1
|
Lu W, Wu X, Xu Y, Wang T, Xiao A, Guo X, Xu Y, Li D, Li S. Predictive value of bronchoscopy combined with CT score for refractory mycoplasma pneumoniae pneumonia in children. BMC Pulm Med 2024; 24:251. [PMID: 38778338 PMCID: PMC11110382 DOI: 10.1186/s12890-024-02996-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 04/04/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION Mycoplasma pneumoniae pneumonia (MPP) is prevalent in paediatric patients and can progress to refractory mycoplasma pneumoniae pneumonia (RMPP). OBJECTIVE To assess the predictive value of bronchoscopy combined with computed tomography (CT) score in identifying RMPP in children. METHODS A retrospective analysis was conducted on 244 paediatric patients with MP, categorising them into RMPP and general mycoplasma pneumoniae pneumonia (GMPP) groups. A paired t-test compared the bronchitis score (BS) and CT score before and after treatment, supplemented by receiver operating characteristic (ROC) analysis. RESULTS The RMPP group showed higher incidences of extrapulmonary complications and pleural effusion (58.10% and 40%, respectively) compared with the GMPP group (44.60%, p = 0.037 and 18.71%, p < 0.001, respectively). The CT scores for each lung lobe were statistically significant between the groups, except for the right upper lobe (p < 0.05). Correlation analysis between the total CT score and total BS yielded r = 0.346 and p < 0.001. The ROC for BS combined with CT score, including area under the curve, sensitivity, specificity, and cut-off values, were 0.82, 0.89, 0.64, and 0.53, respectively. CONCLUSION The combined BS and CT score method is highly valuable in identifying RMPP in children.
Collapse
Affiliation(s)
- Weihong Lu
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, No. 88 of Jiankang Road, Weihui, Henan province, 453100, China
| | - Xiangtao Wu
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, No. 88 of Jiankang Road, Weihui, Henan province, 453100, China
| | - Yali Xu
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, No. 88 of Jiankang Road, Weihui, Henan province, 453100, China
| | - Tuanjie Wang
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, No. 88 of Jiankang Road, Weihui, Henan province, 453100, China
| | - Aiju Xiao
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, No. 88 of Jiankang Road, Weihui, Henan province, 453100, China
| | - Xixia Guo
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, No. 88 of Jiankang Road, Weihui, Henan province, 453100, China
| | - Yuping Xu
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, No. 88 of Jiankang Road, Weihui, Henan province, 453100, China
| | - Duoduo Li
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, No. 88 of Jiankang Road, Weihui, Henan province, 453100, China
| | - Shujun Li
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, No. 88 of Jiankang Road, Weihui, Henan province, 453100, China.
| |
Collapse
|
2
|
Wang F, Cheng Q, Duo H, Wang J, Yang J, Jing S, Li J, Zhou X, Shang Y, Chen N, Tian Z, Zhang H, Cai X. Childhood Mycoplasma pneumoniae: epidemiology and manifestation in Northeast and Inner Mongolia, China. Microbiol Spectr 2024; 12:e0009724. [PMID: 38606996 PMCID: PMC11064562 DOI: 10.1128/spectrum.00097-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/18/2024] [Indexed: 04/13/2024] Open
Abstract
Mycoplasma pneumoniae (MP) is commonly detected in children. However, the epidemiological trends of MP in Northeast (NE) China are unclear. This retrospective study aimed to investigate the prevalence of MP infections in this understudied region. The clinical manifestations and bronchoscopic findings observed in hospitalized patients with severe Mycoplasma pneumoniae pneumonia (SMPP) were collected from comprehensive data obtained from six tertiary hospitals in NE and Inner Mongolian (IM) China, from 1 January 2017 to 31 December 2023. A total of 5,593,530 children who visited the outpatient and emergency departments, and 412,480 inpatient hospitalized children were included in the study. The positivity rate of MP immunoglobulin M (IgM) in the children who visited the outpatient and emergency departments varied from 7.80% to 10.12%, whereas that of MP infection in hospitalized children ranged from 27.18% to 30.10%. Children hospitalized for MP infection were mainly concentrated in the 1- to 4-year (41.39%) and 4- to 7-year (24.25%) age groups. Before 2020, the season with the highest incidence of MP was winter. After the implementation of non-pharmaceutical interventions (NPIs), the MP epidemic season changed, and the number of children with MP infections decreased; however, the proportion of MP infections in hospitalized children did not change significantly. Starting from August 2023, the MP infection rate in outpatient, emergency, and hospitalized children increased sharply, with SMPP and its complications (e.g., plastic bronchitis and pleural effusion) increasing significantly. MP is prevalent in NE and IM, China. When the NPIs ended, MP infection showed a delayed outbreak trend, and the number of children with severe infection increased significantly. IMPORTANCE In Northeastern (NE) and Inner Mongolia (IM), the incidence of Mycoplasma pneumoniae (MP) infections, including severe