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Méndez-Echevarría A, Calle-Miguel L, Miralbés S, Barreiro-Pérez S, Afonso-Rodriguez O, Soler-Simón JA, Espeleta A, Jiménez-Jiménez AB, Méndez-Sánchez A, Rementeria-Radigales JI, Guerrero-Del-Cueto F, Laveglia V, Ortiz-Valentín I, Gómez-Mera E, Fernández-Puentes V, Rodríguez-Noriega-Bejar L, Bustillo M, Retuerta A, Fernàndez-Cantalejo J, Sanz-Rueda L, Ibáñez MM, Berzosa A, Fernández-Ledesma B, Álvaro A, Santamaría-Barrena T, Carazo-Gallego B, Moraleda C, Calvo C. Increased Severity of Mycoplasma pneumoniae Infections in Spanish Children. Pediatr Infect Dis J 2024:00006454-990000000-00927. [PMID: 38920379 DOI: 10.1097/inf.0000000000004461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
BACKGROUND Since the end of 2023, an elevated incidence and severity of Mycoplasma pneumoniae infections among children in Asia has been noted. Subsequently, this trend was observed in several European countries although limited data are currently available. We conducted a national study to delineate the ongoing M. pneumoniae outbreak in our country. METHODS A multicenter retrospective observational study was conducted across 32 hospitals in Spain, encompassing patients under 18 years old hospitalized for M. pneumoniae infection from January 2023 to March 2024. Infection was confirmed by positive polymerase chain reaction and/or by 2 serological tests. RESULTS A total of 623 children were included, with 79% of cases diagnosed in the final 3 months of the study period. Pneumonia was the most common diagnosis (87%). Respiratory symptoms were present in 97% of cases, with 62% requiring oxygen supplementation and 14% requiring admission to the pediatric intensive care unit (PICU). Risk factors for PICU admission included the presence of neurological symptoms, hypoxemia and a history of prematurity. Children admitted to the PICU exhibited significantly higher neutrophil counts upon admission. CONCLUSIONS We have observed a notable increase in hospital admissions, including PICU support by up to 14%, due to M. pneumoniae infection in our country since November 2023, indicative of a more severe clinical course associated with this pathogen.
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Affiliation(s)
- Ana Méndez-Echevarría
- From the Pediatric Infectious and Tropical Diseases Department, La Paz Hospital, Madrid, Spain
- Translational Research Network in Pediatric Infectious Diseases, Madrid, Spain
- Institute for Health Research, IdiPAZ, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
- Pediatric Department, Autonomous University of Madrid, Madrid, Spain
| | | | | | - Sagrario Barreiro-Pérez
- From the Pediatric Infectious and Tropical Diseases Department, La Paz Hospital, Madrid, Spain
| | | | | | - Ana Espeleta
- Hospital Universitario del Niño Jesús, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | - Azucena Retuerta
- Hospital Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | | | | | | | | | | | | | | | | | | | - Cristina Calvo
- From the Pediatric Infectious and Tropical Diseases Department, La Paz Hospital, Madrid, Spain
- Translational Research Network in Pediatric Infectious Diseases, Madrid, Spain
- Institute for Health Research, IdiPAZ, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
- Pediatric Department, Autonomous University of Madrid, Madrid, Spain
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Jia W, Zhang X, Li P, Sun R, Wang D, Song C. Development and validation of an online dynamic nomogram system for pulmonary consolidation in children with Mycoplasma pneumoniae pneumonia. Eur J Clin Microbiol Infect Dis 2024; 43:1231-1239. [PMID: 38656425 DOI: 10.1007/s10096-024-04834-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION The occurrence of pulmonary consolidation in children with Mycoplasma pneumoniae pneumonia (MPP) can lead to exacerbation of the disease. Therefore, early identification of children with MPP in combination with pulmonary consolidation is critical. The purpose of this study was to develop a straightforward, easy-to-use online dynamic nomogram for the identification of children with MPP who are at high risk of developing pulmonary consolidation. METHODS 491 MPP patients were chosen and divided randomly into a training cohort and an internal validation cohort at a 4:1 ratio. Multi-factor logistic regression was used to identify the risk variables for mixed pulmonary consolidation in children with Mycoplasma pneumoniae (MP). The selected variables were utilized to build the nomograms and validated using the C-index, decision curve analysis, calibration curves, and receiver operating characteristic (ROC) curves. RESULTS Seven variables were included in the Nomogram model: age, fever duration, lymphocyte count, C-reactive protein (CRP), ferritin, T8 lymphocyte percentage, and T4 lymphocyte percentage. We created a dynamic nomogram that is accessible online ( https://ertong.shinyapps.io/DynNomapp/ ). The C-index was 0.90. The nomogram calibration curves in the training and validation cohorts were highly comparable to the standard curves. The area under the curve (AUC) of the prediction model was, respectively, 0.902 and 0.883 in the training cohort and validation cohort. The decision curve analysis (DCA) curve shows that the model has a significant clinical benefit. CONCLUSIONS We developed a dynamic online nomogram for predicting combined pulmonary consolidation in children with MP based on 7 variables for the first time. The predictive value and clinical benefit of the nomogram model were acceptable.
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Affiliation(s)
- Wanyu Jia
- Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, 450018, Henan, China
| | - Xue Zhang
- Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, 450018, Henan, China
| | - Peng Li
- Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, 450018, Henan, China
| | - Ruiyang Sun
- Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, 450018, Henan, China
| | - Daobin Wang
- Zhecheng County People's Hospital, Shangqiu, 476200, Henan, China
| | - Chunlan Song
- Henan Province Engineering Research Center of Diagnosis and Treatment of Pediatric Infection and Critical Care, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, 450018, Henan, China.
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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.
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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.
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Huang X, Gu H, Wu R, Chen L, Lv T, Jiang X, Li H, Guo B, Liu J, Li D, Zhao D, Liu F. Chest imaging classification in Mycoplasma pneumoniae pneumonia is associated with its clinical features and outcomes. Respir Med 2024; 221:107480. [PMID: 38043865 DOI: 10.1016/j.rmed.2023.107480] [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: 06/29/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND The imaging findings of Mycoplasma pneumoniae pneumonia (MPP) vary; however, few studies have focused on the relationship of imaging classification with clinical manifestations and outcomes. OBJECTIVE To prospectively investigate whether chest imaging classification in Mycoplasma pneumoniae pneumonia (MPP) is associated with its clinical features and outcomes. METHODS A total of 1,401 hospitalized children with MPP were enrolled from January 2019 to December 2021. Imaging findings were categorized as bronchopneumonia and consolidation/atelectasis according to X-ray, and bronchopneumonia, consolidation/atelectasis, bronchiolitis, and mosaic pattern according to computed tomography (CT). Clinical characteristics and outcomes of patients with different imaging classifications were prospectively analyzed based on electronic medical records. RESULTS Bronchopneumonia was the most common finding (59.6%), while consolidation/atelectasis was the most severe group. Clinical manifestations and laboratory indicators for the consolidation/atelectasis group included serious abnormalities. Further, outcomes of the patients were worse, including having longer total durations of fever and hospitalization, greater hospitalization expenses, and a higher likelihood of developing refractory MPP, necrotizing pneumonia, and bronchiolitis obliterans (BO) in this group. The incidence of bronchiolitis, a disease characterized by a high prevalence of fever, moist rales, and an atopic constitution, tended to increase after the coronavirus disease pandemic and predisposed patients to BO. A mosaic pattern occurred in allergic and young individuals, with wheezing as the main manifestation, with patients having relatively mild symptoms and good outcomes. CONCLUSION Different imaging classifications have different clinical features and clinical outcomes; thus, formulating an imaging-based classification system is of great clinical value.
