{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T16:53:25Z","timestamp":1793033605166,"version":"4.5.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":41,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Pediatr"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Although\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      pneumonia (MPP) is a leading cause of pediatric community-acquired pneumonia, the specific clinical impact of respiratory pathogen co-detection remains incompletely understood.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this retrospective cohort study, we analyzed data from 3081 children hospitalized with confirmed MPP at a single center in China (January 2023\u2013December 2024). Based on comprehensive respiratory pathogen testing, patients were classified into MPP mono-infection (\n                      <jats:italic>n<\/jats:italic>\n                      = 1173) or MPP co-detection (\n                      <jats:italic>n<\/jats:italic>\n                      = 1908) groups. Severe MPP (SMPP) was defined as a composite outcome per national guidelines. The primary outcome was the incidence of SMPP; secondary outcomes included specific complications, healthcare utilization, and costs. Stratified analysis by co-detection pattern (single virus, single bacterium, viral\u2013bacterial, and multiple viruses) was performed. Multivariable logistic regression was used to assess the independent association of co-detection with SMPP, adjusting for sex, age, platelet count, C-reactive protein (CRP) level, and D-dimer level.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The co-detection rate was 61.9% (1908\/3081). Among co-detected cases, single-viral detection was most common (41.8%), followed by viral\u2013bacterial detection (19.1%). Adenovirus (33.5%) and rhinovirus (32.1%) were the predominant single viruses. The co-detection group exhibited a significantly higher incidence of SMPP (51.8% vs. 47.3%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.018), higher total hospitalization costs, longer hospital stays, and longer durations of cough and fever (all\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). Stratified analysis revealed that the viral\u2013bacterial co-detection subtype consistently exhibited the most severe outcomes. After adjusting for sex, age, platelet count, CRP level, and D-dimer level, pathogen co-detection was an independent risk factor for SMPP [adjusted odds ratio (OR) = 1.31; 95% confidence interval = 1.11\u20131.56;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.002]. Elevated D-dimer levels (adjusted OR = 3.66) and older age were also significant independent predictors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Respiratory pathogen co-detection is prevalent in children with MPP and is independently associated with disease progression to SMPP (as defined by guideline criteria), prolonged hospitalization, and increased healthcare costs. The viral\u2013bacterial co-detection pattern is associated with the greatest risk. These findings underscore the importance of comprehensive pathogen screening in the management of pediatric MPP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12519-026-01053-2","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T15:15:40Z","timestamp":1781190940000},"page":"536-545","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of pathogen co-detection on disease severity and clinical outcomes in children with Mycoplasma pneumoniae pneumonia"],"prefix":"10.1007","volume":"22","author":[{"given":"Feng","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Wen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Yu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Bo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan-Yuan","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Bo","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"1053_CR1","doi-asserted-by":"publisher","first-page":"394","DOI":"10.15585\/mmwr.mm7423a1","volume":"74","author":"MH Diaz","year":"2025","unstructured":"Diaz MH, Hersh AL, Olson J, Shah SS, Hall M, Edens C. 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The authors have no conflict of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval was obtained from the Research Ethics Board of Children\u2019s Hospital of Fudan University (approval number: [2022] 307A), with informed consent waived due to the retrospective nature of the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}