Mycoplasma pneumoniae pneumonia (SMPP), is high, posing health risks and imposing substantial economic burdens on the local population. Therefore, it is imperative to prioritize the study of MP prevalence and address the research gaps in MP epidemiology in these areas of China. We obtained a comprehensive collection of pediatric outpatient, emergency, and inpatient data from six public Grade III hospitals. We believe that our study makes a significant contribution to the literature because understanding regional variations in MP infections can help healthcare professionals tailor prevention and treatment strategies, and studying bronchoscopic manifestations can provide insights into the impact of the disease on the respiratory system, potentially leading to a more effective clinical management.
Collapse
Affiliation(s)
- Fei Wang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Qi Cheng
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Hongying Duo
- Department of Pediatrics, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China
| | - Jichun Wang
- Department of Pediatrics, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China
| | - Jingjing Yang
- Diagnosis and Treatment Center for Children, The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Shujun Jing
- Department of Respiratory Medicine, Dalian Women and Children’s Medical Center Group, Dalian, Liaoning, China
| | - Jing Li
- Department of Pediatrics, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Xiandong Zhou
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yunxiao Shang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Ning Chen
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Zhiliang Tian
- Department of Pediatrics, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Han Zhang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xuxu Cai
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| |
Collapse
|
3
|
Zheng Y, Mao G, Dai H, Li G, Liu L, Chen X, Zhu Y. Early predictors of delayed radiographic resolution of lobar pneumonia caused by Mycoplasma pneumoniae in children: a retrospective study in China. BMC Infect Dis 2024; 24:414. [PMID: 38641804 PMCID: PMC11027392 DOI: 10.1186/s12879-024-09289-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 04/03/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Lobar pneumonia caused by Mycoplasma pneumoniae is a relatively difficult-to-treat pneumonia in children. The time of radiographic resolution after treatment is variable, a long recovery time can result in several negative effects, and it has attracted our attention. Therefore, exploring factors associated with delayed radiographic resolution will help to identify these children at an early stage and prepare for early intervention. METHODS The data of 339 children with lobar pneumonia caused by Mycoplasma pneumoniae were collected from the Department of Pediatrics of Fu Yang People's Hospital, China from January 2021 to June 2022. After discharge, the children were regularly followed up in the outpatient department and on the WeChat platform for > 8 weeks. According to whether pulmonary imaging (chest radiography or plain chest computed tomography) returned to normal within 8 weeks, the children were divided into the delayed recovery group (DRG) (n = 69) and the normal recovery group (NRG) (n = 270). The children's general information, laboratory examination findings, bronchoscopy results, and imaging findings were retrospectively analyzed. Single-factor analysis was performed to identify the risk factors for delayed radiographic resolution of lobar pneumonia caused by Mycoplasma pneumoniae, and the factors with statistically significant differences underwent multiple-factor logistic regression analysis. Receiver operating characteristic (ROC) analysis was then performed to calculate the cutoff value of early predictive indicators of delayed radiographic resolution. RESULTS Single-factor analysis showed that the following were significantly greater in the DRG than NRG: total fever duration, the hospitalization time, C-reactive protein (CRP) level, lactate dehydrogenase (LDH) level, D-dimer level, pulmonary lesions involving two or more lobes, a large amount of pleural effusion, the time to interventional bronchoscopy, and mucus plugs formation. Multivariate logistic regression analysis showed that the hospitalization time, CRP level, LDH level, pulmonary lesions involving two or more lobes, and a large amount of pleural effusion were independent risk factors for delayed radiographic resolution of lobar pneumonia caused by Mycoplasma pneumoniae. The cutoff values on the receiver operating characteristic curve were a hospitalization time of ≥ 10.5 days, CRP level of ≥ 25.92 mg/L, and LDH level of ≥ 378 U/L. CONCLUSION If patients with lobar pneumonia caused by Mycoplasma pneumoniae have a hospitalization time of ≥ 10.5 days, CRP level of ≥ 25.92 mg/L, and LDH level ≥ 378 U/L, the time of radiographic resolution is highly likely to exceed 8 weeks. Pediatricians must maintain a high level of vigilance for these factors, control the infection as early as possible, strengthen airway management, and follow up closely to avoid complications and sequelae of Mycoplasma pneumoniae pneumonia.
