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A Mouse Model for the Transition of Streptococcus pneumoniae from Colonizer to Pathogen upon Viral Co-Infection Recapitulates Age-Exacerbated Illness
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Published on: September 28, 2022

Clinical characteristics, co-detection patterns and prognostic risk factors of human metapneumovirus infection in

Wen Li1, Chi Zhu2, Mengfei Yu1

  • 1Department of Pediatric Infectious Diseases, Hangzhou Children's Hospital, Hangzhou, China.

Frontiers in Cellular and Infection Microbiology
|July 22, 2026
PubMed

Insights

Human metapneumovirus (hMPV) infection in children is often co-detected with other viruses, particularly rhinovirus. Bacterial co-infections, especially Streptococcus pneumoniae, prolonged fever, and high procalcitonin levels increase severe pneumonia risk.

Area of Science:

  • Pediatric infectious diseases
  • Virology
  • Respiratory infections

Background:

  • Human metapneumovirus (hMPV) is a significant respiratory pathogen in children.
  • Understanding co-detection patterns and risk factors is crucial for managing hMPV infections.
  • Clinical characteristics and prognostic indicators for severe outcomes remain areas for investigation.

Purpose of the Study:

  • To investigate the clinical features of hMPV infection in children.
  • To analyze co-detection patterns, focusing on viral-viral and viral-bacterial co-infections.
  • To identify independent risk factors for severe pneumonia in pediatric hMPV cases.

Main Methods:

  • Retrospective analysis of 621 children with laboratory-confirmed hMPV infection.
  • Evaluation of clinical data, laboratory results, and co-pathogen detection.
  • Multivariate logistic regression to determine independent risk factors for severe pneumonia.

Main Results:

  • hMPV infection predominantly affects preschool-aged children (median age 3.5 years).
  • Viral-viral co-detection (68.9%) was more common than single detection (64.3%); rhinovirus was the most frequent co-pathogen (39.6%).
  • Viral-bacterial co-detection correlated with longer hospital stays (6.5 days) and higher severe pneumonia rates (14.5%).
  • Independent risk factors for severe pneumonia included *Streptococcus pneumoniae* co-detection (aOR=8.43), prolonged fever (aOR=1.19), and procalcitonin ≥0.5 ng/mL (aOR=4.27).
  • Older age (>3 years) demonstrated a protective effect against severe pneumonia (aOR=0.20-0.03).

Conclusions:

  • hMPV infection is common in preschool children, with frequent co-detections.
  • Viral-bacterial co-infection, particularly with *S. pneumoniae*, significantly worsens clinical outcomes.
  • Early identification of risk factors like prolonged fever and elevated procalcitonin aids in risk stratification for severe pneumonia.
  • Older children exhibit reduced risk, suggesting age-specific disease severity patterns.
Abstract

Keywords:
coinfection patternhuman metapneumovirusinflammatory indexpediatric infectionprognostic risk factor

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