{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T23:03:18Z","timestamp":1793228598233,"version":"4.5.0"},"reference-count":61,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"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                      Refractory\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      pneumonia (RMPP) presents a major clinical challenge in children, largely due to the absence of reliable early diagnostic markers, which contributes to delayed intervention and an increased risk of severe complications. This study aimed to identify early diagnostic biomarkers based on peripheral blood mononuclear cell (PBMC) gene expression profiles and to develop and validate a model capable of distinguishing RMPP from general MPP (GMPP) and healthy controls (Normal).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 349 children (117 Normal, 123 GMPP, and 109 RMPP) were chronologically divided into a prospective training cohort (n=295) for model development and a prospective validation cohort (n=54) for external validation. Single-cell RNA sequencing (scRNA-seq) was performed on PBMCs from a discovery cohort (n=8) randomly selected from the training cohort. Differentially expressed genes that were specifically and significantly upregulated in RMPP groups were screened as candidate early diagnostic biomarkers. After primer validation, expressions of these candidate genes were subsequently measured using RT-qPCR in the entire study population. A multinomial logistic regression model with backward selection was developed on the training set, externally validated in the validation set, and its internal validation was further assessed via 1000 bootstrap resamples of the full dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      scRNA-seq identified eight specifically upregulated genes in the RMPP group. Subsequent RT-qPCR validation in the training cohort confirmed four genes\u2014\n                      <jats:italic>IGHM<\/jats:italic>\n                      ,\n                      <jats:italic>NEAT1<\/jats:italic>\n                      ,\n                      <jats:italic>IL32<\/jats:italic>\n                      , and\n                      <jats:italic>ACTG1<\/jats:italic>\n                      \u2014as early diagnostic biomarker capable of differentiating among the three groups. A combined four-gene three-category logistic regression model (Normal\/GMPP\/RMPP) demonstrated strong performance, with macro-average area under the curve values of 0.968 and 0.987 in the training and external validation, respectively. The final model, refit on the full dataset, attained an overall diagnostic accuracy of 88.8% for three-category classification, which was further confirmed by bootstrap resampling (macro-average AUC\u00a0=\u00a00.969).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We established a robust PBMC-based four-gene signature diagnostic model that accurately discriminates among Normal, GMPP, and RMPP statuses at an early disease stage. This model provides a clinically accessible and precise tool to facilitate early intervention and improve patient management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1741058","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T05:31:20Z","timestamp":1775539880000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["From genes to clinical application: a circulating four-gene signature for early diagnosis model of refractory Mycoplasma pneumoniae pneumonia"],"prefix":"10.3389","volume":"16","author":[{"given":"Qiuting","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Affiliated Shenzhen Children\u2019s Hospital of Shantou University Medical College","place":["Shenzhen, China"]},{"name":"Institute of Pediatrics, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwei","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Affiliated Shenzhen Children\u2019s Hospital of Shantou University Medical College","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuehui","family":"He","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Laboratory Medical Immunology, Radboud University Medical Center","place":["Nijmegen, Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heping","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Affiliated Shenzhen Children\u2019s Hospital of Shantou University Medical College","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Zhang","sequence":"additional","affiliation":[{"name":"Institute of Pediatrics, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangtao","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, First Affiliated Hospital of Xinxiang Medical University","place":["Weihui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weihong","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, First Affiliated Hospital of Xinxiang Medical