Collapse
Affiliation(s)
- Yu Zheng
- Department of Pediatrics, Fu Yang People's Hospital, No.501, Sanqing Road, Yingzhou District, 236000, Fuyang, Anhui Province, China
| | - Guoshun Mao
- Department of Pediatrics, Fu Yang People's Hospital, No.501, Sanqing Road, Yingzhou District, 236000, Fuyang, Anhui Province, China
| | - Hongchen Dai
- Department of Pediatrics, Fu Yang People's Hospital, No.501, Sanqing Road, Yingzhou District, 236000, Fuyang, Anhui Province, China
| | - Guitao Li
- Department of Pediatrics, Fu Yang People's Hospital, No.501, Sanqing Road, Yingzhou District, 236000, Fuyang, Anhui Province, China
| | - Liying Liu
- Department of Pediatrics, Fu Yang People's Hospital, No.501, Sanqing Road, Yingzhou District, 236000, Fuyang, Anhui Province, China
| | - Xiaying Chen
- Department of Pediatrics, Fu Yang People's Hospital, No.501, Sanqing Road, Yingzhou District, 236000, Fuyang, Anhui Province, China
| | - Ying Zhu
- Department of Pediatrics, Fu Yang People's Hospital, No.501, Sanqing Road, Yingzhou District, 236000, Fuyang, Anhui Province, China.
| |
Collapse
|
4
|
Gao J, Wu R, Zhang YJ, Xu X, Sa RN, Li XA, Liu CY. Quantitative evaluation of bronchoalveolar lavage for the treatment of Severe mycoplasma pneumoniae pneumonia in children-A new complementary index: Bronchial Insufflation Sign Score. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024. [PMID: 38581196 DOI: 10.1002/jcu.23678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 03/04/2024] [Accepted: 03/18/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the value of Broncoplasma Insufflation Sign in lung ultrasound signs in assessing the efficacy of bronchoalveolar lavage in Severe mycoplasma pneumoniae pneumonia in children. METHODS Forty-seven children with Severe mycoplasma pneumoniae pneumonia were treated with medication and bronchial lavage. Laboratory and imaging results were collected, and lung ultrasonography was performed before bronchoalveolar lavage and 1, 3, and 7 days after lavage to record changes in Bronchial Insufflation Sign and changes in the extent of solid lung lesions. Factors affecting the effectiveness of bronchoalveolar lavage were analyzed using logistic regression and other factors. RESULTS Bronchial Insufflation Sign Score and the extent of lung solid lesions were the factors affecting the effectiveness of bronchoalveolar lavage treatment. The smaller the area of lung solid lesions and the higher the Bronchial Insufflation Sign Score, the more effective the results of bronchoalveolar lavage treatment were, and the difference was statistically significant, with a difference of p < 0.05. The Bronchial Insufflation Sign Score had the highest sensitivity and specificity for the prediction of the efficacy of bronchoalveolar lavage treatment in the first 7 days after the treatment. CONCLUSION Bronchial Insufflation Sign Score combined with the extent of solid lung lesions can assess the efficacy of bronchoalveolar lavage in the treatment of Severe mycoplasma pneumoniae pneumonia in children; lung ultrasound is a timely and effective means of assessing the efficacy of bronchoalveolar lavage.
