{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T15:10:10Z","timestamp":1779289810880,"version":"3.51.4"},"reference-count":33,"publisher":"Microbiology Society","issue":"5","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Zhengzhou Science and Technology Innovation Guidance Project","award":["2024YLZDJH358"],"award-info":[{"award-number":["2024YLZDJH358"]}]},{"name":"Top Level Public Health Technical Personnel Training Plan","award":["LJRC-03-09"],"award-info":[{"award-number":["LJRC-03-09"]}]},{"name":"Henan Provincial Medical Science and Technology Research Program","award":["SBGJ202402101"],"award-info":[{"award-number":["SBGJ202402101"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,20]]},"abstract":"<jats:p>\n                    <jats:bold>Background.<\/jats:bold>\n                    <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                    (\n                    <jats:italic>MP<\/jats:italic>\n                    ) is a common causative pathogen of community-acquired pneumonia in children, with clinical presentations ranging in severity. Early stratification and timely intervention are essential for improving patient outcomes. However, a major clinical challenge lies in the limited ability to accurately distinguish between mild and severe cases based solely on early clinical indicators.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods.<\/jats:bold>\n                    This prospective real-world study investigated the differences in microbiome and metabolomics between mild and severe\n                    <jats:italic>MP<\/jats:italic>\n                    pneumonia (MPP) in children. Bronchoalveolar lavage fluid samples were collected from 153 children and subjected to metagenomic sequencing and non-targeted metabolomic analysis. Meanwhile, to enhance early diagnostic accuracy, this study developed a machine learning classification model and validated it using a third-party validation set.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results.<\/jats:bold>\n                    The results revealed significant alterations in the abundance of specific bacterial communities in the severe group, most notably the coexistence of\n                    <jats:italic>MP<\/jats:italic>\n                    and\n                    <jats:italic>Alphainfluenzavirus influenzae<\/jats:italic>\n                    , which may contribute to disease exacerbation through synergistic pathogenic mechanisms. Furthermore, the macrolide resistant rate of\n                    <jats:italic>MP<\/jats:italic>\n                    in the severe group exceeded 80%, emphasizing the importance of appropriate antibiotic selection. Metabolomic analysis showed a significant enrichment of metabolites related to cellular energy metabolism and immune regulation in severe cases. The model demonstrated exceptional predictive performance, achieving an area under the curve ranging from 0.909 to 0.991, which significantly outperformed conventional clinical stratification methods.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions.<\/jats:bold>\n                    These findings elucidate the distinct pathophysiological mechanisms underlying both mild and severe MP infections and provide a promising framework for improving early diagnosis and personalized treatment strategies in paediatric MPP.\n                  <\/jats:p>","DOI":"10.1099\/mgen.0.001717","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T14:15:37Z","timestamp":1779286537000},"source":"Crossref","is-referenced-by-count":0,"title":["Unveiling metagenomic and metabolomic signatures in mild and severe pneumonia caused by Mycoplasma pneumoniae in children"],"prefix":"10.1099","volume":"12","author":[{"given":"Yeran","family":"Yang","sequence":"first","affiliation":[{"name":"Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children\u2019s Hospital, Capital Medical University, National Center for Children\u2019s Health (NCCH), Beijing, 100045, PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shitao","family":"Lian","sequence":"additional","affiliation":[{"name":"School of Engineering Medicine, Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Interdisciplinary Innovation Institute of Medicine and Engineering, Beihang University, Beijing, PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao","family":"Li","sequence":"additional","affiliation":[{"name":"Respiratory Department, Children\u2019s Hospital Affiliated to Zhengzhou University, Henan Children\u2019s Hospital, Zhengzhou Children\u2019s Hospital, Zhengzhou, 450018, PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Tang","sequence":"additional","affiliation":[{"name":"Respiratory Department, Children\u2019s Hospital Affiliated to Zhengzhou University, Henan Children\u2019s Hospital, Zhengzhou Children\u2019s Hospital, Zhengzhou, 450018, PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanyan","family":"Su","sequence":"additional","affiliation":[{"name":"Respiratory Department, Children\u2019s Hospital Affiliated to Zhengzhou University, Henan Children\u2019s Hospital, Zhengzhou Children\u2019s Hospital, Zhengzhou, 450018, PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeming","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Engineering Medicine, Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Interdisciplinary Innovation 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