University","place":["Weihui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiru","family":"Su","sequence":"additional","affiliation":[{"name":"Clinical Research Academy, Peking University Shenzhen Hospital","place":["Shenzhen, China"]},{"name":"Clinical Research Department, Clinical Laboratory, Affiliated Shenzhen Children\u2019s Hospital of Shantou University Medical College","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingliang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Affiliated Shenzhen Children\u2019s Hospital of Shantou University Medical College","place":["Shenzhen, China"]},{"name":"Institute of Pediatrics, Shenzhen Children\u2019s Hospital","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"B56","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1111\/j.1474-9726.2011.00732.x","article-title":"Vaccination-induced changes in human B-cell repertoire and pneumococcal IgM and IgA antibody at different ages","volume":"10","author":"Ademokun","year":"2011","journal-title":"Aging Cell"},{"key":"B26","doi-asserted-by":"publisher","first-page":"100870","DOI":"10.1016\/S2666-5247(24)00086-7","article-title":"Whole-genome sequencing unveils the outbreak of Mycoplasma pneumoniae in mainland China","volume":"5","author":"Chen","year":"2024","journal-title":"Lancet Microbe"},{"key":"B37","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1111\/crj.13620","article-title":"Clinical characteristics and serum inflammatory markers of community-acquired mycoplasma pneumonia in children","volume":"17","author":"Fan","year":"2023","journal-title":"Clin. Respir. J."},{"key":"B32","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1186\/s12879-024-09612-6","article-title":"Clinical efficacy of macrolide antibiotics in mycoplasma pneumoniae pneumonia carrying a macrolide-resistant mutation in the 23 S rRNA gene in pediatric patients","volume":"24","author":"He","year":"2024","journal-title":"BMC Infect. Dis."},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2024.113857","article-title":"The role of lncRNA NEAT1 in acute graft-versus-host disease: Regulation of macrophage polarization and inflammatory cytokine secretion via JNK\/NLRP3 pathway","volume":"146","author":"Huang","year":"2025","journal-title":"Int. Immunopharmacol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1984","DOI":"10.3390\/cells12151984","article-title":"The impact of CC16 on pulmonary epithelial-driven host responses during Mycoplasma pneumoniae infection in mouse tracheal epithelial cells","volume":"12","author":"Iannuzo","year":"2023","journal-title":"Cells."},{"key":"B61","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1056\/NEJMoa1500245","article-title":"Community-acquired pneumonia requiring hospitalization among U.S. adults","volume":"373","author":"Jain","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"18029","DOI":"10.1038\/s41598-025-02962-4","article-title":"Predicting and interpreting key features of refractory Mycoplasma pneumoniae pneumonia using multiple machine learning methods","volume":"15","author":"Jiang","year":"2025","journal-title":"Sci. Rep."},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2025.101578","article-title":"Genetic factors driving the Mycoplasma pneumoniae outbreak among children post-COVID-19 in China: a whole genome analysis","volume":"59","author":"Jiao","year":"2025","journal-title":"Lancet Reg. Health West. Pac."},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2023.104868","article-title":"Mycoplasma pneumoniae carriage in children with recurrent respiratory tract infections is associated with a less diverse and altered microbiota","volume":"98","author":"Koenen","year":"2023","journal-title":"EBioMedicine."},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.02719-24","article-title":"Multiplex amplicon sequencing for the comprehensive genotyping of Mycoplasma pneumoniae","volume":"13","author":"Kubota","year":"2025","journal-title":"Microbiol. Spectr."},{"key":"B60","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1093\/cid\/ciy419","article-title":"Mycoplasma pneumoniae among children hospitalized with community-acquired pneumonia","volume":"68","author":"Kutty","year":"2019","journal-title":"Clin. Infect. Dis."},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0014417","article-title":"Critical role of macrophages and their activation via MyD88-NFkappaB signaling in lung innate immunity to Mycoplasma pneumoniae","volume":"5","author":"Lai","year":"2010","journal-title":"PloS One"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1302702","article-title":"Neutrophil-to-lymphocyte ratio as a predictor of poor outcomes of Mycoplasma pneumoniae pneumonia","volume":"14","author":"Li","year":"2023","journal-title":"Front. Immunol."