Combined adenovirus and Mycoplasma pneumoniae infection is an independent risk factor for developing severe community-acquired pneumonia in children

Abstract

Abstract Background: To investigate the pathogenic characteristics and risk factors of pediatric severe community-acquired pneumonia (CAP). Methods:We retrospectively analyzed the clinical data of hospitalized children with severe CAP, including sex, age, results of sputum or bronchoalveolar lavage fluid (BALF) bacterial and fungal cultures, respiratory viruses, serum Mycoplasma pneumoniae (MP)-IgM and Chlamydia Pneumoniae (CP)-IgM, and BALF or blood (1-3)-β-D-glucan/galactomannan test. Results: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 ≤1-year and >1-year groups, namely for bacterial, viral, MP, and CP infections. The top three bacteria cultured were Haemophilus influenza, Streptococcus pneumoniae, and Pseudomonas aeruginosa. The top three viruses detected were adenovirus (ADV), respiratory syncytial virus, and parainfluenza virus. The case numbers of ADV and MP infections in severe CAP were significantly higher than those of other infections, and ADV-positive infection was significantly associated with MP infection. MP infection was a risk factor for severe ADV-infected pneumonia, while sex, age, bacteria, CP, fungal, and ADV infections were risk factors for severe MP-infected pneumonia. Conclusions: ADV-combined MP infection is an independent risk factor for the development of severe CAP in children.