Collapse
Affiliation(s)
- Jin Gao
- Baotou Medical College, Baotou, China
| | - R Wu
- Ordos Central Hospital, Ordos, China
| | - Y J Zhang
- Ordos Central Hospital, Ordos, China
| | - X Xu
- Ordos Central Hospital, Ordos, China
| | - R N Sa
- Ordos Central Hospital, Ordos, China
| | - X A Li
- Ordos Central Hospital, Ordos, China
| | - C Y Liu
- Baotou Medical College, Baotou, China
| |
Collapse
|
5
|
Liu X, Zhang Q, Chen H, Hao Y, Zhang J, Zha S, Zhou B, Yi Y, Xiao R, Hu K. Comparison of the clinical characteristics in parents and their children in a series of family clustered Mycoplasma pneumoniae infections. BMC Pulm Med 2024; 24:107. [PMID: 38439032 PMCID: PMC10910824 DOI: 10.1186/s12890-024-02922-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/22/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Mycoplasma pneumoniae infections have increased in China recently, causing some evidence of familial clustering. The purpose of this study was to compare the clinical features of parents and children in cases of familial clustering of Mycoplasma pneumoniae infection. METHODS A retrospective analysis was performed on the cases of familial clustering of Mycoplasma pneumoniae infection, and the clinical characteristics of parents and children were compared. RESULTS We identified 63 families, of these, 57 (65.5%) adults and 65 (94.2%) children required hospitalization. Fifty-seven adults (mean age 35.1 ± 4.6 years, 80.7% female) and 55 children (mean age 6.3 ± 3.9 years, 54.5% female) were included in the analysis. The incidence of mycoplasma infection in adults had increased gradually over the past year, while the rate in children had spiked sharply since June 2023. The clinical symptoms were similar in the two groups, mainly fever and cough. The peak temperature of children was higher than that of adults (39.1 ± 0.7℃ vs 38.6 ± 0.7℃, p = 0.004). Elevated lactate dehydrogenase was more common in children than in adults (77.8% vs 11.3%, p < 0.001). Bronchial pneumonia and bilateral involvement were more common in children, while adults usually had unilateral involvement. Three (60%) adults and 21 (52.5%) children were macrolide-resistant Mycoplasma pneumoniae infected. Children were more likely to be co-infected (65.5% vs 22.8%, p < .001). Macrolides were used in most children and quinolones were used in most adults. Ten (18.2%) children were diagnosed with severe Mycoplasma pneumoniae pneumonia, whereas all adults had mild disease. Children had a significantly longer fever duration than adults ((5.6 ± 2.2) days vs (4.1 ± 2.2) days, p = 0.002). No patient required mechanical ventilation or died. CONCLUSIONS Mycoplasma pneumoniae infection shows a familial clustering epidemic trend at the turn of summer and autumn, with different clinical characteristics between parents and children.
