{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T08:58:15Z","timestamp":1765961895216,"version":"build-2065373602"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Guangxi Medical and Health Appropriate Technology Development and Promotion Application Project","award":["S2024082"],"award-info":[{"award-number":["S2024082"]}]},{"name":"Guangxi Health Commission self-financing projects","award":["Z-A20220257"],"award-info":[{"award-number":["Z-A20220257"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Klebsiella pneumoniae (KP) is a key pediatric respiratory pathogen, yet comprehensive studies on its clinical profiles and co-infections are limited. This study characterizes KP detection dynamics, clinical features, and outcomes in hospitalized children using targeted next-generation sequencing (tNGS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and Results<\/jats:title>\n                  <jats:p>A retrospective tNGS analysis of 5021 pediatric respiratory infection cases identified KP in 6.3% (314\/5021), predominantly infants aged\u00a0&amp;lt;1 year (58.0%) with male predominance (1.8:1). Co-infections occurred in 97.4% (306\/314), primarily KP\u2013viral\u2013bacterial combinations (63.7%) featuring Acinetobacter baumannii (47.5%), cytomegalovirus (33.8%), and rhinovirus (28.0%). Multivariate analysis identified seven independent intensive care unit (ICU) predictors: younger age [odds ratio (OR): 0.971], reduced lymphocyte percentage (OR: 0.894), elevated lactate dehydrogenase (OR: 1.006), prolonged fever duration (OR: 1.248), bronchial wall thickening (OR: 3.717), respiratory complications (OR: 20.112), and multi-system complications (OR: 2.868). Respiratory complications affected 37.6% (118\/314), with 37.9% (119\/314) having multi-organ involvement. Despite 43.3% requiring respiratory support (including 11.5% invasive ventilation), 92.0% achieved full recovery with zero mortality. Median hospitalization was 7 days (interquartile range:<\/jats:p>\n                  <jats:p>6\u201311).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>KP causes significant polymicrobial respiratory infections in infants, with tNGS effectively revealing complex co-infection patterns. Early identification of pathogens and these ICU predictors may optimize ICU triage and treatment strategies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jambio\/lxaf223","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:02:47Z","timestamp":1760101367000},"source":"Crossref","is-referenced-by-count":1,"title":["<i>Klebsiella pneumoniae<\/i> in pediatric respiratory infections: a targeted next-generation sequencing study on co-infection patterns, clinical profiles, and outcomes"],"prefix":"10.1093","volume":"136","author":[{"given":"Chunyun","family":"Fu","sequence":"first","affiliation":[{"name":"Medical Science Laboratory, Children's Hospital, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region , Nanning 530003 ,","place":["People's Republic of China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning","family":"Zhu","sequence":"additional","affiliation":[{"name":"Medical Science Laboratory, 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