{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T20:10:07Z","timestamp":1794255007711,"version":"4.9.0"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T00:00:00Z","timestamp":1706659200000},"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. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To investigate the pathogenic characteristics and risk factors of pediatric severe community-acquired pneumonia (CAP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed the clinical data of hospitalized children with severe CAP from April 2014 to June 2019 in China. Data of age, sex and pathogenic results were collected: bacterial and fungal cultures, respiratory viruses from sputum or bronchoalveolar lavage fluid (BALF), serum\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      (MP)-IgM and\n                      <jats:italic>Chlamydia Pneumoniae<\/jats:italic>\n                      -IgM, and BALF or blood (1-3)-\u03b2-D-glucan\/galactomannan test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 679 children with severe CAP were included in the analysis. The number of cases infected with MP was higher in males than in females. There were significant differences between the \u22641-year and &amp;gt;1-year groups in terms of pathogen. The top three bacteria cultured were\n                      <jats:italic>Haemophilus influenzae<\/jats:italic>\n                      (57\/679, 8.4%),\n                      <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                      (50\/679, 7.4%), and\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      (25\/679, 3.7%). The top three viruses detected were adenovirus (AdV, 124\/679, 18.3%), respiratory syncytial virus (24\/679, 3.5%), and parainfluenza virus (21\/679, 3.1%). AdV and MP were the leading pathogens, detected in 18.3% and 32.6% cases, respectively. MP infection increased the risk of AdV infection (OR 3.77,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.0001). MP infection was a risk factor for severe AdV-infected pneumonia, while sex, age, bacteria,\n                      <jats:italic>Chlamydia Pneumoniae<\/jats:italic>\n                      , fungal, and AdV infections were risk factors for severe MP-infected pneumonia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AdV and MP were dominant pathogens in children with severe CAP. AdV and MP infection predisposed each other to develop severe illness. AdV-MP co-infection may lead to severe pneumonia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2024.1337786","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T23:36:02Z","timestamp":1706657762000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":38,"title":["Adenovirus and Mycoplasma pneumoniae co-infection as a risk factor for severe community-acquired pneumonia in children"],"prefix":"10.3389","volume":"12","author":[{"given":"Qihong","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yungang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e186","DOI":"10.1016\/S2214-109X(16)30334-5","article-title":"National and subnational all-cause and cause-specific child mortality in China, 1996\u20132015: a systematic analysis with implications for the sustainable development goals","volume":"5","author":"He","year":"2017","journal-title":"Lancet Glob Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1016\/S0140-6736(19)30721-4","article-title":"Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study","volume":"394","year":"2019","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e192","DOI":"10.1017\/S0950268819000839","article-title":"The epidemiology of paediatric Mycoplasma pneumoniae pneumonia in north China: 2006 to 2016","volume":"147","author":"Gao","year":"2019","journal-title":"Epidemiol Infect"},{"key":"B4","doi-asserted-by":"publisher","first-page":"79","DOI":"10.3969\/j.issn.1007-8134.2023.04.002","article-title":"Guidelines for diagnosis and treatment of Mycoplasma pneumonae pneumonia in children (2023 edition)","volume":"50","year":"2023","journal-title":"Int J Epidemiol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e0002622","DOI":"10.1128\/spectrum.00026-22","article-title":"Mycoplasma pneumoniae and adenovirus coinfection cause pediatric severe community-acquired pneumonia","volume":"10","author":"Li","year":"2022","journal-title":"Microbiol Spectr"},{"key":"B6","doi-asserted-by":"publisher","first-page":"161","DOI":"10.3760\/cma.j.issn.1674-2397.2019.03.001","article-title":"State administration of traditional Chinese medicine.guideline for diagnosis and treatment of adenovirus pneumonia in children (2019 version)","volume":"12","year":"2019","journal-title":"Chin J Clin Infect Dis"},{"key":"B7","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1186\/s12879-017-2891-x","article-title":"Etiologic spectrum and occurrence of coinfections in children hospitalized with community-acquired pneumonia","volume":"17","author":"Jiang","year":"2017","journal-title":"BMC Infect Dis"},{"key":"B8","doi-asserted-by":"publisher","first-page":"S54","DOI":"10.1055\/s-0039-1691801","article-title":"Community-acquired pneumonia in children: myths and facts","volume":"36","author":"Yun","year":"2019","journal-title":"Am J Perinatol"},{"key":"B9","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":"B10","doi-asserted-by":"publisher","first-page":"e20161019","DOI":"10.1542\/peds.2016-1019","article-title":"Predicting severe pneumonia outcomes in children","volume":"138","author":"Williams","year":"2016","journal-title":"Pediatrics"},{"key":"B11","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1093\/jpids\/piy046","article-title":"Factors associated with pneumonia severity in children: a systematic review","volume":"7","author":"Dean","year":"2018","journal-title":"J Pediatric Infect Dis Soc"},{"key":"B12","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1186\/s12985-018-1037-0","article-title":"Human adenovirus load in respiratory tract secretions are predictors for disease severity in children with human adenovirus pneumonia","volume":"15","author":"Xie","year":"2018","journal-title":"Virol J"},{"key":"B13","doi-asserted-by":"publisher","first-page":"856","DOI":"10.3760\/cma.j.issn.0578-1310.2013.11.012","article-title":"Chinese medical association the editorial board CJoP. 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