Collapse
Affiliation(s)
- Xu Liu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Qingfeng Zhang
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Hao Chen
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yueying Hao
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Jingyi Zhang
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Shiqian Zha
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Beini Zhou
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yaohua Yi
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, 430079, China
- Research Center of Digital Imaging and Intelligent Perception, Wuhan University, Wuhan, 430079, China
| | - Rui Xiao
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, 430079, China
- Research Center of Digital Imaging and Intelligent Perception, Wuhan University, Wuhan, 430079, China
| | - Ke Hu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
| |
Collapse
|
6
|
Saleem H, Jadoon SK, Akbar A, Hamid Awan N, Arshad Abbasi E, Qadeer Abbasi J, Khursheed S, Ahmed J, Saleem Khan M, Tasneem S. The Impact of Respiratory Function Training and Rehabilitation Nursing on the Recovery of Patients With Mycoplasma Pneumoniae Pneumonia. Cureus 2024; 16:e53461. [PMID: 38435183 PMCID: PMC10909399 DOI: 10.7759/cureus.53461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction The goal of this study was to see how people who had been diagnosed with Mycoplasma pneumoniae pneumonia (MPP) responded to respiratory function training and rehabilitation (RFTR) nursing. Methodology A total of 122 patients (five to 12 years of age) diagnosed with Mycoplasma pneumoniae pneumonia (MPP) and refractory Mycoplasma pneumoniae pneumonia (RMPP) using enzyme-linked immunoassay and PCR were included in this study. These patients were hospitalized at a tertiary care hospital from February 2022 to December 2022. Upon admission, they were assigned a numerical identifier based on the order of admission. Subsequently, they were randomly allocated into two equal groups: the observation (OG) and the control (CG), with each group consisting of 61 patients. Nano-acupoint sticking (NAS) therapy along with respiratory function training and rehabilitation (RFTR) nursing interventions were implemented for patients in the OG. Results The observed disparities in forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and the ratio of FEV1 to FVC among the patients did not exhibit significant disparity prior to the commencement of treatment (p values of 0.700, 0.105, and 0.829, respectively). There was no significant difference observed in the range of inflammation in the right lung (p=0.523). Inflammation in the left lung and fluid volume in both lungs are statistically different in both groups (p values of 0.001 and 0.000, respectively). The patients in the observation group exhibited a shorter duration of cough and sputum, disappearance of lung sounds, and length of hospital stays (LOS) compared to the other groups, with statistical significance (p<0.05). Conclusion Nano-acupoint sticking (NAS) therapy with respiratory function training and rehabilitation (RFTR) in nursing practice has shown enhanced rehabilitation outcomes for individuals diagnosed with Mycoplasma pneumoniae pneumonia (MPP). The present study focuses on the application of NAS therapy in the context of RFTR for individuals diagnosed with MPP.
Collapse
Affiliation(s)
- Humayun Saleem
- Public Health, Health Services Academy, Muzaffarabad, PAK
| | | | - Amna Akbar
- Accident and Emergency, District Headquarter Hospital Jhelum Valley, Muzaffarabad, PAK
| | | | | | | | - Soffia Khursheed
- Pathology, Pakistan Institute of Medical Sciences, Islamabad, PAK
| | - Jhanzeb Ahmed
- General Surgery, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, CHN
| | | | | |
Collapse
|
7
|
Song Z, Jia G, Luo G, Han C, Zhang B, Wang X. Global research trends of Mycoplasma pneumoniae pneumonia in children: a bibliometric analysis. Front Pediatr 2023; 11:1306234. [PMID: 38078315 PMCID: PMC10704248 DOI: 10.3389/fped.2023.1306234] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/13/2023] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Mycoplasma pneumoniae pneumonia (MPP), attributable to Mycoplasma pneumoniae (MP), represents a predominant form of community-acquired pneumonia in pediatric populations, thereby posing a significant threat to pediatric health. Given the burgeoning volume of research literature associated with pediatric MPP in recent years, it becomes imperative to undertake a bibliometric analysis aimed at delineating the current research landscape and emerging trends, thereby furnishing a framework for subsequent investigations. METHODS A comprehensive literature search targeting pediatric MPP was conducted in the Web of Science Core Collection. After the removal of duplicate entries through Endnote software, the remaining articles were subject to scientometric analysis via Citespace software, VOSviewer software and R language, focusing on variables such as publication volume, contributing nations, institutions and authors, references and keywords. RESULTS A total of 1,729 articles pertinent to pediatric MPP were included in the analysis. China and the United States emerged as the nations with the highest publication output. Italian scholar Susanna Esposito and Japanese scholar Kazunobu Ouchi were the most influential authors in the domain of pediatric MPP. Highly-cited articles primarily focused on the epidemiological investigation of pediatric MPP, the clinical characteristics and treatment of macrolide-resistant MPP, and biomarkers for refractory Mycoplasma pneumoniae pneumonia (RMPP). From the corpus of 1,729 articles, 636 keywords were extracted and categorized into ten clusters: Cluster #0 centered on molecular-level typing of macrolide-resistant strains; Cluster #1 focused on lower respiratory tract co-infections; Clusters #2 and #6 emphasized other respiratory ailments caused by MP; Cluster #3 involved biomarkers and treatment of RMPP; Clusters #4 and #9 pertained to extrapulmonary complications of MPP, Clusters #5 and #7 addressed etiological diagnosis of MPP, and Cluster #8 explored pathogenic mechanisms. CONCLUSIONS The past few years have witnessed extensive attention directed towards pediatric MPP. Research in pediatric MPP principally revolves around diagnostic techniques for MP, macrolide resistance, complications of MPP, treatment and diagnosis of RMPP, and elucidation of pathogenic mechanisms. The present study provides pediatric clinicians and researchers with the research status and focal points in this field, thereby guiding the orientation of future research endeavors.
