4.3 Article

Clinical characteristics and serum inflammatory markers of community-acquired mycoplasma pneumonia in children

Journal

CLINICAL RESPIRATORY JOURNAL
Volume 17, Issue 7, Pages 607-617

Publisher

WILEY
DOI: 10.1111/crj.13620

Keywords

cytokine; lymphocyte subsets; Mycoplasma pneumoniae pneumonia; non-mycoplasma pneumoniae pneumonia; refractory mycoplasma pneumoniae pneumonia

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This study compared the demographic and clinical characteristics, laboratory and imaging findings in children with mycoplasma pneumoniae pneumonia (MPP) and non-MPP (NMPP) children, as well as general MPP (GMPP) children and children with refractory MPP (RMPP). The results showed that children with MPP had longer fever duration and hospital stay, and a higher prevalence of pleural effusion, lung consolidation, and bronchopneumonia on imaging. The levels of inflammatory markers were significantly higher in the MPP group, and the clinical symptoms and pulmonary imaging findings were more severe in the RMPP group. IL-6, IL-10, LDH, PT, and D-dimer were identified as predictive indicators for RMPP.
BackgroundTo compare the demographic and clinical features, laboratory and imaging findings in mycoplasma pneumoniae pneumonia (MPP) children with non-MPP (NMPP) children and general MPP (GMPP) children with refractory MPP (RMPP) children and analysis the relationship with the severity of disease. MethodsThe study included 265 children with MPP and 230 children with NMPP in the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University from 2020 to 2021. The children with MPP included RMPP (n = 85) and GMPP (n = 180). Demographic and clinical characteristics, laboratory and imaging findings of all children were measured as baseline data within 24 h after admission and the differences between MPP and NMPP, RMPP and GMPP patients were compared. ROC curves were used to evaluate the diagnostic and predictive value of different indicators for RMPP. ResultsFever duration and hospital stay in children with MPP were longer than those with NMPP. The number of patients with imaging features of pleural effusion, lung consolidation and bronchopneumonia in MPP group was significantly higher than that in NMPP group. Compared with NMPP group, the levels of C-reactive protein (CRP), procalcitonin (PCT), serum amyloid A (SAA), erythrocyte sedimentation rate (ESR), lactic dehydrogenase (LDH), prothrombin time (PT), fibrinogen (FIB) and D-dimer and inflammatory cytokines (interleukin [IL]-6, IL-8, IL-10 and IL-1 beta) in MPP group were significantly higher (P < 0.05). The clinical symptoms and pulmonary imaging findings were more severe in RMPP group. The levels of white blood cell (WBC), CRP, PCT, SAA, ESR, alanine aminotransferase (ALT), LDH, ferritin, PT, FIB, D-dimer and inflammatory cytokines in RMPP group were higher than those in GMPP group. There was no significant difference in the level of lymphocyte subsets between the RMPP and GMPP group. IL-6, IL-10, LDH, PT, D-dimer and lung consolidation were independent risk factors for RMPP. IL-6 levels and LDH activity were good predictors of RMPP. ConclusionIn conclusion, there were differences in clinical characteristics and serum inflammatory markers between MPP group and NMPP group, RMPP group and GMPP group. IL-6, IL-10, LDH, PT and D-dimer can be used as predictive indicators for RMPP.

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