tNGS in pediatric LRTIs shows higher Mycoplasma pneumoniae detection in severe vs non-severe CAP
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Key Takeaway
Consider tNGS findings in pediatric LRTIs as associative, not causal, due to retrospective design.
This retrospective, single-center cohort study analyzed 2,299 children with suspected lower respiratory tract infections, including 1,845 community-acquired pneumonia (CAP) patients (293 with severe CAP [SCAP] and 1,552 with non-severe CAP [nsCAP]). The intervention involved targeted next-generation sequencing (tNGS) of throat swab samples to assess pathogen profiles and associations with disease severity, with no comparator reported. Main results showed a higher detection rate of Mycoplasma pneumoniae in SCAP (35.8%) compared to nsCAP (8.9%), with a P value reported but the exact value cut off in the text; other outcomes included microbial diversity indices and relative abundance of species, but absolute numbers and effect sizes were not reported. Safety and tolerability data were not reported, and key limitations include the inherent limitations of traditional diagnostic methods in comprehensively assessing the etiological spectrum and microecological characteristics of pediatric LRTIs, along with the retrospective, single-center design. In practice, these findings highlight potential associations but do not establish causality, suggesting tNGS may offer insights into pathogen profiles in pediatric LRTIs, though clinical relevance remains uncertain without follow-up or safety data.
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View Original Abstract ↓
BackgroundTraditional diagnostic methods have inherent limitations in the comprehensive assessment of the etiological spectrum and microecological characteristics of pediatric lower respiratory tract infections (LRTIs), particularly community-acquired pneumonia (CAP). Against this backdrop, the present study seeks to delineate the pathogen profile of children with LRTIs via targeted next-generation sequencing (tNGS), and further explore the associations between clinical manifestations, upper respiratory microbiome signatures and disease severity in pediatric CAP cases.MethodsA retrospective, single-center study was conducted on 2299 children with suspected lower respiratory tract infections. Throat swab samples from all patients underwent tNGS for pathogen detection. For 1845 CAP patients (293 SCAP, 1552 non-severe CAP [nsCAP]), clinical data and tNGS results were analyzed. Statistical comparisons, correlation analyses, and multivariate logistic regression were performed to identify factors associated with SCAP. Microbial diversity (Shannon/Simpson indices) and relative abundance of detected species were also analyzed.ResultsMycoplasma pneumoniae was the dominant atypical pathogen, with an outbreak peaking in July 2024. M. pneumoniae detection rate (35.8% vs. 8.9%, P
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