors involved and encourage reflection on the accessibility of diagnostic tools in primary care, while raising questions regarding their implementation and the management of diagnostic uncertainty in clinical practice Mycoplasma Épidémies Microbiologie Sérologie Maladies pulmonaires 610 Miftah, Samira Hansmann, Yves Université de Strasbourg 173113206 Faculté de médecine, maïeutique et sciences de la santé PDF https://publication-theses.unistra.fr/public/theses_exercice/MED/2026/2026_MIFTAH_Samira.pdf These d'exercice Unistra Accès libre