Analysis of clinical pathogenic characteristics of children with co-infected pneumonia_West China Medical Journal

Authors：

WANG Dan ¹ , YANG Xianggui ¹ , YI Jiaxin ² ,  YANG Min ¹

1. Department of Laboratory Medicine, the First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan 610500, P. R. China;
2. School of Laboratory Medicine, Chengdu Medical College, Chengdu, Sichuan 610500, P. R. China;

Corresponding?author：

YANG Min, Email: yangmin20130214@163.com

Keywords：

Children; co-infections; pneumonia; pathogen

DOI：

10.7507/1002-0179.202508004

Video：

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Objective To analyze the clinical pathogenic characteristics of children with co-infected pneumonia, and to provide reference for clinical diagnosis and treatment. Methods Children with co-infected pneumonia treated in the pediatrics department of the First Affiliated Hospital of Chengdu Medical College between June 2023 and May 2024 were selected. According to age, the children were divided into goups of infants, toddlers, preschoolers, school-aged children, and adolescents. The clinical pathogenic characteristics of children with pneumonia were analyzed. Results A total of 358 pediatric patients were included. Among them, there were 189 males (52.79%) and 169 females (47.21%); 71 (19.83%) were infants, 74 (20.67%) were toddlers, 113 (31.56%) were preschoolers, 75 (20.95%) were school-aged children, and 25 (6.98%) were adolescents. There was no statistically significant difference in the composition of males and females among different age groups or types of pneumonia (P>0.05). The bacteria detected were mainly Haemophilus influenzae, Staphylococcus aureus, Moraxella catarrhalis and Streptococcus pneumoniae. Viruses in the pathogen mainly included adenovirus, influenza A and B stream, human rhinovirus and respiratory syncytial virus. The main atypical pathogen detected was Mycoplasma pneumoniae (240 cases). Except for atypical pathogens (P>0.05), the detection rates of bacteria and viruses among different age groups showed statistically significant differences (P<0.05). The compositions of bacterial co-infections, viral co-infections, bacterial+viral infections, and co-infections involving atypical pathogens were compared among different age groups, and the difference was statistically significant (P<0.05). The proportions of different types of pathogens detected in winter were the highest. Conclusions Children with co-infected pneumonia are mainly aged 0-6 years old. The incidence of co-infected pneumonia in children is the highest in winter. Mycoplasma is the main pathogen in dual infections or co-infections. Co-infections in early childhood are mainly caused by bacterial infections, and the incidence of viral infections increases with age.

Citation： WANG Dan, YANG Xianggui, YI Jiaxin, YANG Min. Analysis of clinical pathogenic characteristics of children with co-infected pneumonia. West China Medical Journal, 2025, 40(8): 1217-1222. doi: 10.7507/1002-0179.202508004 Copy