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Affiliation(s)
- Xia Huang
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Haiyan Gu
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Ruxi Wu
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Lei Chen
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Tian Lv
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Xinyi Jiang
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Huili Li
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Bin Guo
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Jie Liu
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Dan Li
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Deyu Zhao
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.
| | - Feng Liu
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.
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Li M, Wei X, Zhang SS, Li S, Chen SH, Shi SJ, Zhou SH, Sun DQ, Zhao QY, Xu Y. Recognition of refractory Mycoplasma pneumoniae pneumonia among Myocoplasma pneumoniae pneumonia in hospitalized children: development and validation of a predictive nomogram model. BMC Pulm Med 2023; 23:383. [PMID: 37817172 PMCID: PMC10566172 DOI: 10.1186/s12890-023-02684-1] [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: 10/28/2022] [Accepted: 09/27/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUD The current diagnostic criteria for refractory Mycoplasma pneumoniae pneumonia (RMPP) among Mycoplasma pneumoniae Pneumonia (MPP) are insufficient for early identification, and potentially delayed appropriate treatment. This study aimed to develop an effective individualized diagnostic prediction nomogram for pediatric RMPP. METHODS A total of 517 hospitalized children with MPP, including 131 with RMPP and 386 without RMPP (non-RMPP), treated at Lianyungang Maternal and Child Health Care Hospital from January 2018 to December 2021 were retrospectively enrolled as a development (modeling) cohort to construct an RMPP prediction nomogram. Additionally, 322 pediatric patients with MPP (64 with RMPP and 258 with non-RMPP, who were treated at the Affiliated Hospital of Xuzhou Medical University from June 2020 to May 2022 were retrospectively enrolled as a validation cohort to assess the prediction accuracy of model. Univariable and multivariable logistic regression analyses were used to identify RMPP risk factors among patients with MPP. Nomogram were generated based on these risk factors using the rms package of R, and the predictive performance was evaluated based on receiver operating characteristic (ROC) curves and using decision curve analysis (DCA). RESULTS Multivariate analysis revealed five significant independent predictors of RMPP among patients with MPP: age (hazard ratio [HR] 1.16, 95% confidence interval [CI] 1.08-1.33, P = 0.038), fever duration (HR 1.34, 95%CI 1.20-1.50, P < 0.001), lymphocyte count (HR 0.45, 95%CI 0.23-0.89, P = 0.021), serum D-dimer (D-d) level (HR 1.70, 95%CI 1.16-2.49, P = 0.006), and pulmonary imaging score (HR 5.16, 95%CI 2.38-11.21, P < 0.001). The area under the ROC curve was 90.7% for the development cohort and 96.36% for the validation cohort. The internal and external verification calibration curves were almost linear with slopes of 1, and the DCA curve revealed a net benefit with the final predictive nomogram. CONCLUSION This study proposes a predictive nomogram only based on five variables. The nomogram can be used for early identification of RMPP among pediatric patients with MPP, thereby facilitating more timely and effective intervention.
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Affiliation(s)
- Meng Li
- Pediatric Respiratory Ward I, Lianyungang Maternal and Child Health Care Hospital, No. 669, Qindongmen Street, Haizhou District, Lianyungang, 220003, Jiangsu, China
- Medical College of Yangzhou University, Yangzhou, Jiangsu, China
| | - Xiang Wei
- Pediatric Respiratory Ward I, Lianyungang Maternal and Child Health Care Hospital, No. 669, Qindongmen Street, Haizhou District, Lianyungang, 220003, Jiangsu, China
| | - Shan-Shan Zhang
- Pediatric Respiratory Ward I, Lianyungang Maternal and Child Health Care Hospital, No. 669, Qindongmen Street, Haizhou District, Lianyungang, 220003, Jiangsu, China
| | - Shan Li
- Department of Pediatric Endocrinology, Lianyungang Maternal and Child Health Care Hospital, Lianyungang, Jiangsu, China
| | - Su-Hong Chen
- Pediatric Respiratory Ward I, Lianyungang Maternal and Child Health Care Hospital, No. 669, Qindongmen Street, Haizhou District, Lianyungang, 220003, Jiangsu, China
| | - Su-Jie Shi
- Pediatric Respiratory Ward I, Lianyungang Maternal and Child Health Care Hospital, No. 669, Qindongmen Street, Haizhou District, Lianyungang, 220003, Jiangsu, China
| | - Shao-Hong Zhou
- Pediatric Respiratory Ward I, Lianyungang Maternal and Child Health Care Hospital, No. 669, Qindongmen Street, Haizhou District, Lianyungang, 220003, Jiangsu, China
| | - Da-Quan Sun
- Pediatric Respiratory Ward I, Lianyungang Maternal and Child Health Care Hospital, No. 669, Qindongmen Street, Haizhou District, Lianyungang, 220003, Jiangsu, China
| | - Qian-Ye Zhao
- Pediatric Respiratory Ward I, Lianyungang Maternal and Child Health Care Hospital, No. 669, Qindongmen Street, Haizhou District, Lianyungang, 220003, Jiangsu, China.
- Medical College of Yangzhou University, Yangzhou, Jiangsu, China.
| | - Yan Xu
- Neonatology Department, The Affiliated Hospital of Xuzhou Medical University, No. 99, Huaihai West Road, Quanshan District, Xuzhou, 221000, Jiangsu, China.
