Pathogen Profile of Pediatric Community-Acquired Pneumonia in Wuhan, 2023: A BALF-Based Study

To analyze the distribution characteristics of pathogens in the bronchoalveolar lavage fluid of children with community-acquired pneumonia.

We retrospectively analyzed the etiological data of 1526 children diagnosed and treated at the Maternal and Child Health Hospital of Hubei Province from January 1, 2023, to December 31, 2023.

Pathogens were detected in 1524 of the 1526 children (99.9%). The five most frequently identified pathogens were Mycoplasma pneumoniae, rhinovirus, Epstein‒Barr virus, Streptococcus pneumoniae, and human bocavirus. The overall mixed infection rate was 62%. Epstein‒Barr virus, rhinovirus, Streptococcus pneumoniae, human bocavirus, and Haemophilus influenzae were the most common co-infections of Mycoplasma pneumoniae. Staphylococcus aureus and Pneumocystis jirovecii infections were more common in males than in females. Human bocavirus, parainfluenza virus, respiratory syncytial virus, Cytomegalovirus, Pneumocystis jirovecii, and WU polyomavirus were more prevalent in infants and young children, and Epstein‒Barr virus was more common in preschool-aged and school-aged children. More than half (51.6%) of the Mycoplasma pneumoniae infections occurred in autumn. Mycobacterium tuberculosis complex, human parainfluenza virus, and Cytomegalovirus were more common in spring and summer, and influenza B virus and adenovirus were more common in autumn and winter. Respiratory syncytial virus, influenza A virus, and Fusobacterium nucleatum were more common in winter and spring. Enteroviruses were more prevalent in summer and autumn.

The positive rate of pathogen detection in bronchoalveolar lavage fluid was extremely high. Most patients presented with mixed infections, and the distribution of some pathogens varied by sex, age, and season.