1.	戴萌娜, 襲燕, 尹文強, 等. 中國 2005—2019 年 0~14 歲兒童肺炎死亡趨勢分析. 中國學校衛生, 2021, 42(9): 1411-1414.
2.	謝婷婷, 羅璨, 李琳. 2018—2021 年江蘇省 5 歲以下兒童肺炎死亡特征分析. 中國婦幼保健, 2024, 39(10): 1847-1850.
3.	Kim SR. Viral infection and airway epithelial immunity in asthma. Int J Mol Sci, 2022, 23(17): 9914.Kim SR. Viral infection and airway epithelial immunity in asthma. Int J Mol Sci, 2022, 23(17): 9914.
4.	Tian J, Shang B, Zhang J, et al. T cell immune evasion by SARS-CoV-2 JN.1 escapees targeting two cytotoxic T cell epitope hotspots. Nat Immunol, 2025, 26(2): 265-278.
5.	茅松, 劉光陵, 夏正坤, 等. 兒童支氣管哮喘變應原檢測與年齡、性別的關系探討. 實用醫學雜志, 2011, 27(18): 3366-3368.
6.	熊振宇, 張娟. 多重感染肺炎患兒臨床與病原學研究. 開封醫專學報, 2000, 19(2): 28-29.
7.	池細俤, 高世華, 張忠源, 等. 急性呼吸道感染常見病毒的流行病學分析. 中國感染控制雜志, 2019, 18(4): 320-325.
8.	王紫荊, 方劍, 胡小林, 等. 兒童非典型病原體肺炎病原及流行病學特征分析. 實用醫院臨床雜志, 2020, 17(6): 156-158.
9.	彭獻華, 李冰冰, 李曉琳, 等. 2021—2022 年某醫院呼吸道感染患兒肺炎支原體感染流行特征. 中華醫院感染學雜志, 2023, 33(18): 2851-2854.
10.	閻進曉, 郭靜娜, 孫苗, 等. 阿奇霉素序貫療法聯合復可托對小兒肺炎支原體感染的療效及 GSH-Px、ICAM-1 水平的影響分析. 貴州醫藥, 2022, 46(10): 1542-1544.
11.	Liccioli G, Filippeschi C, Giovannini M, et al. Mycoplasma pneumoniae-associated mucocutaneous disease in children: a case series with allergy workup in a tertiary care paediatric hospital. Clin Exp Allergy, 2021, 51(5): 740-744.
12.	盧紅霞, 黃晗, 梁利紅, 等. 阿奇霉素聯合特布他林對支原體肺炎患兒體液免疫及炎癥水平的影響. 罕少疾病雜志, 2024, 31(4): 24-26.
13.	Liese JG, Schoen C, van der Linden M, et al. Changes in the incidence and bacterial aetiology of paediatric parapneumonic pleural effusions/empyema in Germany, 2010-2017: a nationwide surveillance study. Clin Microbiol Infect, 2019, 25(7): 857-864.
14.	林野, 龔政, 陸紅云, 等. 江蘇省蘇州市某醫院兒童肺炎支原體分型及臨床特征. 中國熱帶醫學, 2021, 21(11): 1098-1102.
15.	Thaulow CM, Lindemann PC, Klingenberg C, et al. Epidemiology and antimicrobial susceptibility of invasive bacterial infections in children-A population-based study from Norway. Pediatr Infect Dis J, 2021, 40(5): 403-410.
16.	蔣娟, 石遠濱. 兒童社區獲得性肺炎細菌病原分布及細菌耐藥情況分析. 世界最新醫學信息文摘(電子版), 2020, 20(43): 1-2, 5.
17.	Oumei H, Xuefeng W, Jianping L, et al. Etiology of community-acquired pneumonia in 1500 hospitalized children. J Med Virol, 2018, 90(3): 421-428.
18.	鄭圣坤, 卓志強. 兒童肺炎流感嗜血桿菌合并肺炎支原體感染的臨床特征. 中國醫學創新, 2021, 18(19): 10-14.
19.	N?rskov-Lauritsen N. Classification, identification, and clinical significance of Haemophilus and Aggregatibacter species with host specificity for humans. Clin Microbiol Rev, 2014, 27(2): 214-240.
20.	Levine OS, Liu G, Garman RL, et al. Haemophilus influenzae type B and Streptococcus pneumoniae as causes of pneumonia among children in Beijing, China. Emerg Infect Dis, 2000, 6(2): 165-170.
21.	鐘瑩. 兒童肺炎病原學臨床特點回顧性分析. 南昌: 南昌大學, 2019.