Collapse
Affiliation(s)
- Zhe Song
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Guangyuan Jia
- Department of Pediatrics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Guangzhi Luo
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Chengen Han
- Department of Pediatrics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Baoqing Zhang
- Department of Pediatrics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xiao Wang
- Department of Pediatrics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| |
Collapse
|
8
|
Li YT, Zhang J, Wang MZ, Ma YM, Zhi K, Dai FL, Li SJ. Changes in coagulation markers in children with Mycoplasma pneumoniae pneumonia and their predictive value for Mycoplasma severity. Ital J Pediatr 2023; 49:143. [PMID: 37858230 PMCID: PMC10588045 DOI: 10.1186/s13052-023-01545-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND This study investigates the correlation between coagulation levels and the severity of Mycoplasma pneumoniae pneumonia (MPP) in children. In addition, the study analyses the predictive value of coagulation abnormalities in MPP combined with necrotising pneumonia (NP). METHODS A total of 170 children with MPP who underwent treatment between June 2021 and February 2022 were selected for this study. The study population was divided into groups according to the severity of the disease to compare differences in the incidence of coagulation abnormalities between the groups. The participants were also divided into groups according to imaging manifestations to compare the differences in coagulation function among the different groups. All data information was processed for statistical analysis using SPSS Statistics 25.0 and GraphPad Prism 7.0 statistical analysis software. RESULTS The incidence of coagulation abnormalities in the children in the severe MPP (SMPP) group was significantly higher than that in the normal MPP (NMPP) group (P < 0.05). The multi-factor logistic regression analysis revealed that the D-dimer level is an independent risk factor for the development of NP in SMPP (P < 0.05). The receiver operating characteristic curve analysis revealed statistically significant differences (P < 0.05) in D-dimer, fibrinogen degeneration products (FDP), neutrophils, lactate dehydrogenase and serum ferritin for predicting SMPP combined with NP. Bronchoscopic manifestations of coagulation indicators (D-dimer and FDP levels) were significantly higher in the mucus plug group than in the non-mucus plug group, while the activated partial thromboplastin time levels were lower in the former than in the latter (P < 0.05). CONCLUSION The degree of elevated D-dimer and FDP levels was positively correlated with the severity of MPP, with elevated serum D-dimer levels (> 3.705 mg/L) serving as an independent predictor of MPP combined with NP in children.
Collapse
Affiliation(s)
- Yong-Tao Li
- Department of Pediatrics, Luoyang Maternal and Child Health Hospital, No. 206 of Tongqu Road, 471000, Luoyang, Henan province, China
| | - Ju Zhang
- Department of Pediatrics, The First Affiliated Hospital of Xinxiang Medical University, No. 88 of Jiankangroad, 453100, Weihui, Henan province, China
| | - Meng-Zhu Wang
- Department of Pediatrics, The First Affiliated Hospital of Xinxiang Medical University, No. 88 of Jiankangroad, 453100, Weihui, Henan province, China
| | - Yu-Mei Ma
- Department of Pediatrics, Luoyang Maternal and Child Health Hospital, No. 206 of Tongqu Road, 471000, Luoyang, Henan province, China
| | - Ke Zhi
- Department of Pediatrics, Luoyang Maternal and Child Health Hospital, No. 206 of Tongqu Road, 471000, Luoyang, Henan province, China
| | - Fu-Li Dai
- Department of Pediatrics, Luoyang Maternal and Child Health Hospital, No. 206 of Tongqu Road, 471000, Luoyang, Henan province, China
| | - Shu-Jun Li
- Department of Pediatrics, The First Affiliated Hospital of Xinxiang Medical University, No. 88 of Jiankangroad, 453100, Weihui, Henan province, China.