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Rodman Berlot J, Dolenc Š, Krivec U, Keše D. Clinical, Laboratory, and Radiographic Features Can Help Predict Mycoplasma pneumoniae Lower Respiratory Tract Infection in Children. Microorganisms 2023; 11:1358. [PMID: 37317331 DOI: 10.3390/microorganisms11051358] [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: 03/31/2023] [Revised: 05/11/2023] [Accepted: 05/19/2023] [Indexed: 06/16/2023] Open
Abstract
Mycoplasma pneumoniae (Mp) is a common cause of lower respiratory tract infection (LRTI) in children that is difficult to distinguish from LRTI of other etiologies. We aimed to determine if a combination of clinical, laboratory, and chest radiographic features can help identify patients at higher risk of Mp LRTI. We reviewed medical charts of children referred to our tertiary hospital with suspected acute mycoplasmal LRTI. Pharyngeal swabs obtained from patients were tested by Mp PCR. We compared epidemiological and clinical data of children with positive and negative Mp PCR results. In addition, a multivariable logistic regression analysis was performed to predict Mp LRTI based on the patient's age, duration of symptoms, presence of extrapulmonary manifestations, laboratory findings, and chest radiographic findings. We included 65 children with Mp PCR-negative and 49 with Mp PCR-positive LRTI and no viral co-detection. Children with Mp LRTI were older (median age 5.8 vs. 2.2 years, p < 0.001), had a longer duration of symptoms on referral (median 7 vs. 4 days, p < 0.001), and lower median WBC (9.9 vs. 12.7 × 109/L, p < 0.001). On chest radiograph, unilateral infiltrates were more frequently observed in the Mp PCR-positive group (57.5% vs. 24.1%, p = 0.001). Age, duration of symptoms, and chest radiographic findings had the highest predictive value for Mp LRTI in a multivariable logistic regression model. Our analysis suggests that a combination of clinical, laboratory, and chest radiographic features can be used to assess the likelihood of Mp LRTI and assist in decision-making for which children need further tests or macrolide antibiotic treatment.
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Affiliation(s)
- Jasna Rodman Berlot
- Department of Paediatric Pulmonology, University Children's Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Špela Dolenc
- Department of Paediatric Pulmonology, University Children's Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Uroš Krivec
- Department of Paediatric Pulmonology, University Children's Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Darja Keše
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
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Fan F, Lv J, Yang Q, Jiang F. Clinical characteristics and serum inflammatory markers of community-acquired mycoplasma pneumonia in children. THE CLINICAL RESPIRATORY JOURNAL 2023. [PMID: 37142438 PMCID: PMC10363789 DOI: 10.1111/crj.13620] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 02/10/2023] [Accepted: 04/05/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND To 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. METHODS The 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. RESULTS Fever 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-1β) 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. CONCLUSION In 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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Affiliation(s)
- Fei Fan
- Department of Paediatrics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Jun Lv
- Department of Paediatrics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Qianyuan Yang
- Department of Paediatrics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Fei Jiang
- Department of Paediatrics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
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Chu C, Wang L, Wu Y, Li H, Xu S, Zhang L, Liu Q, Zhang X, Xu L, Gao C, Huang L. Multidimensional analysis using low-dose computed tomography to evaluate the severity of Mycoplasma pneumoniae pneumonia in children. Quant Imaging Med Surg 2023; 13:1874-1886. [PMID: 36915342 PMCID: PMC10006136 DOI: 10.21037/qims-22-508] [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: 05/20/2022] [Accepted: 11/20/2022] [Indexed: 01/05/2023]
Abstract
Background It is unclear whether local pathological pulmonary changes truly reflect the severity of childhood Mycoplasma pneumoniae infection, which is characterized by rapid progress and potential mortality. This study multi-dimensionally analyzed low-dose computed tomography findings to assess the severity of Mycoplasma pneumoniae infection and predict its progress in such patients. Methods In all, 752 children with Mycoplasma pneumoniae pneumonia (MPP) who underwent low-dose computed tomography examinations from February 2016 to July 2020 were retrospectively enrolled to conduct a cohort study. Clinical and radiological variables were analyzed using univariate analysis, and radiological variables were further analyzed using multivariable logistic regression in severe cases. Then, the correlation between the key computed tomography features and clinical symptoms, laboratory indicators, and medical costs were assessed using the chi-squared and Kruskal-Wallis H tests. Kaplan-Meier curves and Cox regression models were created to evaluate the correlations between the key computed tomography features, fever duration, and the length of hospital stay. Results Of the 752 included patients, 16.2% (122/752) developed severe MPP. Atelectasis, pleural effusion, and lung consolidation occurred in 9.7% (73/752), 15.8% (119/752), and 90.3% (679/752) of patients, respectively. In addition to pleural effusion, the number of lobes of lung consolidation was the highest risk feature of severe MPP. Patients with consolidation in 2, 3, and 4 lobes had a 1.0-, 3.1-, and 7.5-fold increased risk of severe MPP, compared with patients with consolidation in fewer than 1 lobe. The duration of fever prior to admission had no effect on the proportions of the lobar consolidation (P=0.14) but did have significant effect on the incidence of pleural effusion (P=0.004). Levels of inflammatory markers and medical costs rose consistently with the increase in the number of lobar consolidations (P<0.001). After adjustments for pleural effusion, 1, 2, 3, and 4 lobes of consolidation remained positively associated with fever duration [1 lobe: hazard ratio (HR) =1.55, 95% CI: 1.10-2.18; 2 lobes: HR =1.65, 95% CI: 1.13-2.42l; 3 lobes: HR =1.82, 95% CI: 1.11-2.98; 4 lobes: HR =2.87, 95% CI: 1.25-6.61] compared to 0 lobes of consolidation. Compared to 0 lobes of consolidation, 1, 2, 3, and 4 lobes of consolidation were also positively correlated with the length of hospital stay (1 lobe: HR =2.24, 95% CI: 1.73-2.89; 2 lobes: HR =2.56, 95% CI: 1.91-3.43; 3 lobes: HR =2.87, 95% CI: 1.90-4.32; 4 lobes: HR =4.12, 95% CI: 2.01-8.46). Conclusions Lobar consolidation is a stable and reliable computed tomography feature that can be used to assess the severity of MPP in children. Quantitative analysis of lobar consolidation can comprehensively and accurately predict the progression of Mycoplasma pneumoniae. Low-dose computed tomography is recommended for children with severe MPP with complicated courses.
