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Differences in pulmonary microbiota of severe community-acquired pneumonia with different pathogenic microorganisms

Yingying Luo1, Ruxi Wu1, Weiwei Wu2

  • 1Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, China.

BMC Pediatrics
|June 3, 2025
PubMed

Insights

Children with severe community-acquired pneumonia (SCAP) caused by Mycoplasma pneumoniae show a more intense inflammatory response. Pulmonary microbiota diversity differs across pathogens, impacting clinical features in pediatric SCAP.

Area of Science:

  • Pediatric Pulmonology
  • Microbiome Research
  • Infectious Diseases

Background:

  • Severe community-acquired pneumonia (SCAP) is a growing concern in children under 5, leading to hospitalization and death.
  • Understanding pulmonary microbiota changes and their clinical correlations in SCAP is crucial but remains unclear.
  • Specific pathogens like Streptococcus pneumoniae (SP), Mycoplasma pneumoniae (MP), and Haemophilus influenzae (HI) are common causes of pediatric SCAP.

Purpose of the Study:

  • To investigate the differences in clinical features and pulmonary microbiota composition among children with SCAP caused by distinct pathogens (SP, MP, HI).
  • To explore the correlation between pulmonary microbiota and the clinical manifestations of SCAP.
  • To elucidate the inflammatory response associated with different SCAP pathogens.

Main Methods:

  • Bronchoalveolar lavage fluid (BALF) was collected from 105 children diagnosed with SCAP.
  • Metagenomics next-generation sequencing (mNGS) was performed on BALF samples.
  • Children were categorized into SP, MP, and HI groups based on the primary pathogen identified by mNGS.

Main Results:

  • Children with MP-associated SCAP exhibited significantly higher fever duration and elevated levels of C-reactive protein (CRP), procalcitonin (PCT), lactate dehydrogenase (LDH), D-dimer, and heparin-binding protein (HBP) compared to the HI group.
  • LDH levels were also significantly higher in the MP group compared to the SP group.
  • MP abundance correlated positively with fever duration and levels of PCT, LDH, and D-dimer, while α diversity was higher in the SP group than in the MP and HI groups.

Conclusions:

  • Mycoplasma pneumoniae-infected SCAP is associated with a more pronounced inflammatory response compared to SP and HI infections.
  • Pulmonary α diversity in SCAP is higher in SP and HI infections than in MP infections.
  • These findings highlight pathogen-specific differences in clinical presentation and pulmonary microbiota in pediatric SCAP.
Abstract

Keywords:
Haemophilus influenzaeMycoplasma pneumoniaeStreptococcus pneumoniaeMicrobiotaSevere community-acquired pneumonia

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