1. 戴萌娜, 襲燕, 尹文強, 等. 中國 2005—2019 年 0~14 歲兒童肺炎死亡趨勢分析. 中國學校衛生, 2021, 42(9): 1411-1414.
2. 謝婷婷, 羅璨, 李琳. 2018—2021 年江蘇省 5 歲以下兒童肺炎死亡特征分析. 中國婦幼保健, 2024, 39(10): 1847-1850.
3. Kim SR. Viral infection and airway epithelial immunity in asthma. Int J Mol Sci, 2022, 23(17): 9914.Kim SR. Viral infection and airway epithelial immunity in asthma. Int J Mol Sci, 2022, 23(17): 9914.
4. Tian J, Shang B, Zhang J, et al. T cell immune evasion by SARS-CoV-2 JN.1 escapees targeting two cytotoxic T cell epitope hotspots. Nat Immunol, 2025, 26(2): 265-278.
5. 茅松, 劉光陵, 夏正坤, 等. 兒童支氣管哮喘變應原檢測與年齡、性別的關系探討. 實用醫學雜志, 2011, 27(18): 3366-3368.
6. 熊振宇, 張娟. 多重感染肺炎患兒臨床與病原學研究. 開封醫專學報, 2000, 19(2): 28-29.
7. 池細俤, 高世華, 張忠源, 等. 急性呼吸道感染常見病毒的流行病學分析. 中國感染控制雜志, 2019, 18(4): 320-325.
8. 王紫荊, 方劍, 胡小林, 等. 兒童非典型病原體肺炎病原及流行病學特征分析. 實用醫院臨床雜志, 2020, 17(6): 156-158.
9. 彭獻華, 李冰冰, 李曉琳, 等. 2021—2022 年某醫院呼吸道感染患兒肺炎支原體感染流行特征. 中華醫院感染學雜志, 2023, 33(18): 2851-2854.
10. 閻進曉, 郭靜娜, 孫苗, 等. 阿奇霉素序貫療法聯合復可托對小兒肺炎支原體感染的療效及 GSH-Px、ICAM-1 水平的影響分析. 貴州醫藥, 2022, 46(10): 1542-1544.
11. Liccioli G, Filippeschi C, Giovannini M, et al. Mycoplasma pneumoniae-associated mucocutaneous disease in children: a case series with allergy workup in a tertiary care paediatric hospital. Clin Exp Allergy, 2021, 51(5): 740-744.
12. 盧紅霞, 黃晗, 梁利紅, 等. 阿奇霉素聯合特布他林對支原體肺炎患兒體液免疫及炎癥水平的影響. 罕少疾病雜志, 2024, 31(4): 24-26.
13. Liese JG, Schoen C, van der Linden M, et al. Changes in the incidence and bacterial aetiology of paediatric parapneumonic pleural effusions/empyema in Germany, 2010-2017: a nationwide surveillance study. Clin Microbiol Infect, 2019, 25(7): 857-864.
14. 林野, 龔政, 陸紅云, 等. 江蘇省蘇州市某醫院兒童肺炎支原體分型及臨床特征. 中國熱帶醫學, 2021, 21(11): 1098-1102.
15. Thaulow CM, Lindemann PC, Klingenberg C, et al. Epidemiology and antimicrobial susceptibility of invasive bacterial infections in children-A population-based study from Norway. Pediatr Infect Dis J, 2021, 40(5): 403-410.
16. 蔣娟, 石遠濱. 兒童社區獲得性肺炎細菌病原分布及細菌耐藥情況分析. 世界最新醫學信息文摘(電子版), 2020, 20(43): 1-2, 5.
17. Oumei H, Xuefeng W, Jianping L, et al. Etiology of community-acquired pneumonia in 1500 hospitalized children. J Med Virol, 2018, 90(3): 421-428.
18. 鄭圣坤, 卓志強. 兒童肺炎流感嗜血桿菌合并肺炎支原體感染的臨床特征. 中國醫學創新, 2021, 18(19): 10-14.
19. N?rskov-Lauritsen N. Classification, identification, and clinical significance of Haemophilus and Aggregatibacter species with host specificity for humans. Clin Microbiol Rev, 2014, 27(2): 214-240.
20. Levine OS, Liu G, Garman RL, et al. Haemophilus influenzae type B and Streptococcus pneumoniae as causes of pneumonia among children in Beijing, China. Emerg Infect Dis, 2000, 6(2): 165-170.
21. 鐘瑩. 兒童肺炎病原學臨床特點回顧性分析. 南昌: 南昌大學, 2019.

West China Medical Journal

Analysis of clinical pathogenic characteristics of children with co-infected pneumonia

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