Targeted next-generation sequencing reveals pathogen mono- and co-detection patterns in pediatric Mycoplasma pneumoniae pneumonia

IF 2.6 4区医学 Q3 INFECTIOUS DISEASES

Infection Genetics and Evolution Pub Date : 2025-09-18 DOI:10.1016/j.meegid.2025.105832

Genfeng Wu , Yuejie Zheng , Kangyan Yuan , Yanmin Bao , Li Li , Yuzheng Li , Wenjian Wang , Heping Wang

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引用次数: 0

Abstract

Background

Following pandemic control optimization, Mycoplasma pneumoniae (MP) has emerged as a predominant pediatric respiratory pathogen in Shenzhen. Understanding its epidemiological patterns and drug resistance is critical for managing severe MP-associated pneumonia.

Methods

This retrospective study analyzed 607 hospitalized children (February–November 2023) using targeted next-generation sequencing (tNGS) of bronchoalveolar lavage fluid. MP-positive cases were stratified by age, gender, clinical features, drug resistance genes, and co-detection profiles.

Results

Pathogens were identified in 605 cases (99.7 %), with MP constituting 85.0 % of detected pathogens. Among 209 cases with resistance genes, A2063G mutation predominated (98.1 %). Patients were categorized into: MP-positive (n = 444), MP-carriage (n = 72), and MP-negative (n = 91) groups. Age stratification revealed significantly older MP-positive patients (median 72 months, IQR 48–96) versus carriages (29.5 months, IQR 14–60) and negatives (36 months, IQR 16–60) (P < 0.001). Gender distribution showed no significant intergroup differences (χ² = 2.619, p = 0.270). The MP-positive group demonstrated lower co-detection rates of Haemophilus influenzae (12.2 % vs 37.5 %/31.5 %) and Moraxella catarrhalis (10.6 % vs 25.0 %/20.2 %) compared to carriages and negatives (P < 0.001). tNGS uncovered atypical pathogens including Tropheryma whipplei (13.3 %) and Fusobacterium nucleatum (6.3 %).

Conclusion

Post-pandemic MP resurgence correlates with increased severe pediatric pneumonia despite declining macrolide resistance rates (23.2 % in 2023 vs historical 80–90 %). MP primarily manifests as monoinfections, while M. catarrhalis and H. influenzae co-detection may confer observed co-detection pattern. These findings underscore tNGS's clinical utility in identifying atypical pathogens and guiding antimicrobial stewardship in pediatric pneumonia management.

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靶向下一代测序揭示了儿童肺炎支原体肺炎的病原体单一和共同检测模式。

背景：随着大流行控制的优化，肺炎支原体（MP）已成为深圳主要的儿科呼吸道病原体。了解其流行病学模式和耐药性对于管理严重的mp相关性肺炎至关重要。方法：采用支气管肺泡灌洗液靶向新一代测序（tNGS）对607例住院儿童（2023年2 - 11月）进行回顾性研究。mp阳性病例按年龄、性别、临床特征、耐药基因和共检概况进行分层。结果：检出病原菌605例（99.7 %），其中MP占检出病原菌的85.0% %。209例耐药基因中以A2063G突变为主（98.1% %）。患者分为：mp阳性组（n = 444）、mp携带组（n = 72）和mp阴性组（n = 91）。年龄分层显示，mp阳性患者（中位72 个月，IQR 48-96）与阴性患者（中位29.5 个月，IQR 14-60）和阴性患者（中位36 个月，IQR 16-60）相比（P 2 = 2.619,P = 0.270）具有显著性差异。MP-positive集团展示了co-detection利率下降的流感嗜血杆菌(12.2 vs 37.5  % % / 31.5 %)和莫拉克斯氏菌属复活(10.6 vs 25.0  % % / 20.2 %)相比,车厢和底片(P 结论:流行后议员复苏与增长尽管大环内酯物电阻率下降,严重的小儿肺炎(23.2 % 2023年和80 - 90年的历史 %)。MP主要表现为单感染，而卡塔卡分枝杆菌和流感嗜血杆菌共同检测可能会产生观察到的共同检测模式。这些发现强调了tNGS在鉴别非典型病原体和指导儿科肺炎抗菌药物管理方面的临床应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection Genetics and Evolution 医学-传染病学

CiteScore

8.40

自引率

0.00%

发文量

215

审稿时长

82 days

期刊介绍： (aka Journal of Molecular Epidemiology and Evolutionary Genetics of Infectious Diseases -- MEEGID) Infectious diseases constitute one of the main challenges to medical science in the coming century. The impressive development of molecular megatechnologies and of bioinformatics have greatly increased our knowledge of the evolution, transmission and pathogenicity of infectious diseases. Research has shown that host susceptibility to many infectious diseases has a genetic basis. Furthermore, much is now known on the molecular epidemiology, evolution and virulence of pathogenic agents, as well as their resistance to drugs, vaccines, and antibiotics. Equally, research on the genetics of disease vectors has greatly improved our understanding of their systematics, has increased our capacity to identify target populations for control or intervention, and has provided detailed information on the mechanisms of insecticide resistance. However, the genetics and evolutionary biology of hosts, pathogens and vectors have tended to develop as three separate fields of research. This artificial compartmentalisation is of concern due to our growing appreciation of the strong co-evolutionary interactions among hosts, pathogens and vectors. Infection, Genetics and Evolution and its companion congress [MEEGID](http://www.meegidconference.com/) (for Molecular Epidemiology and Evolutionary Genetics of Infectious Diseases) are the main forum acting for the cross-fertilization between evolutionary science and biomedical research on infectious diseases. Infection, Genetics and Evolution is the only journal that welcomes articles dealing with the genetics and evolutionary biology of hosts, pathogens and vectors, and coevolution processes among them in relation to infection and disease manifestation. All infectious models enter the scope of the journal, including pathogens of humans, animals and plants, either parasites, fungi, bacteria, viruses or prions. The journal welcomes articles dealing with genetics, population genetics, genomics, postgenomics, gene expression, evolutionary biology, population dynamics, mathematical modeling and bioinformatics. We also provide many author benefits, such as free PDFs, a liberal copyright policy, special discounts on Elsevier publications and much more. Please click here for more information on our author services .