Respiratory microbiota imbalance in children with Mycoplasma pneumoniae pneumonia

Figures & data

Figure 1. Forest plot for the risk factors associated with MPP when compared with the control group. The odds ratio (OR) was based on the logistic regression model and adjusted for a potential confounding factor (age). MPP, Mycoplasma pneumoniae pneumonia patient; Control, other bacterial or viral pneumonia; CI, confidence interval.

Table 1. Characteristics of the study population.

Characteristics	MPP					Control (n = 29)	P-value**
	Total (n = 158)	MPR (n = 99)	MPA (n = 51)	MPC (n = 8)	P-value*
Age (years)					0.52		0.0011
Median (interquartile range)	7.6 (6.0, 9.6)	8.0 (6.0, 10.0)	7.3(5.9, 9.0)	7.8 (7.0, 8.3)		4.6 (1.0, 10.0)
Full range	(1.0, 16.0)	(1.0, 16.0)	(1.0, 13.0)	(3.8, 10.0)		(0.2, 13.0)
Gender					0.17		0.15
Male	72 (45.6)	42 (42.4)	28 (54.9)	2 (25.0)		11 (37.9)
Female	86 (54.4)	57 (57.6)	23 (45.1)	6 (75.0)		18 (62.1)
Severity					0.51	—	—
Mild	101 (63.9)	66 (66.7)	31 (60.8)	4 (50.0)
Severe	57 (36.1)	33 (33.3)	20 (39.2)	4 (50.0)
Clinical presentations
Fever	102 (64.6)	72 (72.7)	26 (51.0)	4 (50.0)	0.02	12 (41.4)	0.03
Cough	146 (92.4)	92 (92.9)	47 (92.2)	7 (87.5)	0.65	23 (79.3)	0.04
Pleural effusion	46 (29.1)	8 (28.3)	16 (31.4)	2 (25.0)	0.91	3 (10.3)	0.06
Pulmonary atelectasis	18 (11.4)	10 (10.1)	5 (9.8)	3 (37.5)	0.09	6 (20.7)	0.22
Necrotizing pneumonia	9 (5.7)	2 (2.0)	5 (9.8)	2 (25.0)	0.01	1 (3.4)	1
Respiratory distress	1 (0.6)	0 (0.0)	1 (2.0)	0 (0.0)	0.37	2 (6.9)	0.06
C-reactive protein elevated	28 (17.7)	18 (15.2)	8 (15.7)	2 (25.0)	0.77	4 (13.8)	0.79
Dysfunction of blood coagulation	134 (84.8)	85 (85.9)	44 (86.3)	5 (62.5)	0.20	15 (51.7)	<0.001
Hepatic Insufficiency^†	22 (13.9)	17 (17.2)	4 (7.8)	1 (12.5)	0.25	3 (10.3)	0.77
Myocardial damage^‡	11 (7.0)	9 (9.1)	2 (3.9)	0 (0.0)	0.46	5 (17.2)	0.08

*P-values for comparison between MPP subgroups; **P-values for comparison between MPP and Control groups;

^† Hepatic insufficiency, liver damage, and hepatic dysfunction;

^‡ Myocardial damage, and electrocardiographic changes associated with myocardial damage.

Figure 2. Comparisons of respiratory microbiota in MPP and Control groups. (A) Alpha diversity was evaluated by the Shannon index. (B) Alpha diversity was evaluated by the Simpson index. (C) Principal coordinate analysis based on the Weighted Unifrac matrix between MPP and Control groups. (D) Relative abundance of respiratory microbiota at the phylum and genus level. (E) The species with significant differences in abundance between the two groups by using LEfSe analysis. MPP, Mycoplasma pneumoniae pneumonia patient; Control, other bacterial or viral pneumonia. **P < 0.01, ***P < 0.001.

Figure 3. Comparisons of respiratory microbiota in Control, severe MPP, and mild MPP groups. (A) Alpha diversity was evaluated by the Shannon index. (B) Alpha diversity was evaluated by the Simpson index. (C) Principal coordinate analysis based on the Weighted Unifrac matrix. (D) Relative abundance of respiratory microbiota at the phylum and genus level. (E) The species with significant differences in abundance between the mild and severe MPP groups by using LEfSe analysis. MPP, Mycoplasma pneumoniae pneumonia patient; Control, other bacterial or viral pneumonia. ***P < 0.001.

Figure 4. Comparisons of respiratory microbiota in MPP children enrolled based on different diagnostic standard. (A) Alpha diversity was evaluated by the Shannon index. (B) Principal coordinate analysis based on the Weighted Unifrac matrix. (C) Relative abundance of respiratory microbiota at the phylum level. (D) Relative abundance of respiratory microbiota at the genus level. NS, no significance.

Figure 5. Relative abundance of Tenericutes, Mycoplasmataceae and Mycoplasma in MPP and Control groups. (A) Tenericutes. (B) Mycoplasmataceae. (C) Mycoplasma. MPP, Mycoplasma pneumoniae pneumonia patient; Control, other bacterial or viral pneumonia. ***P < 0.001.

Figure 6. Relative abundance at the genus level of the children with discordant diagnosis based on the clinical diagnosis and Mycoplasma abundance.

Figure 7. Correlation networks between microbiota and disease severity. (A) Concordance of the MP abundance and complication numbers. (B) Correlation between the different abundance of respiratory microbiota at the genus level and the clinical indices in children with severe MPP when compared with mild MPP.