| |
Collapse
|
9
|
Wu X, Lu W, Wang T, Xiao A, Guo X, Xu Y, Li S, Liu X, Zeng H, He S, Zhang X. Optimization strategy for the early timing of bronchoalveolar lavage treatment for children with severe mycoplasma pneumoniae pneumonia. BMC Infect Dis 2023; 23:661. [PMID: 37798699 PMCID: PMC10557288 DOI: 10.1186/s12879-023-08619-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Early evaluation of severe mycoplasma pneumoniae pneumonia (SMPP) and the prompt utilization of fiberoptic bronchoscopic manipulation can effectively alleviate complications and restrict the progression of sequelae. This study aim to establish a nomogram forecasting model for SMPP in children and explore an optimal early therapeutic bronchoalveolar lavage (TBAL) treatment strategy. METHODS This retrospective study included children with mycoplasma pneumoniae pneumonia (MPP) from January 2019 to December 2021. Multivariate logistic regression analysis was used to screen independent risk factors for SMPP and establish a nomogram model. The bootstrap method was employed and a receiver operator characteristic (ROC) curve was drawn to evaluate the accuracy and robustness of the model. Kaplan-Meier analysis was used to assess the effect of lavage and hospitalization times. RESULTS A total of 244 cases were enrolled in the study, among whom 68 with SMPP and 176 with non-SMPP (NSMPP). A prediction model with five independent risk factors: left upper lobe computed tomography (CT) score, sequential organ failure assessment (SOFA) score, acute physiology and chronic health assessment (APACHE) II score, bronchitis score (BS), and c-reactive protein (CRP) was established based on the multivariate logistic regression analysis. The ROC curve of the prediction model showed the area under ROC curve (AUC) was 0.985 (95% confidence interval (CI) 0.972-0.997). The Hosmer-Lemeshow goodness-of-fit test results showed that the nomogram model predicted the risk of SMPP well (χ2 = 2.127, P = 0.977). The log-rank result suggested that an early BAL treatment could shorten MPP hospitalization time (P = 0.0057). CONCLUSION This nomogram model, based on the left upper lobe CT score, SOFA score, APACHE II score, BS, and CRP level, represents a valuable tool to predict the risk of SMPP in children and optimize the timing of TBAL.
Collapse
Affiliation(s)
- Xiangtao Wu
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510260, China
- Department of Neonatology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Weihong Lu
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Tuanjie Wang
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Aiju Xiao
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Xixia Guo
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Yali Xu
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Shujun Li
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China.
| | - Xue Liu
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Hanshi Zeng
- Department of Neonatology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Shaoru He
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510260, China
- Department of Neonatology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Xingliang Zhang
- Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China.
- Department of Respiratory Medicine, Institute of Pediatrics, Shenzhen Children's Hospital, Shenzhen, 518038, China.
