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Updated: Jun 12, 2025
Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
Co-detection of respiratory pathogens in children with Mycoplasma pneumoniae pneumonia: a multicenter study
Xiaoyan Dong1, Rui Li1, Yingxue Zou2
1Department of Pulmonology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Objective:
To investigate the prevalence and clinical significance of respiratory pathogen co-detection in children diagnosed with Mycoplasma pneumoniae pneumonia (MPP).
Methods:
A prospective observational multicenter study was conducted, collecting clinical data from pediatric patients diagnosed with MPP in four hospitals across China from December 1 to December 31, 2023. Targeted next-generation sequencing (tNGS) results and clinical characteristics were analyzed. Participants were divided into mild and severe groups according to disease severity. Severe cases were further subdivided into an MP alone group and a multi-pathogen co-detection group. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive performance of inflammatory biomarkers for multi-pathogen co-detection.
Results:
A total of 266 children were enrolled. Severe cases had significantly higher C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH), D-dimer, interleukin-6 (IL-6), IL-10, and interferon-γ (IFN-γ) levels, as well as longer hospital stays (all P < 0.05). Multi-pathogen co-detection was found in 49.62% of MPP patients, and was more frequent in severe cases than in mild cases (54.05% vs. 39.51%, P < 0.05). The most common co-detected pathogens were rhinovirus, adenovirus, influenza A virus, Haemophilus influenzae, and Streptococcus pneumoniae. Among severe cases, the white blood cell (WBC) count and LDH, IL-6, and IL-10 levels were significantly higher in the multi-pathogen co-detection group compared to the MP alone group (P < 0.05).ROC analysis revealed that IL-6 and IL-10, especially in combination, effectively predicted multi-pathogen co-detection.
Conclusions:
Multi-pathogen co-infections substantially influence the severity of pediatric MPP. The findings highlight the diagnostic value of tNGS for identifying co-pathogens and underscore the predictive potential of inflammatory biomarkers (especially IL-6 and IL-10). The integration of tNGS and these biomarkers may facilitate early detection and targeted therapeutic interventions, thereby improving prevention and treatment outcomes in pediatric MPP.
Insights
Co-infections with other respiratory pathogens significantly worsen pediatric Mycoplasma pneumoniae pneumonia (MPP). Inflammatory markers like IL-6 and IL-10 can predict these co-infections, aiding early detection and treatment.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Molecular Diagnostics
Background:
- Mycoplasma pneumoniae pneumonia (MPP) is a common childhood respiratory infection.
- The role of co-pathogen detection in MPP severity and outcomes requires further investigation.
- Understanding co-infection patterns is crucial for effective pediatric respiratory illness management.
Purpose of the Study:
- To determine the prevalence of respiratory pathogen co-detection in children with MPP.
- To assess the clinical significance and impact of co-infections on MPP severity.
- To evaluate the predictive value of inflammatory biomarkers for co-pathogen detection in pediatric MPP.
Main Methods:
- A prospective, multicenter observational study involving 266 pediatric patients with MPP.
- Targeted next-generation sequencing (tNGS) was employed to identify co-pathogens.
- Clinical data, inflammatory markers (CRP, ESR, LDH, IL-6, IL-10, IFN-γ), and disease severity were analyzed.
Main Results:
- Nearly half (49.62%) of pediatric MPP cases had co-detected respiratory pathogens, more frequent in severe cases.
- Severe MPP cases exhibited elevated inflammatory markers (CRP, ESR, LDH, IL-6, IL-10, IFN-γ) and longer hospital stays.
- Interleukin-6 (IL-6) and Interleukin-10 (IL-10) levels, particularly combined, effectively predicted multi-pathogen co-detection in severe MPP.
Conclusions:
- Multi-pathogen co-infections significantly contribute to the severity of pediatric MPP.
- tNGS is valuable for identifying co-pathogens in MPP.
- IL-6 and IL-10 are promising biomarkers for predicting co-infections, enabling timely interventions.
