{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:40:44Z","timestamp":1792597244803,"version":"4.5.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To analyze the clinical differences between pertussis and\/or\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      (MP) infections in children and provide insights for clinical differential diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed children with respiratory symptoms who attended Shandong University Children\u2019s Hospital (Jinan, China) from 2019 to 2024 and underwent simultaneous testing for pertussis and MP. Patients were categorized as pertussis-only, MP-only, or dual-positive, and differences in demographics, seasonality, manifestations, hematologic indices, and co-detected pathogens were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 7184 children were included: 2,982 pertussis-only, 3,166 MP-only, and 1,036 dual-positive. Significant differences were observed in sex (\u03c7\u00b2 = 30.964), age (\u03c7\u00b2 = 393.010), and season (\u03c7\u00b2 = 436.070) (all\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). Pertussis-only cases were more common in boys, during spring and winter, and in patients aged 6 years to &amp;lt;12 years. MP-only cases clustered in ages 2 to &amp;lt;6 and 6 to &amp;lt;12 years, with peaks in summer and autumn. Dual-positive cases were slightly more frequent in girls, clustered in the 6 to &amp;lt;12-year-old group, and occurred more often in spring and summer. Fever (\u03c7\u00b2 = 442.36,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) was more frequent in the MP-only and dual-positive groups, whereas gastrointestinal symptoms (\u03c7\u00b2 = 30.00,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), cyanosis (\u03c7\u00b2 = 12.91,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002), spasmodic cough (\u03c7\u00b2 = 212.07,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), and cockcrow-like echo (\u03c7\u00b2 = 77.38,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) were more common in the pertussis-only group. Lung crackles (\u03c7\u00b2 = 52.44,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) and multilobar involvement (\u03c7\u00b2 = 28.08,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) were predominantly observed in the MP-only group. The duration of cough before diagnosis was shorter in the MP-only group than in both the pertussis-only and dual-positive groups (H = 371.49,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). Lymphocyte counts (H = 178.03) were the highest in the pertussis-only group, and neutrophil counts (H = 119.45) and C-reactive protein (H = 369.80) were the highest in the MP-only group (all p&amp;lt;0.001). Among the 7184 children, 1,224 (15.65%) had codetection of other pathogens, with human rhinovirus,\n                      <jats:italic>Haemophilus influenzae<\/jats:italic>\n                      , and\n                      <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                      most common. The MP-only group was more often accompanied with influenza A\/B (\u03c7\u00b2 = 16.688,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) and\n                      <jats:italic>Legionella pneumophila<\/jats:italic>\n                      (\u03c7\u00b2 = 12.715,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002); pertussis-only,\n                      <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                      (\u03c7\u00b2 = 11.872,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003); dual-positive,\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      (\u03c7\u00b2 = 7.284,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pertussis and MP infections in children show distinct demographic, seasonal, clinical, and laboratory patterns. Recognition of these epidemiologic and clinical signatures supports early differentiation at the bedside and the use of multiplex PCR combined with specific laboratory markers to enable more targeted clinical management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1711371","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T06:52:19Z","timestamp":1772175139000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical characteristics analysis of pertussis and Mycoplasma pneumoniae infection in children"],"prefix":"10.3389","volume":"16","author":[{"given":"Min","family":"Xue","sequence":"first","affiliation":[{"name":"Jinan Institute of Pediatric Research, Children\u2019s Hospital Affiliated to Shandong University (Ji\u2019nan Children\u2019s Hospital)","place":["Jinan, Shandong, China"]},{"name":"Jinan Key Lab of Respiratory Diseases for Children, Jinan Children\u2019s Hospital","place":["Jinan, Shandong, China"]},{"name":"Shandong Provincial Clinical Research Center for Children\u2019s Health and Disease, Jinan Children\u2019s Hospital","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoling","family":"Wei","sequence":"additional","affiliation":[{"name":"Jinan Key Lab of Respiratory Diseases for Children, Jinan Children\u2019s Hospital","place":["Jinan, Shandong, China"]},{"name":"Shandong Provincial Clinical Research Center for Children\u2019s Health and Disease, Jinan Children\u2019s Hospital","place":["Jinan, Shandong, China"]},{"name":"Department of Health Data Application and Management, Children\u2019s Hospital Affiliated to Shandong University(Ji\u2019nan Children\u2019s Hospital)","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Wang","sequence":"additional","affiliation":[{"name":"Jinan Key Lab of Respiratory Diseases for Children, Jinan Children\u2019s Hospital","place":["Jinan, Shandong, China"]},{"name":"Shandong Provincial Clinical Research Center for Children\u2019s Health and Disease, Jinan Children\u2019s Hospital","place":["Jinan, Shandong, China"]},{"name":"Department of Respiratory Medicine, Children\u2019s Hospital Affiliated to Shandong University (Ji\u2019nan Children\u2019s Hospital)","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Liu","sequence":"additional","affiliation":[{"name":"Jinan Key Lab of Respiratory Diseases for Children, Jinan Children\u2019s Hospital","place":["Jinan, Shandong, China"]},{"name":"Shandong Provincial Clinical Research Center for Children\u2019s Health and Disease, Jinan Children\u2019s Hospital","place":["Jinan, Shandong, China"]},{"name":"Department of Respiratory Medicine, Children\u2019s Hospital Affiliated to Shandong University (Ji\u2019nan Children\u2019s Hospital)","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Jinan Key Lab of Respiratory Diseases for Children, Jinan Children\u2019s Hospital","place":["Jinan, Shandong, China"]},{"name":"Shandong Provincial Clinical Research Center for Children\u2019s Health and Disease, Jinan Children\u2019s Hospital","place":["Jinan, Shandong, China"]},{"name":"Department of Respiratory Medicine, Children\u2019s Hospital Affiliated to Shandong University (Ji\u2019nan Children\u2019s Hospital)","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Ma","sequence":"additional","affiliation":[{"name":"Jinan Key Lab of Respiratory Diseases for Children, Jinan Children\u2019s Hospital","place":["Jinan, Shandong, China"]},{"name":"Shandong Provincial Clinical Research Center for Children\u2019s Health and Disease, Jinan Children\u2019s Hospital","place":["Jinan, Shandong, China"]},{"name":"Department of Respiratory Medicine, Children\u2019s Hospital Affiliated to Shandong University (Ji\u2019nan Children\u2019s Hospital)","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"5139","DOI":"10.1128\/iai.00895-08","article-title":"Pertussis Toxin Inhibits Early Chemokine Production To Delay Neutrophil Recruitment in Response toBordetella pertussisRespiratory Tract Infection in Mice","volume":"76","author":"Andreasen","year":"2008","journal-title":"Infection Immunity."},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1332078","article-title":"Reduction of acute respiratory infections in day-care by non-pharmaceutical interventions: a narrative review","volume":"12","author":"Andrup","year":"2024","journal-title":"Front. 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