Piao Meiying, Liu Na, Meng Fanyang, Liang Hang
Department of Respiratory, Children's Medical Center, The First Hospital of Jilin University, Changchun, China.
Department of Radiology, The First Hospital of Jilin University, Changchun, China.
Eur J Clin Microbiol Infect Dis. 2025 Jun 26. doi: 10.1007/s10096-025-05194-6.
Mycoplasma pneumoniae (MP) is a major pathogen that causes community-acquired pneumonia in children with a high rate of co-infection. Human adenovirus (HAdV) is a common co-infecting pathogen. This study aimed to analyze the clinical characteristics of children with lobar pneumonia caused by co-infection with MP and HAdV, and to investigate the correlation between the MP mutation sequence ratio (mutation depth/MP count) and HAdV sequence count with disease severity, thus providing evidence for clinical diagnosis and treatment.
Children with MP-infected lobar pneumonia hospitalized in the Department of Pediatric Respiratory Medicine at the First Hospital of Jilin University from September to November 2023 were enrolled in this study and divided into MP and MP + HAdV groups. Clinical manifestations, laboratory examinations, and treatments were compared between the two groups. Correlations of the MP mutation sequence ratio and HAdV sequence count with clinical manifestations, laboratory examinations, and treatments were analyzed.
A total of 154 children with MP lobar pneumonia were included, with 96 cases in the MP group and 58 cases in the MP + HAdV group. The results showed that the MP + HAdV group had a longer total disease duration, fever duration, intravenous anti-MP drug administration duration, and systemic corticosteroid application duration, with a higher proportion of intravenous immunoglobulin use. The MP group had higher CRP levels and a higher incidence of pulmonary necrosis. After 10 days of treatment, the MP group showed better improvement in the pneumonia volume than the MP + HAdV group. There were no significant differences between the two groups in the length of hospital stay, peak fever, wheezing and rash, oxygen therapy proportion, or second-line anti-MP drug usage. No significant differences were observed between the two groups in the WBC, ESR, LDH, D-dimer, albumin, ALT, ferritin levels, incidence of atelectasis, pleural effusion, or bronchoscopy findings.
Co-infection with HAdV can exacerbate the condition of children with MP lobar pneumonia and increase treatment difficulty. Higher MP mutation sequence ratios are associated with more severe airway mucosal damage, and higher HAdV viral loads correlate with more severe disease.
肺炎支原体（MP）是引起儿童社区获得性肺炎的主要病原体，合并感染率高。人腺病毒（HAdV）是常见的合并感染病原体。本研究旨在分析MP与HAdV合并感染所致大叶性肺炎患儿的临床特征，探讨MP突变序列比（突变深度/MP计数）和HAdV序列计数与疾病严重程度的相关性，为临床诊断和治疗提供依据。
选取2023年9月至11月在吉林大学第一医院小儿呼吸内科住院的MP感染大叶性肺炎患儿，分为MP组和MP+HAdV组。比较两组患儿的临床表现、实验室检查及治疗情况。分析MP突变序列比和HAdV序列计数与临床表现、实验室检查及治疗的相关性。
共纳入154例MP大叶性肺炎患儿，其中MP组96例，MP+HAdV组58例。结果显示，MP+HAdV组的总病程、发热持续时间、静脉应用抗MP药物持续时间及全身应用糖皮质激素持续时间更长，静脉应用免疫球蛋白的比例更高。MP组的CRP水平更高，肺坏死发生率更高。治疗10天后，MP组的肺炎体积改善情况优于MP+HAdV组。两组患儿的住院时间、发热峰值、喘息及皮疹、氧疗比例或二线抗MP药物使用情况无显著差异。两组患儿的白细胞、血沉、乳酸脱氢酶、D-二聚体、白蛋白、谷丙转氨酶、铁蛋白水平、肺不张发生率、胸腔积液发生率或支气管镜检查结果无显著差异。
HAdV合并感染可加重MP大叶性肺炎患儿的病情，增加治疗难度。较高的MP突变序列比与更严重的气道黏膜损伤相关，较高的HAdV病毒载量与更严重的疾病相关。