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Affiliation(s)
- Caiting Chu
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lijun Wang
- Department of Infectious Diseases, Xinhua Children's Hospital, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhang Wu
- Department of Infectious Diseases, Xinhua Children's Hospital, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huajun Li
- Department of Infectious Diseases, Xinhua Children's Hospital, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shanshan Xu
- Department of Infectious Diseases, Xinhua Children's Hospital, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liya Zhang
- Department of Infectious Diseases, Xinhua Children's Hospital, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Quanhua Liu
- Department of Pediatric Respiration, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi Zhang
- Clinical Research Unit, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Xu
- Department of Radiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chengjin Gao
- Department of Emergency, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lisu Huang
- Department of Infectious Diseases, Xinhua Children's Hospital, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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9
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The clinical significance of and the factors associated with macrolide resistance and poor macrolide response in pediatric Mycoplasma pneumoniae infection: A retrospective study. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2023:S1684-1182(23)00010-5. [PMID: 36737359 DOI: 10.1016/j.jmii.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 10/28/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND Macrolide-resistant Mycoplasma pneumoniae (MRMP) infection is increasing worldwide. However, its clinical significance is still uncertain. METHODS The data of the Laboratory Medicine Department of Chang Gung Memorial Hospital in northern Taiwan was searched for children with molecular confirmed macrolide-susceptible Mycoplasma pneumoniae (MSMP) and MRMP infections between January 2011 and December 2018. The clinical features, laboratory data, and chest image presentations were compared between patients with MRMP and MSMP infections and between patients with good and poor macrolide response, respectively. RESULTS Records from 158 patients were recovered. Of the enrolled patients 34 (22%) suffered MRMP infection, 27 (17%) had pleural effusions, and 47 (32%) had poor macrolide response. The macrolide resistance rate was 12% in 2011, 20% between 2015 and 2016, and 50% between 2017 and 2018, respectively. Other than a poor macrolide response, the MRMP and MSMP infections are clinically indistinguishable. The presence of pleural effusion and MRMP infections were found to be independently associated with a poor macrolide response, with odds ratios (95% confidence interval) of 14.3 (4.9-42.0) and 14.6 (5.4-40), respectively. The macrolide resistance rate of the patients with a poor macrolide response was 49% and 18% among all the patients enrolled and the patients with a pleural effusion, respectively. CONCLUSION The macrolide resistance rate had possibly increased in recent years in Taiwan and should be continuously monitored. In addition, the macrolide response could be misleading in predicting a macrolide resistance especially for the patients with a pleural effusion.
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10
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Hu S, Zhu Y, Dong D, Wang B, Zhou Z, Wang C, Tian J, Peng Y. Chest Radiographs Using a Context-Fusion Convolution Neural Network (CNN): Can It Distinguish the Etiology of Community-Acquired Pneumonia (CAP) in Children? J Digit Imaging 2022; 35:1079-1090. [PMID: 35585465 PMCID: PMC9116701 DOI: 10.1007/s10278-021-00543-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/02/2021] [Accepted: 11/11/2021] [Indexed: 11/25/2022] Open
Abstract
Clinical symptoms and inflammatory markers cannot reliably distinguish the etiology of CAP, and chest radiographs have abundant information related with CAP. Hence, we developed a context-fusion convolution neural network (CNN) to explore the application of chest radiographs to distinguish the etiology of CAP in children. This retrospective study included 1769 cases of pediatric pneumonia (viral pneumonia, n = 487; bacterial pneumonia, n = 496; and mycoplasma pneumonia, n = 786). The chest radiographs of the first examination, C-reactive protein (CRP), and white blood cell (WBC) were collected for analysis. All patients were stochastically divided into training, validation, and test cohorts in a 7:1:2 ratio. Automatic lung segmentation and hand-crafted pneumonia lesion segmentation were performed, from which three image-based models including a full-lung model, a local-lesion model, and a context-fusion model were built; two clinical characteristics were used to build a clinical model, while a logistic regression model combined the best CNN model and two clinical characteristics. Our experiments showed that the context-fusion model which integrated the features of the full-lung and local-lesion had better performance than the full-lung model and local-lesion model. The context-fusion model had area under curves of 0.86, 0.88, and 0.93 in identifying viral, bacterial, and mycoplasma pneumonia on the test cohort respectively. The addition of clinical characteristics to the context-fusion model obtained slight improvement. Mycoplasma pneumonia was more easily identified compared with the other two types. Using chest radiographs, we developed a context-fusion CNN model with good performance for noninvasively diagnosing the etiology of community-acquired pneumonia in children, which would help improve early diagnosis and treatment.
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Affiliation(s)
- Shasha Hu
- Department of Radiology, National Center for Children' Health, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Yongbei Zhu
- CAS Key Laboratory of Molecular Imaging, State Key Laboratory of Management and Control for Complex Systems, Beijing Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing, 100191, China
| | - Di Dong
- CAS Key Laboratory of Molecular Imaging, State Key Laboratory of Management and Control for Complex Systems, Beijing Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Bei Wang
- Department of Radiology, National Center for Children' Health, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Zuofu Zhou
- Department of Radiology, Fujian Provincial Maternity and Children's Hospital, Fujian Medical University, Fuzhou, 350000, China
| | - Chi Wang
- Department of Radiology, National Center for Children' Health, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Jie Tian
- CAS Key Laboratory of Molecular Imaging, State Key Laboratory of Management and Control for Complex Systems, Beijing Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China.
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing, 100191, China.
| | - Yun Peng
- Department of Radiology, National Center for Children' Health, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China.
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11
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Park YK, Park YN, Moon JE, Kim HB, Shin M, Lee E, Kim CH, Lee JS, Lee YJ, Kim BS, Kim HY, Jung S, Kim Y, Kim S, Park C, Seo JH, Shim JY, Sol IS, Sung M, Song DJ, Ahn YM, Oh HL, Yu J, Lee KS, Jang GC, Jang YY, Chung HL, Chung EH, Choi SM, Choi YJ, Han MY, Kim JT, Kim CK, Yang HJ. The incidence and risk factors of extrapulmonary manifestations in Mycoplasma pneumoniae pneumonia. ALLERGY ASTHMA & RESPIRATORY DISEASE 2022. [DOI: 10.4168/aard.2022.10.4.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yoo Kyung Park
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - You Na Park
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Ji Eun Moon
- Department of Biostatistics, Clinical Trial Center, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Hyo-Bin Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Meeyong Shin
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Chul-Hong Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Yong Ju Lee
- Department of Pediatrics, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Bong-Seong Kim
- Department of Pediatrics, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Hyung Young Kim
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan, Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan, Korea
| | - Yunsun Kim
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Sangyoung Kim
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Chorong Park
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Ju-Hee Seo
- Departmentof Pediatrics, Dankook University Hospital, Dankook University Medical School, Cheonan, Korea
| | - Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - In Suk Sol
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Myongsoon Sung
- Department of Pediatrics, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi, Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Young Min Ahn
- Department of Pediatrics, Eulji General Hospital, Eulji University, Seoul, Korea
| | - Hea Lin Oh
- Department of Pediatrics, Korea Cancer Center Hospital, Ilsan, Korea
| | - Jinho Yu
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung Suk Lee
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Ilsan, Korea
| | - Yoon-Young Jang
- Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Hai Lee Chung
- Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Eun Hee Chung
- Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sung-Min Choi
- Department of Pediatrics, Dongguk University Gyeongju Hospital, Gyeongju, Korea
| | - Yun Jung Choi
- Departmentof Pediatrics, Seoul National University Children Hospital, Seoul, Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Jin Tack Kim
- Department of Pediatrics, The Catholic University of Korea Uijeongbu St. Mary's Hospital, Uijeongbu, Korea
| | - Chang-Keun Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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12
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Unni A, Hidayathulla P, Kavitha K, Paloth MN, Nair PR, Kumar P J, Radhakrishnan C. A fulminant pneumonia due to Mycoplasma pneumoniae – Case report and literature review. IDCases 2022; 29:e01552. [PMID: 35832783 PMCID: PMC9271957 DOI: 10.1016/j.idcr.2022.e01552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/23/2022] [Indexed: 12/03/2022] Open
Abstract
Fulminant pneumonia due to Mycoplasma pneumoniae [MP] is quite rare even though there is a high prevalence of Mycoplasma species infection in the general population. We report a case of an atypical pneumonia with Acute Respiratory Distress Syndrome (ARDS) due to Mycoplasma pneumoniae in a young female and the clinical challenges encountered along with the current literature review.