| |
Collapse
|
10
|
Luo Y, Wang Y, Gong K. Risk prediction model for long-term atelectasis in children with pneumonia. BMC Pulm Med 2023; 23:169. [PMID: 37189036 DOI: 10.1186/s12890-023-02464-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 04/29/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND This study aimed to develop a risk prediction model for long-term atelectasis in children with pneumonia. METHODS A retrospective study of 532 children with atelectasis was performed at the Children's Hospital of Chongqing Medical University from February 2017 to March 2020. The predictive variables were screened by LASSO regression analysis and the nomogram was drawn by R software. The area under the Receiver Operating Characteristic (ROC) curve, calibration chart and decision curve were used to evaluate the predictive accuracy and clinical utility. 1000 Bootstrap resampling was used for internal verification. RESULTS Multivariate logistic regression analysis showed that clinical course before bronchoscopy, length of stay, bronchial mucus plug formation, age were independent risk factors for long-term atelectasis in children. The area under the ROC curve of nomogram was 0.857(95% CI = 0.8136 ~ 0.9006) in training set and 0.849(95% CI = 0.7848-0.9132) in the testing set. The calibration curve demonstrated that the nomogram was well-fitted, and decision curve analysis (DCA) showed that the nomogram had good clinical utility. CONCLUSIONS The model based on the risk factors of long-term atelectasis in children with pneumonia has good predictive accuracy and consistency, which can provide a certain reference value for clinical prevention and treatment of long-term atelectasis in children.
Collapse
Affiliation(s)
- Yonghan Luo
- Second Department of Infectious Disease, Kunming Children's Hospital, Kunming, 650000, Yunnan, China
| | - Yanchun Wang
- Second Department of Infectious Disease, Kunming Children's Hospital, Kunming, 650000, Yunnan, China.
| | - Kenan Gong
- Department of Respiratory Diseases, Children's Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
11
|
Tang X, Ren H, Qian J, Wang Y, Xiang L, Zhao Z. Bronchoalveolar lavage improved ventilation/perfusion matching in pediatric severe mycoplasma pneumoniae pneumonia with lung consolidation. Pediatr Pulmonol 2023; 58:350-352. [PMID: 36193868 DOI: 10.1002/ppul.26174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 09/11/2022] [Accepted: 09/28/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Xiaoliao Tang
- Department of Critical Care Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hong Ren
- Department of Critical Care Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Juan Qian
- Department of Critical Care Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ying Wang
- Department of Critical Care Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Long Xiang
- Department of Critical Care Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Department of Neonatology, Second People's Hospital of Kashgar, Xinjiang Uygur Autonomous Region, China
| | - Zhanqi Zhao
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, China.,Institute of Technical Medicine, Furtwangen University, Villingen-Schwenningen, Germany
| |
Collapse
|
12
|
Lu J, Zhang J, Wang G, Zhang X, Li Z. Effects of bronchoalveolar lavage on Mycoplasma Pneumoniae pneumonia: A propensity score matched-cohort study. Front Pediatr 2022; 10:1066640. [PMID: 36683805 PMCID: PMC9846808 DOI: 10.3389/fped.2022.1066640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the efficacy and safety of BAL in treating MPP. METHODS From January 2013 to January 2019, 1,689 pediatric patients with MPP were analyzed retrospectively. Patients were subdivided into BAL group and non-BAL group according to whether they received BAL treatment within seven days after admission. The propensity score matching method matched patients' baseline characteristics (1:1). The primary outcomes were hospital stays and the cure rate. Secondary outcomes included mortality, co-infection, repeat hospitalization within 30 days, and total cost of treatment. RESULTS After matching, 524 patients (BAL: 262; control: 262) were recorded. The BAL group had significantly shorter hospital stays (OR: 0.5, 95% CI: 0.4-0.7). Meanwhile, BAL did not significantly modify the cost, co-infection rate, and mortality. In subgroup analyses, the group with BAL intervention within three days had a significantly shorter hospital stay (OR: 0.4, 95% CI: 0.3-0.5) compared with the group with BAL intervention three days after admission. CONCLUSIONS Early BAL intervention is a better treatment than conventional drug therapy alone, and no significant complications were seen in this study. BAL intervention has an excellent clinical benefit. The earlier the intervention, the better the effect.
Collapse
Affiliation(s)
- Jinmiao Lu
- Department of Pharmacy, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Junqi Zhang
- Department of Pharmacy, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Guangfei Wang
- Department of Pharmacy, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Xiaobo Zhang
- Department of Respiratory Disease, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| | - Zhiping Li
- Department of Pharmacy, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China
| |
Collapse
|