},{"key":"B42","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1186\/s12890-023-02684-1","article-title":"Recognition of refractory Mycoplasma pneumoniae pneumonia among Myocoplasma pneumoniae pneumonia in hospitalized children: development and validation of a predictive nomogram model","volume":"23","author":"Li","year":"2023","journal-title":"BMC Pulm. Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"5632","DOI":"10.1038\/s41598-024-55311-2","article-title":"Observational retrospective clinical study on clinical features of macrolide-resistant Mycoplasma pneumoniae pneumonia in Chinese pediatric cases","volume":"14","author":"Li","year":"2024","journal-title":"Sci. Rep."},{"key":"B33","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/1471-2180-14-27","article-title":"Global secretome characterization of A549 human alveolar epithelial carcinoma cells during Mycoplasma pneumoniae infection","volume":"14","author":"Li","year":"2014","journal-title":"BMC Microbiol"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1486352","article-title":"A comprehensive immune repertoire signature distinguishes pulmonary infiltration in SARS-CoV-2 Omicron variant infection","volume":"15","author":"Li","year":"2024","journal-title":"Front. Immunol."},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2025.1595521","article-title":"Proteomic characteristics of bronchoalveolar lavage fluid in children with mild and severe Mycoplasma pneumoniae pneumonia","volume":"16","author":"Liang","year":"2025","journal-title":"Front. Microbiol."},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2025.1537182","article-title":"Respiratory microbiome and metabolome features associate disease severity and the need for doxycycline treatment in children with macrolide-resistant Mycoplasma pneumoniae-mediated pneumonia","volume":"15","author":"Liao","year":"2025","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"4593","DOI":"10.2147\/IDR.S419873","article-title":"Clinical value of metagenomics next-generation sequencing in antibiotic resistance of a patient with severe refractory Mycoplasma pneumoniae pneumonia: a case report","volume":"16","author":"Lin","year":"2023","journal-title":"Infect. Drug Resist."},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2024.112337","article-title":"Long non-coding RNA NEAT1 exacerbates NLRP3-mediated pyroptosis in allergic rhinitis through regulating the PTBP1\/FOXP1 cascade","volume":"137","author":"Liu","year":"2024","journal-title":"Int. Immunopharmacol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1186\/s12890-024-02996-w","article-title":"Predictive value of bronchoscopy combined with CT score for refractory mycoplasma pneumoniae pneumonia in children","volume":"24","author":"Lu","year":"2024","journal-title":"BMC Pulm. Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"e165904","DOI":"10.1172\/JCI165904","article-title":"Integrated host\/microbe metagenomics enables accurate lower respiratory tract infection diagnosis in critically ill children","volume":"133","author":"Mick","year":"2023","journal-title":"J. Clin. Invest."},{"key":"B16","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1164\/rccm.201712-2472OC","article-title":"Validation of a host response assay, SeptiCyte LAB, for discriminating sepsis from systemic inflammatory response syndrome in the ICU","volume":"198","author":"Miller","year":"2018","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"B34","doi-asserted-by":"publisher","first-page":"31406","DOI":"10.1038\/s41598-025-15333-w","article-title":"Combining circ_0054633 and clinical features to predict refractory Mycoplasma pneumoniae pneumonia in children","volume":"15","author":"Mu","year":"2025","journal-title":"Sci. Rep."},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1099\/mgen.0.001563","article-title":"Global transcriptional reprogramming by cytomegalovirus infection suppresses MHC class II antigen presentation while enhancing migration machinery in murine dendritic cells","volume":"11","author":"Parry","year":"2025","journal-title":"Microb. Genom."},{"key":"B12","doi-asserted-by":"publisher","first-page":"3534","DOI":"10.1128\/JCM.01345-07","article-title":"First report of macrolide-resistant strains and description of a novel nucleotide sequence variation in the P1 adhesin gene in Mycoplasma pneumoniae clinical strains isolated in France over 12 years","volume":"45","author":"Pereyre","year":"2007","journal-title":"J. Clin. Microbiol."},{"key":"B48","doi-asserted-by":"publisher","first-page":"826","DOI":"10.1164\/rccm.201502-0355OC","article-title":"A molecular biomarker to diagnose community-acquired pneumonia on intensive care unit admission","volume":"192","author":"Scicluna","year":"2015","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1007\/s12519-017-0014-9","article-title":"Effects of methylprednisolone or immunoglobulin when added to standard treatment with intravenous azithromycin for refractory Mycoplasma pneumoniae pneumonia in children","volume":"13","author":"Shan","year":"2017","journal-title":"World J. Pediatr."