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Affiliation(s)
- Athira Unni
- Department of Emergency Medicine, Government Medical College, Kozhikode 673008, Kerala, India
| | - P.K. Hidayathulla
- Department of Emergency Medicine, Government Medical College, Kozhikode 673008, Kerala, India
| | - K.P. Kavitha
- Department of Emergency Medicine, Government Medical College, Kozhikode 673008, Kerala, India
| | - Mohammed Niyas Paloth
- Department of Emergency Medicine, Government Medical College, Kozhikode 673008, Kerala, India
| | | | - Jayesh Kumar P
- Department of Medicine, Government Medical College, Kozhikode 673008, Kerala, India
| | - Chandni Radhakrishnan
- Department of Emergency Medicine, Government Medical College, Kozhikode 673008, Kerala, India
- Correspondence to: Emergency Medicine, Government Medical College, Kozhikode 673008, Kerala, India.
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13
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Lee M, Kim YA, Jung S. Clinical characteristics and associated factors of Mycoplasma pneumoniae pneumonia with atelectasis in children. ALLERGY ASTHMA & RESPIRATORY DISEASE 2022. [DOI: 10.4168/aard.2022.10.3.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Miran Lee
- Department of Pediatrics, Pusan National University Children’s Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Young A Kim
- Department of Pediatrics, Pusan National University Children’s Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Children’s Hospital, Pusan National University School of Medicine, Yangsan, Korea
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14
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Laya BF, Concepcion NDP, Garcia-Peña P, Naidoo J, Kritsaneepaiboon S, Lee EY. Pediatric Lower Respiratory Tract Infections: Imaging Guidelines and Recommendations. Radiol Clin North Am 2021; 60:15-40. [PMID: 34836562 DOI: 10.1016/j.rcl.2021.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Lower respiratory tract infection (LRTI) remains a major cause of morbidity and mortality in children. Various organisms cause LRTI, including viruses, bacteria, fungi, and parasites, among others. Infections caused by 2 or more organisms also occur, sometimes enhancing the severity of the infection. Medical imaging helps confirm a diagnosis but also plays a role in the evaluation of acute and chronic sequelae. Medical imaging tests help evaluate underlying pathology in pediatric patients with recurrent or long-standing symptoms as well as the immunocompromised.
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Affiliation(s)
- Bernard F Laya
- Section of Pediatric Radiology, Institute of Radiology, St. Luke's Medical Center-Quezon City, 279 E. Rodriguez Sr. Ave., Quezon City, 1112 Philippines.
| | - Nathan David P Concepcion
- Section of Pediatric Radiology, Institute of Radiology, St. Luke's Medical Center-Quezon City, 279 E. Rodriguez Sr. Ave., Quezon City, 1112 Philippines
| | - Pilar Garcia-Peña
- Autonomous University of Barcelona (AUB), University Hospital Materno-Infantil Vall d'Hebron, Pso. Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Jaishree Naidoo
- Paeds Diagnostic Imaging and Envisionit Deep AI, 2nd Floor, One-on Jameson Building, 1 Jameson Avenue, Melrose Estate, Johannesburg, 2196, South Africa
| | - Supika Kritsaneepaiboon
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine, Prince of Songkla University, Kanjanavanich Road, Hat Yai, 90110, Thailand
| | - Edward Y Lee
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
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15
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Wu TH, Wang NM, Liu FC, Pan HH, Huang FL, Fang YP, Chiang TW, Yang YY, Song CS, Wu HC, Lee CY. Macrolide Resistance, Clinical Features, and Cytokine Profiles in Taiwanese Children With Mycoplasma pneumoniae Infection. Open Forum Infect Dis 2021; 8:ofab416. [PMID: 34557557 PMCID: PMC8454522 DOI: 10.1093/ofid/ofab416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/09/2021] [Indexed: 12/30/2022] Open
Abstract
Background The factors that predict the progression of Mycoplasma pneumoniae infection remain inconclusive. Therefore, we investigated macrolide resistance prevalence, M pneumoniae genotype, and clinical characteristics of childhood M pneumoniae respiratory tract infections in Taiwan. Methods A total of 295 children hospitalized with respiratory tract infections with positive serological M pneumoniae immunoglobulin M test results were enrolled in this 3-year prospective study. Oropharyngeal swabs were obtained for M pneumoniae cultures and polymerase chain reaction tests. All M pneumoniae specimens were further characterized by P1 typing, multilocus variable-number tandem-repeat analysis (MLVA), and macrolide resistance genotyping. The clinical characteristics and blood cytokine profiles were analyzed accordingly. Results Of 138 M pneumoniae specimens, type I P1 was the predominant (136 of 138, 98.6%). The MLVA type P (4-4-5-7-2) was the leading strain (42 of 138, 30.4%), followed by type J, U, A, and X. The overall macrolide-resistant rate was 38.4% (53 of 138); the resistance rate increased dramatically yearly: 10.6% in 2017, 47.5% in 2018, and 62.5% in 2019 (P < .001). All macrolide-resistant M pneumoniae (MRMP) harbored the A2063G mutation and were MLVA type 4-5-7-2 (49 of 53, 92.5%), especially type U and X. No significant differences in clinical symptoms, duration of hospital stay, and radiographic findings were identified among patients between MRMP and macrolide-sensitive M pneumoniae (MSMP) groups. Patients with MRMP infection had more febrile days before and during hospitalization and higher interleukin (IL)-13 and IL-33 levels than patients with MSMP infection (P < .05). Conclusions Macrolide-resistant M pneumoniae surged in Taiwan throughout the study period, but macrolide resistance was not a determinant factor of clinical severity.
