Association between normalized Mycoplasma pneumoniae sequence reads and severity of pediatric pneumonia: a cross-sectional study
Abstract
Background Mycoplasma pneumoniae (MP) is a leading cause of pediatric community-acquired pneumonia (CAP), with an increasing proportion of severe cases in the post-coronavirus disease 2019 (COVID-19) era. High-throughput targeted next-generation sequencing (tNGS) enables semi-quantitative detection of MP; however, the clinical significance of normalized MP sequence reads derived from oropharyngeal swabs remains unclear. This study aimed to explore whether normalized MP sequence reads from oropharyngeal swabs can serve as a biomarker for early assessment of disease severity in pediatric MP pneumonia (MPP). Methods In this cross-sectional study, 262 consecutive children with MPP were enrolled from January to December 2023 at Fujian Children’s Hospital. Clinical and laboratory data were retrospectively reviewed. Normalized MP sequence reads were derived from pre-antibiotic oropharyngeal swabs and processed using a standardized fastp/Bowtie2 bioinformatics pipeline. Severe MPP (SMPP) was defined according to the 2019 Chinese Guidelines for the Management of CAP in Children. Associations between MP reads and disease severity were assessed using multivariable logistic regression, adjusting for age, sex, fever duration, coinfection, and A2063G mutation status. Model discrimination, calibration, and incremental value were evaluated using area under the curve (AUC), DeLong test, Hosmer-Lemeshow test, bootstrap validation, integrated discrimination improvement (IDI), continuous net…
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