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

OBJECTIVES

Co-detection are frequent in pediatric Mycoplasma pneumoniae pneumonia (MPP), yet their full pathogen spectrum and clinical impact remain incompletely characterized. This study aimed to characterize co-detection etiology and clinical impacts of MPP in hospitalized children.

METHODS

A multicenter retrospective cohort study was conducted among hospitalized children under 14 years with MPP, diagnosed by metagenomic or targeted next-generation sequencing of bronchoalveolar lavage fluid, from June 2023 to July 2024. Multivariate logistic regression models were used to assess differences in clinical characteristics among various Mycoplasma pneumoniae (MP) co-detection patterns.

RESULTS

Among 570 MPP cases, co-detection occurred in 338 (59.3%) cases: viral-only (29.3%), bacterial-only (30.2%), and viral-bacterial (40.5%). The main bacteria were Streptococcus pneumoniae and Haemophilus influenzae, while human adenovirus and Epstein-Barr virus were the most common viruses. Co-detection rates inversely correlated with age, decreasing from 91.1% in infants to 48.1% in adolescents. Younger age (36-72 mo vs 72-168 mo, OR: 1.57), non-summer seasons (Spring, OR: 2.44; Autumn, OR: 1.93; Winter, OR: 2.77), and elevated white blood cell count (OR: 1.18) were associated with higher risk of co-detection, whereas higher fibrinogen and pleural effusion reduced risk (all P < 0.01).

CONCLUSIONS

The high prevalence of co-detection in pediatric MPP, notably viral-bacterial, exhibits distinct age and seasonal patterns essential for informing targeted control strategies. Study limitations include its retrospective design and potential heterogeneity from multicenter differences in NGS methodologies.