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Affiliation(s)
- Tsung-Hua Wu
- Department of Pediatrics, Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Nancy M Wang
- Department of Biology, National Changhua University of Education, Changhua, Taiwan
| | - Fang-Ching Liu
- Department of Pediatrics, Jen-Ai Hospital, Taichung, Taiwan
| | - Hui-Hsien Pan
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Fang-Liang Huang
- Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Ping Fang
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Ting-Wei Chiang
- Department of Biology, National Changhua University of Education, Changhua, Taiwan
| | - Yu-Ying Yang
- Department of Clinical Laboratory, Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Chiah-Sing Song
- Department of Clinical Laboratory, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Hsiang-Chin Wu
- Department of Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chun-Yi Lee
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
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16
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Nantanda R, Bwanga F, Najjingo I, Ndeezi G, Tumwine JK. Prevalence, risk factors and outcome of Mycoplasma pneumoniae infection among children in Uganda: a prospective study. Paediatr Int Child Health 2021; 41:188-198. [PMID: 34743675 PMCID: PMC8791631 DOI: 10.1080/20469047.2021.1980698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND : Atypical bacteria cause 10-40% of all childhood pneumonia.. Data on the burden of atypical pneumonia in sub-Saharan Africa are limited. AIM : To determine the prevalence, associated factors, and outcome of Mycoplasma pneumoniae infection in children with respiratory symptoms at Mulago National Referral Hospital, Kampala. METHODS : Children aged 2 months to 12 years with cough and/or difficult breathing and fast breathing were recruited. A clinical history and physical examination were undertaken. Blood samples for Mycoplasma pneumoniae IgM antibodies were taken at enrolment and Day 21 and induced sputum for DNA-PCR. Admitted participants were followed for a maximum of 7 days or until discharge or death, whichever came first. RESULTS : A total of 385 children were enrolled, and, of these, 368 (95.6%) were <5 years. Overall, 60/385 (15.6%) participants tested positive for M. pneumoniae IgM and/or DNA-PCR. Of these, 56/60 (93.3%) were <5 years of age. Wheezing was present in 21/60 (35.0%) of the children with atypical pneumonia and in 128/325 (39.4%) with typical pneumonia. The factors associated with M. pneumonia were female sex (AOR 1.94, 95% CI 1.22-3.08, p < 0.001), age ≥12 months (AOR 2.73, 95% CI 1.53-4.87, p = 0.01) and a history of prematurity (AOR 2.07, 95% CI 1.23-3.49, p = 0.01). Mortality was 17/352 (4.8%) and, of these, 4/17 (23.5%) had M. pneumonia. CONCLUSION : M. pneumonia is common in young children , especially females above 2 years and those with history of prematurity. It presents with severe symptoms. The results of the study highlight the importance of considering atypical bacteria in under-5s with the symptoms of pneumonia.
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Affiliation(s)
- Rebecca Nantanda
- Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Freddie Bwanga
- Department of Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Irene Najjingo
- Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Grace Ndeezi
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - James K Tumwine
- Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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17
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Bi Y, Zhu Y, Ma X, Xu J, Guo Y, Huang T, Zhang S, Wang X, Zhao D, Liu F. Development of a scale for early prediction of refractory Mycoplasma pneumoniae pneumonia in hospitalized children. Sci Rep 2021; 11:6595. [PMID: 33758243 PMCID: PMC7987979 DOI: 10.1038/s41598-021-86086-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 03/09/2021] [Indexed: 12/25/2022] Open
Abstract
Now there is no clinical scale for early prediction of refractory Mycoplasma pneumoniae pneumonia (RMPP). The aim of this study is to identify indicators and develop an early predictive scale for RMPP in hospitalized children. First we conducted a retrospective cohort study of children with M. pneumoniae pneumonia admitted to Children's Hospital of Nanjing Medical University, China in 2016. Children were divided into two groups, according to whether their pneumonia were refractory and the results were used to develop an early predictive scale. Second we conducted a prospective study to validate the predictive scale for RMPP in children in 2018. 618 children were included in the retrospective study, of which 73 with RMPP. Six prognostic indicators were identified and included in the prognostic assessment scale. The sensitivity of the prognostic assessment scale was 74.0% (54/73), and the specificity was 88.3% (481/545) in the retrospective study. 944 children were included in the prospective cohort, including 92 with RMPP, the sensitivity of the prognostic assessment scale was 78.3% (72/92) and the specificity was 86.2% (734/852). The prognostic assessment scale for RMPP has high diagnostic accuracy and is suitable for use in standard clinical practice.
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Affiliation(s)
- Ying Bi
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, China
- Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, China
| | - Yifan Zhu
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, China
| | - Xiao Ma
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, China
| | - Jiejing Xu
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, China
- Department of Pediatrics, The Second People's Hospital of Changzhou, Affiliate Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Yun Guo
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, China
- Department of Respiratory Medicine, The Affiliated Wuxi Children's Hospital of Nanjing Medical University, Wuxi, China
| | - Tianyu Huang
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, China
| | - Siqing Zhang
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, China
| | - Xin Wang
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, China
| | - Deyu Zhao
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, China.
| | - Feng Liu
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, China.
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18
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Predictive Factors of the Responses to Treatment of Mycoplasma pneumoniae Pneumonia. J Clin Med 2021; 10:jcm10061154. [PMID: 33801856 PMCID: PMC7998824 DOI: 10.3390/jcm10061154] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/08/2021] [Accepted: 03/08/2021] [Indexed: 12/14/2022] Open
Abstract
The prevalence of refractory Mycoplasma pneumoniae (MP) pneumonia is increasing. The present study aimed to identify the predictive factors of responses to treatment of MP pneumonia in children. A total of 149 children were diagnosed with MP pneumonia, of whom 56 were included in the good response group, 75 children in the slow response group, and 18 children in no response or progression group. Data on the clinical, laboratory, and radiologic features were retrospectively obtained through medical chart reviews. The severity of pneumonia, based on the extent of pneumonic lesions on chest x-ray (adjusted odds ratio (aOR), 10.573; 95% confidence intervals (CIs), 2.303-48.543), and lactate dehydrogenase (LDH) levels (aOR, 1.002; 95% CIs, 1.000-1.004) at the time of admission were associated with slow response to treatment of MP pneumonia. Pleural effusion (aOR, 5.127; 95% CIs, 1.404-18.727), respiratory virus co-infection (aOR, 4.354; 95% CIs, 1.374-13.800), and higher LDH levels (aOR, 1.005; 95% CIs, 1.002-1.007) as well as MP-specific IgM titer (aOR, 1.309; 95% CIs, 1.095-1.564) were associated with no response or progression of MP pneumonia. The area under the curve for the prediction of no or poor response in MP pneumonia using pleural effusion, respiratory virus co-infection, LDH levels, and MP-specific IgM titer at the time of admission was 0.8547. This study identified the predictive factors of responses to treatment of MP pneumonia in children, which would be helpful in establishing a therapeutic plan and predicting the clinical course of MP pneumonia in children.
