Characterization of Nasopharyngeal Microbiota Dysbiosis in Children with Mycoplasma pneumoniae Pneumonia

Mycoplasma pneumoniae pneumonia (MPP) is a leading cause of community-acquired pneumonia in children, yet little is known about the role of nasopharyngeal microbiota dysbiosis in susceptibility to infection and disease subtype. In this study, we performed 16S rRNA sequencing on nasopharyngeal samples from 102 pediatric MPP patients, 104 influenza A patients, and 103 healthy controls and compared the microbial diversity, composition, and functional profiles across groups. The MPP group exhibits an altered nasopharyngeal microbial composition, characterized by reduced microbial diversity and an increased relative abundance of genera including Mycoplasma, Pseudomonas, Acinetobacter, and Tannerella. Distinct microbiota profiles were identified for the MPP subtypes, with Mycoplasma more abundant in bronchopneumonia (BP) than in lobar pneumonia (LP). A microbial classifier based on the relative abundance of the nasopharyngeal microbiota was established to distinguish MPP patients from both influenza patients and healthy controls, with an area under the receiver operating characteristic curves of 0.978. Key microbial features associated with MPP included Mycoplasma, Mycobacterium, Aeromonas, and Acinetobacter. In addition, PICRUSt2-based functional predictions suggested alterations in amino acid metabolism and predicted functional pathways associated with bacterial infection and antimicrobial resistance in MPP patients. In conclusion, this study provides comprehensive insights into alterations in the nasopharyngeal microbiota in pediatric MPP. These findings highlight the potential role of dysbiosis in disease progression and suggest that changes in microbiota composition and functional profiles are associated with MPP infection.