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1401","DOI":"10.1016\/j.cell.2020.08.002","article-title":"Elevated calprotectin and abnormal myeloid cell subsets discriminate severe from mild COVID-19","volume":"182","author":"Silvin","year":"2020","journal-title":"Cell."},{"key":"B13","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1186\/s12931-018-0910-0","article-title":"FBXO17 promotes cell proliferation through activation of Akt in lung adenocarcinoma cells","volume":"19","author":"Suber","year":"2018","journal-title":"Respir. Res."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/ped4.12469","article-title":"Evidence-based guideline for the diagnosis and treatment of Mycoplasma pneumoniae pneumonia in children, (2023)","volume":"9","year":"2025","journal-title":"Pediatr. Investig."},{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2025.2482703","article-title":"Characterizing the epidemiology of Mycoplasma pneumoniae infections in China in 2022-2024: a nationwide cross-sectional study of over 1.6 million cases","volume":"14","author":"Sun","year":"2025","journal-title":"Emerg. Microbes Infect."},{"key":"B17","doi-asserted-by":"publisher","first-page":"346ra91","DOI":"10.1126\/scitranslmed.aaf7165","article-title":"Robust classification of bacterial and viral infections via integrated host gene expression diagnostics","volume":"8","author":"Sweeney","year":"2016","journal-title":"Sci. Transl. Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.jinf.2008.06.012","article-title":"Methylprednisolone pulse therapy for refractory Mycoplasma pneumoniae pneumonia in children","volume":"57","author":"Tamura","year":"2008","journal-title":"J. Infect."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1493","DOI":"10.1378\/chest.121.5.1493","article-title":"Role of interleukin-18 and T-helper type 1 cytokines in the development of Mycoplasma pneumoniae pneumonia in adults","volume":"121","author":"Tanaka","year":"2002","journal-title":"Chest."},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2025.106525","article-title":"Multi-omics analysis of human plasma reveals reprogramming of tryptophan metabolism associated with inflammation in Mycoplasma pneumoniae pneumonia in children","volume":"91","author":"Tang","year":"2025","journal-title":"J. Infect."},{"key":"B53","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1016\/j.cca.2020.08.035","article-title":"Admission IL-32 concentration predicts severity and mortality of severe community-acquired pneumonia independently of etiology","volume":"510","author":"Tang","year":"2020","journal-title":"Clin. Chim. Acta"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2824","DOI":"10.3390\/jcm11102824","article-title":"Refractory Mycoplasma pneumoniae pneumonia in children: Early recognition and management","volume":"11","author":"Tong","year":"2022","journal-title":"J. Clin. Med."},{"key":"B50","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1186\/s13054-019-2513-7","article-title":"Matrix metalloproteinase-8: a useful biomarker to refine the diagnosis of community-acquired pneumonia upon intensive care unit admission","volume":"23","author":"Uhel","year":"2019","journal-title":"Crit. Care"},{"key":"B21","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1038\/s41467-025-55932-9","article-title":"A diagnostic host-specific transcriptome response for Mycoplasma pneumoniae pneumonia to guide pediatric patient treatment","volume":"16","author":"Viz-Lasheras","year":"2025","journal-title":"Nat. Commun."},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2025.111747","article-title":"A 5-transcript signature for discriminating viral and bacterial etiology in pediatric pneumonia","volume":"28","author":"Viz-Lasheras","year":"2025","journal-title":"iScience."},{"key":"B22","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1128\/CMR.17.4.697-728.2004","article-title":"Mycoplasma pneumoniae and its role as a human pathogen","volume":"17","author":"Waites","year":"2004","journal-title":"Clin. Microbiol. Rev."},{"key":"B25","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1128\/CMR.00114-16","article-title":"Mycoplasma pneumoniae from the respiratory tract and beyond","volume":"30","author":"Waites","year":"2017","journal-title":"Clin. Microbiol. Rev."},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2018.00382","article-title":"Molecular distance to health transcriptional score and disease severity in children hospitalized with community-acquired pneumonia","volume":"8","author":"Wallihan","year":"2018","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"19358","DOI":"10.1038\/s41598-022-21496-7","article-title":"Integrative cross-species analysis of GABAergic neuron cell types and their functions in Alzheimer's disease","volume":"12","author":"Wang","year":"2022","journal-title":"Sci. Rep."