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Foust AM, McAdam AJ, Chu WC, Garcia-Peña P, Phillips GS, Plut D, Lee EY. Practical guide for pediatric pulmonologists on imaging management of pediatric patients with COVID-19. Pediatr Pulmonol 2020; 55:2213-2224. [PMID: 32462724 PMCID: PMC7283678 DOI: 10.1002/ppul.24870] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/23/2020] [Accepted: 05/25/2020] [Indexed: 12/26/2022]
Abstract
Understanding of coronavirus disease 2019 is rapidly evolving with new articles on the subject daily. This flood of articles can be overwhelming for busy practicing clinicians looking for key pieces of information that can be applied in daily practice. This review article synthesizes the reported imaging findings in pediatric Coronavirus disease 2019 (COVID-19) across the literature, offers imaging differential diagnostic considerations and useful radiographic features to help differentiate these entities from COVID-19, and provides recommendations for requesting imaging studies to evaluate suspected cases of pediatric COVID-19.
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Affiliation(s)
- Alexandra M Foust
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alexander J McAdam
- Department of Laboratory Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Winnie C Chu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Pilar Garcia-Peña
- Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d'Heborn, Barcelona, Spain
| | - Grace S Phillips
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
| | - Domen Plut
- Department of Pediatric Radiology, Clinical Radiology Institute, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Edward Y Lee
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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Zhao J, Li Y, Zhang W. The clinical significance of IL-6 s and IL-27 s in Bronchoalveolar lavage fluids from children with mycoplasma pneumoniae pneumonia. BMC Infect Dis 2020; 20:331. [PMID: 32393186 PMCID: PMC7216321 DOI: 10.1186/s12879-020-05017-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 04/06/2020] [Indexed: 12/19/2022] Open
Abstract
Background IL-6 was associated with the severity of mycoplasma pneumoniae pneumonia (MPP). But the relationship between IL-27 and MPP was unknown. Methods Ninety-eight patients with MPP < 14 years old were enrolled in this study and divided into groups by severity (mild cases and severe cases), infection types (MP single infection group and MP mixed infection group) and DNA loads (low MP DNA loads group and high MP DNA loads group), respectively. Fifteen children with foreign bodies in bronchus were also enrolled as control. IL-6 s and IL-27 s in bronchoalveolar lavage fluids (BALFs) from these children were measured by ELISA. Results There were significant differences in IL-6 s of BALFs from patients between mild cases and severe cases, MP single infection group and MP mixed infection group, and low MP DNA loads group and high MP DNA loads group, respectively (P < 0.05). Compared with IL-6 s of BALFs from control, IL-6 s in BALFs from the 6 patient groups were significantly higher (P < 0.05). IL-27 s in BALFs from MP mixed infection group were significantly lower than those from MP single infection group and control (P < 0.05) respectively. Conclusion IL-6 was firmly associated with MPP and had potential application in clinical practice while IL-27 was not related to MP infection.
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Affiliation(s)
- Jie Zhao
- Pediatrics, Zibo Central Hospital, Zibo, 255036, Shandong Province, China
| | - Yuyun Li
- Allergy Clinic, Zibo Central Hospital, Zibo, 255036, Shandong Province, China
| | - Wen Zhang
- Clinical Laboratory, Zibo Central Hospital, No. 54, Gongqingtuanxi Street, Zibo, 255036, Shandong Province, China.
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Foust AM, Phillips GS, Chu WC, Daltro P, Das KM, Garcia-Peña P, Kilborn T, Winant AJ, Lee EY. International Expert Consensus Statement on Chest Imaging in Pediatric COVID-19 Patient Management: Imaging Findings, Imaging Study Reporting, and Imaging Study Recommendations. Radiol Cardiothorac Imaging 2020; 2:e200214. [PMID: 33778577 PMCID: PMC7233446 DOI: 10.1148/ryct.2020200214] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/20/2020] [Accepted: 04/23/2020] [Indexed: 12/14/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has quickly spread since it was first detected in December 2019 and has evolved into a global pandemic with over 1.7 million confirmed cases in over 200 countries around the world at the time this document is being prepared. Owing to the novel nature of the virus and the rapidly evolving understanding of the disease, there is a great deal of uncertainty surrounding the diagnosis and management of COVID-19 pneumonia in pediatric patients. Chest imaging plays an important role in the evaluation of pediatric patients with COVID-19; however, there is currently little information available describing imaging manifestations of COVID-19 in pediatric patients and even less information discussing the utilization of imaging studies in pediatric patients. To specifically address these concerns, a group of international experts in pediatric thoracic imaging from five continents convened to create a consensus statement describing the imaging manifestations of COVID-19 in the pediatric population, discussing the potential utility of structured reporting during the COVID-19 pandemic, and generating consensus recommendations for utilization of chest radiographs and CT in the evaluation of pediatric patients with COVID-19. The results were compiled into two structured reporting algorithms (one for chest radiographs and one for chest CT) and eight consensus recommendations for the utilization of chest imaging in pediatric COVID-19 infection. © RSNA, 2020.
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Affiliation(s)
- Alexandra M. Foust
- From the Department of Radiology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.M.F., A.J.W., E.Y.L.); Department of Radiology, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, Wash (G.S.P.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Radiology, ALTA-Excelência Diagnóstica/Dasa, Rio de Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Hebron, Barcelona, Spain (P.G.P.); and Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Grace S. Phillips
- From the Department of Radiology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.M.F., A.J.W., E.Y.L.); Department of Radiology, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, Wash (G.S.P.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Radiology, ALTA-Excelência Diagnóstica/Dasa, Rio de Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Hebron, Barcelona, Spain (P.G.P.); and Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Winnie C. Chu
- From the Department of Radiology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.M.F., A.J.W., E.Y.L.); Department of Radiology, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, Wash (G.S.P.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Radiology, ALTA-Excelência Diagnóstica/Dasa, Rio de Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Hebron, Barcelona, Spain (P.G.P.); and Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Pedro Daltro
- From the Department of Radiology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.M.F., A.J.W., E.Y.L.); Department of Radiology, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, Wash (G.S.P.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Radiology, ALTA-Excelência Diagnóstica/Dasa, Rio de Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Hebron, Barcelona, Spain (P.G.P.); and Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Karuna M. Das
- From the Department of Radiology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.M.F., A.J.W., E.Y.L.); Department of Radiology, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, Wash (G.S.P.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Radiology, ALTA-Excelência Diagnóstica/Dasa, Rio de Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Hebron, Barcelona, Spain (P.G.P.); and Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Pilar Garcia-Peña
- From the Department of Radiology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.M.F., A.J.W., E.Y.L.); Department of Radiology, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, Wash (G.S.P.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Radiology, ALTA-Excelência Diagnóstica/Dasa, Rio de Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Hebron, Barcelona, Spain (P.G.P.); and Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Tracy Kilborn
- From the Department of Radiology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.M.F., A.J.W., E.Y.L.); Department of Radiology, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, Wash (G.S.P.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Radiology, ALTA-Excelência Diagnóstica/Dasa, Rio de Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Hebron, Barcelona, Spain (P.G.P.); and Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Abbey J. Winant
- From the Department of Radiology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.M.F., A.J.W., E.Y.L.); Department of Radiology, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, Wash (G.S.P.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Radiology, ALTA-Excelência Diagnóstica/Dasa, Rio de Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Hebron, Barcelona, Spain (P.G.P.); and Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
| | - Edward Y. Lee
- From the Department of Radiology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115 (A.M.F., A.J.W., E.Y.L.); Department of Radiology, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, Wash (G.S.P.); Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China (W.C.C.); Department of Radiology, ALTA-Excelência Diagnóstica/Dasa, Rio de Janeiro, Brazil (P.D.); Department of Radiology, College of Medicine and Health Sciences, Al Ain, United Arab Emirates (K.M.D.); Department of Pediatric Radiology, University Hospital Materno-Infantil Vall d’Hebron, Barcelona, Spain (P.G.P.); and Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa (T.K.)
