Children hospitalized with community-acquired pneumonia in China between October 2022 and June 2025 showed a complex pattern of respiratory pathogen detections, with at least one pathogen identified in 67.2 percent of 2,253 enrolled patients, according to a prospective multicenter surveillance study published in Annals of Clinical Microbiology and Antimicrobials.
The study involved 17 clinical departments from 16 hospitals across 14 Chinese cities and enrolled children aged 1 to 14 years who were hospitalized with community-acquired pneumonia. Detection relied on a standardized protocol combining multiplex real-time PCR for common respiratory viruses, serum Mycoplasma pneumoniae IgM testing, and conventional bacterial culture.
Across the 2,324 pathogen detection events recorded in the study, viral nucleic acid detections accounted for the largest proportion, 45.1 percent, or 1,047 detections. M. pneumoniae detection based on IgM positivity followed closely at 43.8 percent, or 1,017 detections, while bacterial culture detections made up 11.2 percent, or 260 detections.
Among the respiratory viruses detected, those with confirmed relevance to pneumonia were human adenovirus, influenza B virus, influenza A virus, and respiratory syncytial virus. Epstein-Barr virus was frequently observed as an upper respiratory codetection, but the authors note that independent diagnostic criteria for EBV pneumonia do not exist, so its presence was not treated as a pneumonia-causing agent.
Codetection of more than one pathogen occurred in 36.2 percent of the 1,513 pathogen-positive children, or 547 patients. Within this group, viral and M. pneumoniae codetection was the predominant pattern, representing 69.3 percent of codetections, or 379 cases.
Severity outcomes were analyzed using multivariable generalized linear mixed models that accounted for clustering at the hospital level. In these models, viral detection, M. pneumoniae IgM positivity, pathogen codetection, and bacterial positivity were each independently associated with severe community-acquired pneumonia.
The authors conclude that viral pathogens and M. pneumoniae represented the predominant detection categories in this post-pandemic pediatric population, and that frequent codetection was independently linked to severe disease. They state that the findings provide epidemiological evidence supporting diagnostic strategies oriented toward patient age, region, and severity, and may inform public health considerations regarding influenza and respiratory syncytial virus prevention.
As a surveillance study, the work describes detection patterns among hospitalized children rather than establishing causal contributions of individual pathogens to disease, and serological M. pneumoniae detection reflects immune response rather than direct pathogen identification. The study period, from October 2022 to June 2025, captures a period after the COVID-19 pandemic, during which the authors note that the distribution of respiratory pathogens may have changed.
The article was published as open access on 15 October 2026 and is being shared early as a peer-reviewed, accepted version that remains subject to further editorial edits before the final version of record appears.
Subject of Research: Respiratory pathogen detection and codetection patterns among children hospitalized with community-acquired pneumonia in China
Article Title: Respiratory pathogen detections and codetection patterns among 2,253 children hospitalized with community-acquired pneumonia in China, 2022–2025: a prospective multicenter surveillance study
Article References: Wang, X.-F., Liu, H.-M., Zhao, S.-Y., Xiong, L., Li, X.-M., Zhao, D.-Y., Li, Y.-M., Jiang, Y.-H., Zhang, B.-Q., Hu, Y., Xu, H., Zhang, J.-H., Peng, Y., Wang, M.-Q., Xu, Y.-S., Xie, D., He, P., Li, W.-W., Chen, L.-N., … Tian, Z.-F. (2026). Respiratory pathogen detections and codetection patterns among 2,253 children hospitalized with community-acquired pneumonia in China, 2022–2025: a prospective multicenter surveillance study. Annals of Clinical Microbiology and Antimicrobials. https://doi.org/10.1186/s12941-026-00890-3
Image Credits: AI Generated
DOI: 10.1186/s12941-026-00890-3
Keywords: community-acquired pneumonia, children, respiratory pathogens, Mycoplasma pneumoniae, codetection, surveillance, China, severe pneumonia, multiplex PCR, RSV, influenza, adenovirus
News Source: Kristina Jarvis. (October 28, 2026). Viruses and Mycoplasma pneumoniae dominate pneumonia detections in hospitalized Chinese children. Scienmag.
