利用靶向二代测序技术检测患有急性下呼吸道感染的住院儿科患者中的肺炎支原体。

Detection of Mycoplasma pneumoniae in hospitalized pediatric patients presenting with acute lower respiratory tract infections utilizing targeted next-generation sequencing.

作者信息

Fu Chunyun, Mo Lishai, Feng Yanhua, Zhu Ning, Huang Huiping, Huang Ziyin, Lu Cuihong, Wei Yubing, Zhao Jiangyang, Lu Xiangjun, Chen Ruting, Yao RenYe, Wu Li, Liu Guangbing, Li Mengjun, Ruan Jialing, Chen Jielin, Jiang Silin, Huang Ya, Li Qifei, Tan Jie

机构信息

Medical Science Laboratory, Children's Hospital, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, People's Republic of China.

Department of Pediatric Respiratory Medicine, Children's Hospital, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, People's Republic of China.

出版信息

Infection. 2025 Jan 31. doi: 10.1007/s15010-024-02467-8.

DOI:10.1007/s15010-024-02467-8

PMID:39888587

Abstract

BACKGROUND

Mycoplasma pneumoniae is a prevalent pathogen in pediatric community-acquired pneumonia. Currently, limited literature exists on the clinical utilization of pathogen-targeted sequencing technologies.

METHODS

Targeted next-generation sequencing (tNGS) technology was employed to analyze bronchoalveolar lavage fluid (BALF) from 1,070 hospitalized pediatric patients with acute lower respiratory tract infections. Subsequently, the clinical data of children diagnosed with Mycoplasma pneumoniae pneumonia were systematically evaluated.

RESULTS

tNGS identified pathogenic infections in 1,064 (99.4%) of these patients, with M. pneumoniae infections representing 56.9% of the cases. Of these with M. pneumoniae cases, 169 patients (27.75%, 169/609) had infections solely due to with M. pneumoniae, while 440 patients (72.25%, 440/609) presented with co-infections involving M. pneumoniae and additional microorganisms. Among the co-infections, Rhinovirus was the most frequent co-infecting pathogen (120/609), followed by Streptococcus pneumoniae (91/609), human respiratory syncytial virus (78/609) and human parainfluenza virus (74/609). Among the 609 children identified M. pneumoniae infection, 274 were found to harbor macrolide-resistant M. pneumoniae (MRMP), yielding a resistance rate of 45.0% (274/609). In children with M. pneumoniae infection, pleural effusion and respiratory failure emerged as the most prevalent respiratory complications, while hepatic impairment and myocardial impairment were the predominant complications of other systems. The median duration of hospitalization for the children diagnosed with M. pneumoniae infection was 7 days. Out of 609 children with M. pneumoniae infection, 10 cases required intensive care unit (ICU) admission, accounting for 1.64% of the total.

CONCLUSION

tNGS technology exhibits substantial clinical utility in identifying pathogens associated with respiratory tract infections. This study delineates the clinical manifestations and co-infection patterns of M. pneumoniae in Guangxi, China.

摘要

背景

肺炎支原体是儿童社区获得性肺炎中一种常见的病原体。目前，关于病原体靶向测序技术临床应用的文献有限。

方法

采用靶向新一代测序（tNGS）技术分析1070例住院的急性下呼吸道感染儿科患者的支气管肺泡灌洗液（BALF）。随后，对诊断为肺炎支原体肺炎的儿童的临床资料进行系统评估。

结果

tNGS在1064例（99.4%）患者中检测到病原性感染，其中肺炎支原体感染占病例的56.9%。在这些肺炎支原体病例中，169例患者（27.75%，169/609）仅因肺炎支原体感染，而440例患者（72.25%，440/609）表现为肺炎支原体与其他微生物的合并感染。在合并感染中，鼻病毒是最常见的合并感染病原体（120/609），其次是肺炎链球菌（91/609）、人呼吸道合胞病毒（78/609）和人副流感病毒（74/609）。在609例确诊为肺炎支原体感染的儿童中，发现274例携带大环内酯耐药肺炎支原体（MRMP），耐药率为45.0%（274/609）。在肺炎支原体感染的儿童中，胸腔积液和呼吸衰竭是最常见的呼吸道并发症，而肝功能损害和心肌损害是其他系统的主要并发症。诊断为肺炎支原体感染的儿童的中位住院时间为7天。在609例肺炎支原体感染的儿童中，有10例需要入住重症监护病房（ICU），占总数的1.64%。