Department of Pediatric Respiratory Medicine, Children's Hospital, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning 530003, PR China.
Medical Science Laboratory, Children's Hospital, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning 530003, PR China.
Clin Chim Acta. 2025 Jan 15;565:119985. doi: 10.1016/j.cca.2024.119985. Epub 2024 Oct 1.
Severe pneumonia in children represents a significant clinical challenge due to its high incidence and associated mortality. This study aimed to assess the distribution of pathogens and patterns of infection in pediatric patients with severe pneumonia.
This study included 110 pediatric patients diagnosed with severe pneumonia, who were admitted to Guangxi Maternal and Child Health Hospital between July 2021 and November 2023. Pathogen-targeted next-generation sequencing (tNGS) was employed to identify respiratory pathogens in these cases.
Pathogens were detected in 109 out of 110 cases, yielding a positive detection rate of 99.09%. Among these cases, 25 (22.72%) involved single-pathogen infections, while 84 (76.36%) were characterized by mixed infections. The infection pattern in children with severe pneumonia was relatively common with bacterial-viral coinfection (28.2%, 31/110). A total of 39 pathogens were identified from the 110 children with severe pneumonia, with the top three pathogens being Mycoplasma pneumoniae (30.91%, 34/110), Human Respiratory Syncytial Virus Type A (26.36%, 29/110), and Human Herpesvirus (18.18%, 20/110). Notably, 38.2% (13/34) of the cases were found to have macrolide-resistant Mycoplasma pneumoniae (MRMP). Additionally, 40% (44/110) of the children required admission to the intensive care unit (ICU).
The application of tNGS demonstrates significant utility in the detection of pathogens in pediatric patients with severe pneumonia. The predominant pathogens identified in this study are Mycoplasma pneumoniae, Human Respiratory Syncytial Virus, and Human Herpesvirus. Furthermore, mixed infections involving multiple pathogens were observed in 76.36% of the cases, and a substantial proportion (40%) of these patients necessitated intensive care.
儿童重症肺炎发病率高，致死率高，临床诊治极具挑战。本研究旨在评估儿童重症肺炎患者的病原体分布及感染模式。
本研究纳入 2021 年 7 月至 2023 年 11 月在广西壮族自治区妇幼保健院就诊的 110 例重症肺炎患儿，采用靶向二代测序（tNGS）技术检测呼吸道病原体。
110 例患儿中 109 例（99.09%）检出病原体，25 例（22.72%）为单一病原体感染，84 例（76.36%）为混合感染，以细菌-病毒混合感染多见（28.2%，31/110）。110 例重症肺炎患儿共检出 39 种病原体，前三位病原体分别为肺炎支原体（30.91%，34/110）、甲型人呼吸道合胞病毒（26.36%，29/110）、人类疱疹病毒（18.18%，20/110），其中耐大环内酯类肺炎支原体（MRMP）检出率为 38.2%（13/34）。40%（44/110）患儿需入住重症监护病房（ICU）。
tNGS 技术可用于检测儿童重症肺炎的病原体，本研究的主要病原体为肺炎支原体、甲型人呼吸道合胞病毒、人类疱疹病毒，混合感染占比 76.36%，40%的患儿需入住 ICU。
