To assess whether human rhino-/enterovirus PCR co-detection is associated with a distinct clinical phenotype in children with M. pneumoniae infection.
Approach:
Study population: Reanalyzed 236 children with PCR-detected M. pneumoniae treated at a tertiary pediatric hospital in Zurich from April 2022 through March 2025.
Comparisons: Compared children with and without human rhino-/enterovirus co-detection, then repeated the comparison after excluding other respiratory pathogen co-detections.
Analysis: Used Mann–Whitney U and Fisher’s exact tests; statistical significance was defined as P < 0.05.
Key Findings:
Among 236 children, 66 had human rhino-/enterovirus co-detection; 44 had M. pneumoniae and human rhino-/enterovirus detected without other co-detections.
Demographic characteristics, fever, CRP, leukocyte counts, and neutrophil counts did not differ meaningfully between groups.
Results were unchanged when analyses were restricted to isolated M. pneumoniae detection versus M. pneumoniae with human rhino-/enterovirus alone.
Human rhino-/enterovirus co-detection was more frequent after NPI implementation than before (28.0% vs. 6.0%); the authors note that testing strategy changed from singleplex to multiplex PCR.
Interpretation:
In this post-NPI cohort, demographic characteristics, clinical presentation, and inflammatory markers did not differ meaningfully between children with M. pneumoniae detected alone and those with concurrent human rhino-/enterovirus detection. The authors state that some co-detections may reflect incidental viral detection rather than clinically relevant co-infection.
Limitations:
The apparent increase in co-detection across periods may partly reflect the change from singleplex to multiplex PCR after the COVID-19 pandemic.
Conclusion:
In this post-NPI cohort, human rhino-/enterovirus PCR co-detection was not associated with meaningful differences in clinical presentation or inflammatory markers among children with M. pneumoniae detection.
