A diagnostic host-specific transcriptome response for Mycoplasma pneumoniae pneumonia to guide pediatric patient treatment

Sandra Viz-Lasheras, Alberto Gómez-Carballa, Xabier Bello, Irene Rivero-Calle, Ana Isabel Dacosta, Myrsini Kaforou, Dominic Habgood-Coote, Aubrey J. Cunnington, Marieke Emonts, Jethro A. Herberg, Victoria J. Wright, Enitan D. Carrol, Stephane C. Paulus, Werner Zenz, Daniela S. Kohlfürst, Nina Schweintzger, Michiel Flier, Ronald Groot, Luregn J. Schlapbach, Philipp Agyeman, Andrew J. Pollard, Colin Fink, Taco T. Kuijpers, Suzanne Anderson, Ulrich Both, Marko Pokorn, Dace Zavadska, María Tsolia, Henriëtte A. Moll, Clementien Vermont, Michael Levin, Federico Martinón-Torres and Antonio Salas ()
Additional contact information
Sandra Viz-Lasheras: Universidade de Santiago de Compostela
Alberto Gómez-Carballa: Universidade de Santiago de Compostela
Xabier Bello: Universidade de Santiago de Compostela
Irene Rivero-Calle: 15706 Hospital Clínico Universitario de Santiago (SERGAS)
Ana Isabel Dacosta: 15706 Hospital Clínico Universitario de Santiago (SERGAS)
Myrsini Kaforou: Imperial College London
Dominic Habgood-Coote: Imperial College London
Aubrey J. Cunnington: Imperial College London
Marieke Emonts: Newcastle upon Tyne Hospitals NHS Foundation Trust
Jethro A. Herberg: Imperial College London
Victoria J. Wright: Imperial College London
Enitan D. Carrol: Alder Hey Children’s NHS Foundation Trust
Stephane C. Paulus: University of Oxford and the NIHR Oxford Biomedical Research Centre
Werner Zenz: Graz
Daniela S. Kohlfürst: Graz
Nina Schweintzger: Graz
Michiel Flier: University Medical Center Utrecht
Ronald Groot: Radboud University Medical Center
Luregn J. Schlapbach: University of Zürich
Philipp Agyeman: University of Bern
Andrew J. Pollard: University of Oxford and the NIHR Oxford Biomedical Research Centre
Colin Fink: University of Warwick
Taco T. Kuijpers: Amsterdam Univiersyt Medical Center (Amsterdam UMC)
Suzanne Anderson: Medical Research Council Unit at the London School of Hygene & Tropical Medicine
Ulrich Both: LMU Munich
Marko Pokorn: University of Ljubljana
Dace Zavadska: Rīga Stradins University
María Tsolia: Kyriakou Children’s Hospital
Henriëtte A. Moll: Erasmus MC Sophia Children’s Hospital
Clementien Vermont: Erasmus MC Sophia Children’s Hospital
Michael Levin: Imperial College London
Federico Martinón-Torres: 15706 Hospital Clínico Universitario de Santiago (SERGAS)
Antonio Salas: Universidade de Santiago de Compostela

Nature Communications, 2025, vol. 16, issue 1, 1-13

Abstract: Abstract Mycoplasma pneumoniae causes atypical pneumonia in children and young adults. Its lack of a cell wall makes it resistant to beta-lactams, which are the first-line treatment for typical pneumonia. Current diagnostic tests are time-consuming and have low specificity, leading clinicians to administer empirical antibiotics. Using a LASSO regression simulation approach and blood microarray data from 107 children with pneumonia (including 30 M. pneumoniae) we identify eight different transcriptomic signatures, ranging from 3-10 transcripts, that differentiate mycoplasma pneumonia from other bacterial/viral pneumonias with high accuracy (AUC: 0.84–0.95). Additionally, we demonstrate that existing signatures for broadly distinguishing viral/bacterial infections and viral/bacterial pneumonias are ineffective in distinguishing M. pneumoniae from viral pneumonia. The new signatures are successfully validated in an independent RNAseq cohort of children with pneumonia, demonstrating their robustness. The high sensibility of these signatures presents a valuable opportunity to guide the treatment and management of M. pneumoniae pneumonia patients.

Date: 2025
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DOI: 10.1038/s41467-025-55932-9

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