Characteristics and risk factors for outcomes in patients with Mycoplasma pneumoniae mono- and coinfections: A multicenter surveillance study in Wuhan, China, 2023
Objectives: Mycoplasma pneumoniae (MP) is a key cause of community-acquired pneumonia, and coinfections lead to varied patient outcomes. A comprehensive understanding of the outcome characteristics and associated etiologies of coinfections in MP patients is lacking. Methods and results: We analyzed...
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KeAi Communications Co., Ltd.
2025-09-01
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| Series: | Infectious Disease Modelling |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468042725000326 |
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| author | Banghua Chen Jie Pan Ying Peng Yuanyuan Zhang Yunan Wan Hongjie Wei Kangguo Li Wentao Song Yunkang Zhao Kang Fang Huiming Ye Jiali Cao Jia Rui Zeyu Zhao Tianmu Chen |
| author_facet | Banghua Chen Jie Pan Ying Peng Yuanyuan Zhang Yunan Wan Hongjie Wei Kangguo Li Wentao Song Yunkang Zhao Kang Fang Huiming Ye Jiali Cao Jia Rui Zeyu Zhao Tianmu Chen |
| author_sort | Banghua Chen |
| collection | DOAJ |
| description | Objectives: Mycoplasma pneumoniae (MP) is a key cause of community-acquired pneumonia, and coinfections lead to varied patient outcomes. A comprehensive understanding of the outcome characteristics and associated etiologies of coinfections in MP patients is lacking. Methods and results: We analyzed 121,357 MP cases from 522,292,680 visits in Wuhan, China, in 2023 (the final year of the COVID-19 pandemic). Children aged 1–10 years had the highest incidence, whereas those over 60 years had elevated hospitalization, severe infection, and fatality rates. Coinfection patterns differed by age, with bacterial-viral-Chlamydia pneumoniae (C. pneumoniae) / other pathogens prevalent in infants, bacterial-viral pathogens prevalent in preschoolers, and viral-viral pathogens prevalent in school-aged children. Bacterial coinfections were most common in MP-infected patients, especially those who were hospitalized. Coinfection, especially with C. pneumoniae, Pseudomonas aeruginosa (P. aeruginosa), Haemophilus influenzae (H. influenzae), and Streptococcus pneumoniae (S. pneumoniae), increased hospitalization rates. The most severe outcomes and deaths occurred in patients coinfected with C. pneumoniae-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A-parainfluenza virus (PIV) or adenovirus-PIV. Logistic regression analysis demonstrated that male sex and adult age (particularly ≥40 years) were significantly associated with adverse outcomes in MP monoinfection. For coinfections, significantly higher hospitalization rates were reported among very young children (0–5 years) and adults aged ≥40 years, whereas adults presented an increased risk of severe disease. Coinfection outcomes were significantly associated with seasons of the year (winter, spring, and summer), specific age groups (3–5 years, 18–39 years, 40–50 years, and 60 years and over), gender (male), and longer onset-to-diagnosis periods. Middle-aged and elderly patients, coinfection, spring and summer, gender (male), and longer onset-to-diagnosis periods were significantly associated with increased hospitalization and serious illness risk. Coinfection, winter, older (adult) age, and gender (male) were significantly associated with an increased risk of death. Conclusions: Compared with adults, children with MP have a greater morbidity risk, whereas middle-aged and older adults face greater risks of hospitalization, serious illness, and death. Coinfection with other pathogens heightens hospitalization and death risks. These insights are crucial for etiological screening, diagnosing multiple pathogens, and preventing and treating infections. |
| format | Article |
| id | doaj-art-c597eec1a46f48bba21744b7cce3a290 |
| institution | DOAJ |
| issn | 2468-0427 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | KeAi Communications Co., Ltd. |
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| series | Infectious Disease Modelling |
| spelling | doaj-art-c597eec1a46f48bba21744b7cce3a2902025-08-20T03:13:39ZengKeAi Communications Co., Ltd.Infectious Disease Modelling2468-04272025-09-01103989100110.1016/j.idm.2025.04.006Characteristics and risk factors for outcomes in patients with Mycoplasma pneumoniae mono- and coinfections: A multicenter surveillance study in Wuhan, China, 2023Banghua Chen0Jie Pan1Ying Peng2Yuanyuan Zhang3Yunan Wan4Hongjie Wei5Kangguo Li6Wentao Song7Yunkang Zhao8Kang Fang9Huiming Ye10Jiali Cao11Jia Rui12Zeyu Zhao13Tianmu Chen14Wuhan Center for Disease Control and Prevention, People's Republic of ChinaState Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen 361102, People's Republic of ChinaWuhan Center for Disease Control and Prevention, People's Republic of ChinaWuhan Center for Disease Control and Prevention, People's Republic of ChinaWuhan Center for Disease Control and Prevention, People's Republic of ChinaState Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen 361102, People's Republic of ChinaState Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen 361102, People's Republic of ChinaState Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen 361102, People's Republic of ChinaState Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen 361102, People's Republic of ChinaState Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen 361102, People's Republic of ChinaDepartment of Laboratory