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Lee E, Kim CH, Lee YJ, Kim HB, Kim BS, Kim HY, Kim Y, Kim S, Park C, Seo JH, Sol IS, Sung M, Song MS, Song DJ, Ahn YM, Oh HL, Yu J, Jung S, Lee KS, Lee JS, Jang GC, Jang YY, Chung EH, Chung HL, Choi SM, Choi YJ, Han MY, Shim JY, Kim JT, Kim CK, Yang HJ. Annual and seasonal patterns in etiologies of pediatric community-acquired pneumonia due to respiratory viruses and Mycoplasma pneumoniae requiring hospitalization in South Korea. BMC Infect Dis 2020; 20:132. [PMID: 32050912 PMCID: PMC7017508 DOI: 10.1186/s12879-020-4810-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/21/2020] [Indexed: 11/24/2022] Open
Abstract
Background Community–acquired pneumonia (CAP) is one of the leading worldwide causes of childhood morbidity and mortality. Its disease burden varies by age and etiology and is time dependent. We aimed to investigate the annual and seasonal patterns in etiologies of pediatric CAP requiring hospitalization. Methods We conducted a retrospective study in 30,994 children (aged 0–18 years) with CAP between 2010 and 2015 at 23 nationwide hospitals in South Korea. Mycoplasma pneumoniae (MP) pneumonia was clinically classified as macrolide-sensitive MP, macrolide-less effective MP (MLEP), and macrolide-refractory MP (MRMP) based on fever duration after initiation of macrolide treatment, regardless of the results of in vitro macrolide sensitivity tests. Results MP and respiratory syncytial virus (RSV) were the two most commonly identified pathogens of CAP. With the two epidemics of MP pneumonia (2011 and 2015), the rates of clinical MLEP and MRMP pneumonia showed increasing trends of 36.4% of the total MP pneumonia. In children < 2 years of age, RSV (34.0%) was the most common cause of CAP, followed by MP (9.4%); however, MP was the most common cause of CAP in children aged 2–18 years of age (45.3%). Systemic corticosteroid was most commonly administered for MP pneumonia. The rate of hospitalization in intensive care units was the highest for RSV pneumonia, and ventilator care was most commonly needed in cases of adenovirus pneumonia. Conclusions The present study provides fundamental data to establish public health policies to decrease the disease burden due to CAP and improve pediatric health.
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Affiliation(s)
- Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Chul-Hong Kim
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Yong Ju Lee
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea
| | - Hyo-Bin Kim
- Asthma and Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital, 1342 Dongil-ro, Nowon-gu, Seoul, 01757, South Korea
| | - Bong-Seong Kim
- Department of Pediatrics, Ulsan University Gangneung Asan Hospital, Gangneung, South Korea
| | - Hyung Young Kim
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, South Korea
| | - Yunsun Kim
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - Sangyoung Kim
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - Chorong Park
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - Ju-Hee Seo
- Department of Pediatrics, Dankook University Hospital, Dankook University Medical School, Cheonan, South Korea
| | - In Suk Sol
- Department of Pediatrics, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
| | - Myongsoon Sung
- Department of Pediatrics, Soonchunhyang University Gumi Hospital, Seoul, South Korea
| | - Min Seob Song
- Department of Pediatrics, Inje University Haeundae Paik Hospital, Pusan, South Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Young Min Ahn
- Department of Pediatrics, Eulji University, Eulji General Hospital, Seoul, South Korea
| | - Hea Lin Oh
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, South Korea
| | - Jinho Yu
- Department of Pediatrics, Asan Medical Center, Ulsan University Medical School, Seoul, South Korea
| | - Sungsu Jung
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, South Korea
| | - Kyung Suk Lee
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Service, Ilsan Hospital, Ilsan, South Korea
| | - Yoon-Young Jang
- Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - Eun Hee Chung
- Department of Pediatrics, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Hai Lee Chung
- Department of Pediatrics, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - Sung-Min Choi
- Department of Pediatrics, Dongguk University Kyungju Hospital, Kyungju, South Korea
| | - Yun Jung Choi
- Department of Pediatrics, Seoul National University Children Hospital, Seoul, South Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Jung Yeon Shim
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jin Tack Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chang-Keun Kim
- Asthma and Allergy Center, Department of Pediatrics, Inje University Sanggye Paik Hospital, 1342 Dongil-ro, Nowon-gu, Seoul, 01757, South Korea.
| | - Hyeon-Jong Yang
- SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, South Korea. .,Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, South Korea.
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Lee MJ, Shin HJ, Yoon H. Imaging of Acute Pulmonary and Airway Diseases in Children. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2020; 81:756-769. [PMID: 36238171 PMCID: PMC9432207 DOI: 10.3348/jksr.2020.81.4.756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/12/2020] [Accepted: 07/11/2020] [Indexed: 11/15/2022]
Abstract
소아의 다양한 응급질환 중 급성 폐질환 또는 급성 기도질환은 영상의학과 의사가 자주 대하게 되는 임상 상황이며, 일차적으로 시행되는 영상검사는 흉부 방사선사진이다. 따라서 다양한 임상 상황에서의 감별진단과 영상 소견을 숙지하는 것이 중요하다. 본 종설에서는 급성 폐질환의 다양한 원인과 폐렴을 알아보고, 폐렴과 감별해야 하는 급성 폐질환을 생각해보았다. 급성 기도질환으로는 크룹, 급성 후두염, 기관연화증, 천식, 감염 후 폐쇄세기관지염, 그리고 이물 흡인을 검토하였다. 이렇게 소아에서 고려해야 할 질환들의 영상 소견을 검토하여 진단과 치료에 도움을 줄 수 있길 바란다.
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Affiliation(s)
- Mi-Jung Lee
- Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Joo Shin
- Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Haesung Yoon
- Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
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