{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T18:11:03Z","timestamp":1779214263749,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T00:00:00Z","timestamp":1770508800000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["APMIS"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    We aimed to characterize the distribution of respiratory pathogens and antimicrobial resistance profiles in children with lower respiratory tract\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                    <\/jats:styled-content>\n                    pneumonia (MPP) and to identify clinical factors associated with multidrug\u2010resistant (MDR) infection. A retrospective analysis of 125 pediatric MPP patients was conducted. Microbiological identification and antimicrobial susceptibility testing were performed on bronchoalveolar lavage fluid isolates. Based on susceptibility results, patients were categorized into an MDR group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200925) and a non\u2010MDR group (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009100). Multivariate logistic regression identified independent predictors of MDR infection. Among Gram\u2010negative isolates,\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    <\/jats:styled-content>\n                    had the highest resistance to cefotaxime (40%),\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                    <\/jats:styled-content>\n                    to piperacillin (50%), and\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    <\/jats:styled-content>\n                    to aztreonam (54%). For Gram\u2010positive bacteria, resistance to penicillin was most pronounced in\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    <\/jats:styled-content>\n                    (76%) and\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                    <\/jats:styled-content>\n                    (83%).\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Staphylococcus epidermidis<\/jats:italic>\n                    <\/jats:styled-content>\n                    showed elevated resistance to clindamycin, levofloxacin, and penicillin (43% each). Multivariate analysis identified prolonged hospitalization (\u2265\u200914\u2009days), antibiotic exposure for \u2265\u20097\u2009days, and invasive respiratory procedures as independent risk factors for MDR infection (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). Co\u2010isolated bacterial pathogens from children with lower respiratory tract MPP show notable antimicrobial resistance. Routine pathogen testing and susceptibility profiling are crucial for guiding targeted therapy and curbing multidrug resistance.\n                  <\/jats:p>","DOI":"10.1111\/apm.70158","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T05:59:26Z","timestamp":1770616766000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pathogen Distribution and Antimicrobial Resistance Patterns in Pediatric Lower Respiratory Tract\n                    <i>Mycoplasma pneumoniae<\/i>\n                    Pneumonia"],"prefix":"10.1111","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9035-6811","authenticated-orcid":false,"given":"Boying","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Pediatrics The Affiliated People's Hospital of Ningbo University  Ningbo Zhejiang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6089-5419","authenticated-orcid":false,"given":"Zhe","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The Affiliated People's Hospital of Ningbo University  Ningbo Zhejiang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenbo","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The Affiliated People's Hospital of Ningbo University  Ningbo Zhejiang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiaoyi","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The Affiliated People's Hospital of Ningbo University  Ningbo Zhejiang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huali","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The Affiliated People's Hospital of Ningbo University  Ningbo Zhejiang China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,8]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijmr.IJMR_1582_16"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmii.2020.10.002"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2411919121"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2019.07.002"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idnow.2023.104782"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1095166"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.04476-22"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12519-024-00831-0"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2022.2028773"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00284-022-03103-0"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmmb.2023.100435"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2014.07.017"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-024-05519-1"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-017-2710-4"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200060050-00006"},{"key":"e_1_2_11_17_1","article-title":"Hospital Acquired Infections in a Private Paediatric Hospital in Kenya: A Retrospective Cross\u2010Sectional Study","volume":"41","author":"Patil R. K.","year":"2022","journal-title":"Pan African Medical Journal"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piaa056"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1089\/ped.2022.0198"},{"issue":"4","key":"e_1_2_11_20_1","article-title":"Prophylactic Anti\u2010Staphylococcal Antibiotics for Cystic Fibrosis","volume":"4","author":"Smyth A. 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