Xiao Yujia, Wang Xia, Feng Shuwen, Yang Yiyu, Zheng Junwen, Zhao Dongchi
Department of Pediatrics, Women and Children's Hospital, Zhongnan Hospital, Wuhan University, 169 Donghu Roa, Wuhan, China.
Children's Digital Health and Data Center, Wuhan University, Wuhan, China.
Eur J Clin Microbiol Infect Dis. 2025 Jun;44(6):1313-1324. doi: 10.1007/s10096-025-05094-9. Epub 2025 Mar 14.
To characterize the epidemiology of pathogens in children with lower respiratory tract infections (LRTI) using targeted next-generation sequencing (tNGS), assess the correlation between reads per ten million (RPTM) of co-detected pathogens, identify common co-detection patterns, and explore their clinical significance.
Children aged 29 days to 14 years hospitalized for LRTI at the Department of Pediatrics, Zhongnan Hospital of Wuhan University, from April 2023 to August 2024 were included. Bronchoalveolar lavage fluid (BALF) or nasopharyngeal swab (NS) samples were tested for pathogens using tNGS, and clinical data were collected. The data and RPTM were statistically analyzed based on lung X-ray and CT scan results, classifying cases as pneumonia or lung consolidation/pulmonary atelectasis (LC/PA).
Among 1118 children, the highest pathogen detection rate was Mycoplasma pneumoniae (MP) at 60.20%, followed by Haemophilus influenzae (HI) at 42.40% and Streptococcus pneumoniae (SP) at 35.42%. In children under 4 years old, common pathogens were HI, Rhinovirus (RhV), and Respiratory syncytial virus (RSV). For those over 4 years old, MP and HI were predominant. In common pneumonia cases, MP, HI, and RhV were frequent, with MP being the primary pathogen in LC/PA. 80.70% of respiratory samples detected two or more pathogens, and viruses were more frequently detected in NS than in BALF. Correlation analysis showed that MP RPTM was negatively correlated with other co-detected pathogens' RPTM, SP was negatively correlated with RSV but positively correlated with Influenza virus (flu virus), HI was positively correlated with Adenovirus (ADV) and flu virus, RhV was negatively correlated with flu virus. Clinical characteristics of co-detected pathogens showed no significant differences in acute LRTI symptoms among different combinations.
Co-detection of pathogens in children's LRTI using tNGS was common, with MP and bacterial infections being predominant. There were synergistic and competitive relationships between the RPTM of co-detected pathogens.
采用靶向二代测序（tNGS）对下呼吸道感染（LRTI）儿童的病原体流行病学特征进行分析，评估共检测病原体的每千万读数（RPTM）之间的相关性，确定常见的共检测模式，并探讨其临床意义。
纳入2023年4月至2024年8月在武汉大学中南医院儿科因LRTI住院的29天至14岁儿童。采用tNGS检测支气管肺泡灌洗液（BALF）或鼻咽拭子（NS）样本中的病原体，并收集临床数据。根据肺部X线和CT扫描结果对数据和RPTM进行统计分析，将病例分为肺炎或肺实变/肺不张（LC/PA）。
1118例儿童中，病原体检出率最高的是肺炎支原体（MP），为60.20%，其次是流感嗜血杆菌（HI），为42.40%，肺炎链球菌（SP）为35.42%。4岁以下儿童常见病原体为HI、鼻病毒（RhV）和呼吸道合胞病毒（RSV）。4岁以上儿童以MP和HI为主。在常见肺炎病例中，MP、HI和RhV较为常见，MP是LC/PA的主要病原体。80.70%的呼吸道样本检测到两种或更多种病原体，NS中病毒的检出频率高于BALF。相关性分析显示，MP的RPTM与其他共检测病原体的RPTM呈负相关，SP与RSV呈负相关，但与流感病毒呈正相关，HI与腺病毒（ADV）和流感病毒呈正相关，RhV与流感病毒呈负相关。共检测病原体的临床特征显示，不同组合的急性LRTI症状无显著差异。
使用tNGS对儿童LRTI进行病原体共检测很常见，以MP和细菌感染为主。共检测病原体的RPTM之间存在协同和竞争关系。
