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Etiology and clinical characteristics of pathogen co-detection in pediatric Mycoplasma pneumoniae pneumonia: A

Xufeng Li1, Li Pan1, Zhongke Li1

  • 1Department of Children's Medical Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|November 16, 2025
PubMed
Abstract

Insights

Co-infections are common in pediatric Mycoplasma pneumoniae pneumonia (MPP), with viral-bacterial co-detections being most frequent. These patterns vary by age and season, impacting treatment strategies for children with MPP.

Area of Science:

  • Pediatric Infectious Diseases
  • Respiratory Medicine
  • Microbiology

Background:

  • Co-detection of pathogens is frequent in pediatric Mycoplasma pneumoniae pneumonia (MPP).
  • The full spectrum of co-pathogens and their clinical impact in MPP are not fully understood.
  • Characterizing co-detection patterns is crucial for effective management of pediatric MPP.

Purpose of the Study:

  • To determine the etiology of co-detections in hospitalized children with MPP.
  • To investigate the clinical impact of different co-detection patterns in pediatric MPP.
  • To identify factors associated with co-detection in pediatric MPP.

Main Methods:

  • A multicenter retrospective cohort study of hospitalized children (<14 years) with MPP.
  • Diagnosis of MPP using metagenomic or targeted next-generation sequencing (NGS) of bronchoalveolar lavage fluid.
  • Multivariate logistic regression analysis to assess clinical characteristics and co-detection patterns.

Main Results:

  • Co-detection occurred in 59.3% of 570 MPP cases, with viral-bacterial co-detections being most common (40.5%).
  • Key co-pathogens included Streptococcus pneumoniae, Haemophilus influenzae, human adenovirus, and Epstein-Barr virus.
  • Co-detection rates decreased with age and were associated with younger age, non-summer seasons, and elevated white blood cell count.

Conclusions:

  • High prevalence of co-detection, particularly viral-bacterial, in pediatric MPP.
  • Distinct age and seasonal patterns of co-detection necessitate targeted control strategies.
  • Retrospective design and potential NGS heterogeneity are study limitations.
Keywords:
Bronchoalveolar lavage fluidCo-detectionMycoplasma pneumoniae pneumoniaNext-generation sequencingPediatric

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