},{"key":"B47","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.ijid.2014.07.020","article-title":"Clinical and laboratory profiles of refractory Mycoplasma pneumoniae pneumonia in children","volume":"29","author":"Wang","year":"2014","journal-title":"Int. J. Infect. Dis."},{"key":"B10","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1186\/s12931-024-02892-1","article-title":"The role of LDH and ferritin levels as biomarkers for corticosteroid dosage in children with refractory Mycoplasma pneumoniae pneumonia","volume":"25","author":"Wei","year":"2024","journal-title":"Respir. Res."},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2020.110998","article-title":"Proteomic and mechanistic study of Qingxuan Tongluo formula and curcumin in the treatment of Mycoplasma pneumoniae pneumonia","volume":"133","author":"Wei","year":"2021","journal-title":"Biomed. Pharmacother."},{"key":"B35","doi-asserted-by":"publisher","first-page":"744","DOI":"10.1186\/s12879-025-11133-9","article-title":"Predictive value of an early comprehensive assessment model for refractory mycoplasma pneumoniae pneumonia and internal validation","volume":"25","author":"Wu","year":"2025","journal-title":"BMC Infect. Dis."},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2024.1438777","article-title":"Characteristics of lower respiratory microbiota in children's refractory Mycoplasma pneumoniae pneumonia pre- and post-COVID-19 era","volume":"14","author":"Xi","year":"2024","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"262","DOI":"10.3390\/antibiotics13030262","article-title":"Post-COVID-19 pandemic rebound of macrolide-resistant Mycoplasma pneumoniae infection: a descriptive study","volume":"13","author":"Xing","year":"2024","journal-title":"Antibiot. (Basel)."},{"key":"B2","doi-asserted-by":"publisher","first-page":"522","DOI":"10.21037\/tp-20-149","article-title":"Dynamic change of Mycoplasma pneumoniae pneumonia in hospitalized children in a general hospital: a 3-year retrospective analysis","volume":"9","author":"Xing","year":"2020","journal-title":"Transl. Pediatr."},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1177\/03000605211016376","article-title":"Mutations in domain V of Mycoplasma pneumoniae 23S rRNA and clinical characteristics of pediatric M. pneumoniae pneumonia in Nanjing, China","volume":"49","author":"Xu","year":"2021","journal-title":"J. Int. Med. Res."},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2024.2353298","article-title":"Epidemic features and megagenomic analysis of childhood Mycoplasma pneumoniae post COVID-19 pandemic: a 6-year study in southern China","volume":"13","author":"Xu","year":"2024","journal-title":"Emerg. Microbes Infect."},{"key":"B57","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1093\/jleuko\/qiad072","article-title":"Bioinformatic identification and experiment validation revealed that ACTG1 is a promising prognostic signature and therapeutic target for sepsis","volume":"114","author":"Yao","year":"2023","journal-title":"J. Leukoc. Biol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1186\/s13052-022-01376-6","article-title":"Correlation between Mycoplasma pneumoniae drug resistance and clinical characteristics in bronchoalveolar lavage fluid of children with refractory Mycoplasma pneumoniae pneumonia","volume":"48","author":"Zhan","year":"2022","journal-title":"Ital. J. Pediatr."},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1088725","article-title":"Serum cytokine profiling reveals different immune response patterns during general and severe Mycoplasma pneumoniae pneumonia","volume":"13","author":"Zhang","year":"2022","journal-title":"Front. Immunol."},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1038\/srep37037","article-title":"Cytokines as the good predictors of refractory Mycoplasma pneumoniae pneumonia in school-aged children","volume":"6","author":"Zhang","year":"2016","journal-title":"Sci. Rep."},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1002\/advs.202405087","article-title":"Accurate diagnosis of lower respiratory infections using host response and respiratory microbiome from a single metatranscriptome test of bronchoalveolar lavage fluid","volume":"12","author":"Zou","year":"2025","journal-title":"Adv. Sci. (Weinh)."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1741058\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T05:31:23Z","timestamp":1775539883000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2026.1741058\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":61,"alternative-id":["10.3389\/fcimb.2026.1741058"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2026.1741058","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]},"article-number":"1741058"}}