Medicine, Fujian Key Clinical Specialty of Laboratory Medicine, Women and Children's Hospital, School of Medicine, Xiamen University, People's Republic of ChinaDepartment of Laboratory Medicine, Fujian Key Clinical Specialty of Laboratory Medicine, Women and Children's Hospital, School of Medicine, Xiamen University, People's Republic of ChinaState Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen 361102, People's Republic of China; Corresponding author. School of Public Health, Xiamen University, Xiamen City, 361102, Fujian Province, People's Republic of China.State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen 361102, People's Republic of China; Corresponding author. School of Public Health, Xiamen University, Xiamen City, 361102, Fujian Province, People's Republic of China.State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen 361102, People's Republic of China; Corresponding author. School of Public Health, Xiamen University, Xiamen City, 361102, Fujian Province, People's Republic of China.Objectives: Mycoplasma pneumoniae (MP) is a key cause of community-acquired pneumonia, and coinfections lead to varied patient outcomes. A comprehensive understanding of the outcome characteristics and associated etiologies of coinfections in MP patients is lacking. Methods and results: We analyzed 121,357 MP cases from 522,292,680 visits in Wuhan, China, in 2023 (the final year of the COVID-19 pandemic). Children aged 1–10 years had the highest incidence, whereas those over 60 years had elevated hospitalization, severe infection, and fatality rates. Coinfection patterns differed by age, with bacterial-viral-Chlamydia pneumoniae (C. pneumoniae) / other pathogens prevalent in infants, bacterial-viral pathogens prevalent in preschoolers, and viral-viral pathogens prevalent in school-aged children. Bacterial coinfections were most common in MP-infected patients, especially those who were hospitalized. Coinfection, especially with C. pneumoniae, Pseudomonas aeruginosa (P. aeruginosa), Haemophilus influenzae (H. influenzae), and Streptococcus pneumoniae (S. pneumoniae), increased hospitalization rates. The most severe outcomes and deaths occurred in patients coinfected with C. pneumoniae-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A-parainfluenza virus (PIV) or adenovirus-PIV. Logistic regression analysis demonstrated that male sex and adult age (particularly ≥40 years) were significantly associated with adverse outcomes in MP monoinfection. For coinfections, significantly higher hospitalization rates were reported among very young children (0–5 years) and adults aged ≥40 years, whereas adults presented an increased risk of severe disease. Coinfection outcomes were significantly associated with seasons of the year (winter, spring, and summer), specific age groups (3–5 years, 18–39 years, 40–50 years, and 60 years and over), gender (male), and longer onset-to-diagnosis periods. Middle-aged and elderly patients, coinfection, spring and summer, gender (male), and longer onset-to-diagnosis periods were significantly associated with increased hospitalization and serious illness risk. Coinfection, winter, older (adult) age, and gender (male) were significantly associated with an increased risk of death. Conclusions: Compared with adults, children with MP have a greater morbidity risk, whereas middle-aged and older adults face greater risks of hospitalization, serious illness, and death. Coinfection with other pathogens heightens hospitalization and death risks. These insights are crucial for etiological screening, diagnosing multiple pathogens, and preventing and treating infections.http://www.sciencedirect.com/science/article/pii/S2468042725000326Respiratory tract diseaseCoinfectionMultifactorial analysisOutcome |
| spellingShingle | Banghua Chen Jie Pan Ying Peng Yuanyuan Zhang Yunan Wan Hongjie Wei Kangguo Li Wentao Song Yunkang Zhao Kang Fang Huiming Ye Jiali Cao Jia Rui Zeyu Zhao Tianmu Chen Characteristics and risk factors for outcomes in patients with Mycoplasma pneumoniae mono- and coinfections: A multicenter surveillance study in Wuhan, China, 2023 Infectious Disease Modelling Respiratory tract disease Coinfection Multifactorial analysis Outcome |
| title | Characteristics and risk factors for outcomes in patients with Mycoplasma pneumoniae mono- and coinfections: A multicenter surveillance study in Wuhan, China, 2023 |
| title_full | Characteristics and risk factors for outcomes in patients with Mycoplasma pneumoniae mono- and coinfections: A multicenter surveillance study in Wuhan, China, 2023 |
| title_fullStr | Characteristics and risk factors for outcomes in patients with Mycoplasma pneumoniae mono- and coinfections: A multicenter surveillance study in Wuhan, China, 2023 |
| title_full_unstemmed | Characteristics and risk factors for outcomes in patients with Mycoplasma pneumoniae mono- and coinfections: A multicenter surveillance study in Wuhan, China, 2023 |
| title_short | Characteristics and risk factors for outcomes in patients with Mycoplasma pneumoniae mono- and coinfections: A multicenter surveillance study in Wuhan, China, 2023 |
| title_sort | characteristics and risk factors for outcomes in patients with mycoplasma pneumoniae mono and coinfections a multicenter surveillance study in wuhan china 2023 |
| topic | Respiratory tract disease Coinfection Multifactorial analysis Outcome |
| url | http://www.sciencedirect.com/science/article/pii/S2468042725000326 |
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