Pathogen distribution and infection patterns in pediatric severe pneumonia: A targeted next-generation sequencing...

Area of Science:

• Pediatric Infectious Diseases
• Respiratory Medicine
• Microbiology

Background:

• Severe pneumonia in children poses a significant global health challenge, marked by high incidence and mortality rates.
• Accurate and rapid pathogen identification is crucial for effective treatment and management of pediatric severe pneumonia.

Purpose of the Study:

• To investigate the spectrum of pathogens and infection patterns in children diagnosed with severe pneumonia.
• To evaluate the utility of pathogen-targeted next-generation sequencing (tNGS) in identifying causative agents of severe pediatric pneumonia.

Main Methods:

• A cohort of 110 pediatric patients with severe pneumonia was studied.
• Pathogen-targeted next-generation sequencing (tNGS) was utilized to detect respiratory pathogens in patient samples.
• Data were collected from July 2021 to November 2023 at Guangxi Maternal and Child Health Hospital.

Main Results:

• A high pathogen detection rate of 99.09% was achieved using tNGS.
• Mixed infections were prevalent, occurring in 76.36% of cases, with bacterial-viral coinfection being common (28.2%).
• The most frequent pathogens identified were Mycoplasma pneumoniae (30.91%), Human Respiratory Syncytial Virus Type A (26.36%), and Human Herpesvirus (18.18%).
• A significant proportion of patients (40%) required intensive care unit (ICU) admission.
• Macrolide-resistant Mycoplasma pneumoniae (MRMP) was identified in 38.2% of Mycoplasma pneumoniae cases.

Conclusions:

• tNGS is a valuable tool for pathogen detection in pediatric severe pneumonia.
• Mycoplasma pneumoniae, Human Respiratory Syncytial Virus, and Human Herpesvirus are key pathogens in this population.
• The high rate of mixed infections and the prevalence of MRMP highlight the complexity of severe pediatric pneumonia and the need for advanced diagnostics.