This editorial reflects on the research,which investigates the potential of serum markers to predict the severity of Mycoplasma pneumoniae infections.Mycoplasma pneumoniae pneumonia(MPP)is a prevalent cause of respira...This editorial reflects on the research,which investigates the potential of serum markers to predict the severity of Mycoplasma pneumoniae infections.Mycoplasma pneumoniae pneumonia(MPP)is a prevalent cause of respiratory infections in children,often leading to significant morbidity.Predicting the severity of MPP can significantly enhance patient management and outcomes.This editorial reviews the role of specific laboratory markers:(1)Lactate dehydrogenase;(2)Interleukin(IL)-6;(3)IL-10;(4)Tumor necrosis factor-α;and(5)D-dimer in predicting the severity of MPP in pediatric patients.Elevated levels of these markers are strongly associated with severe cases of MPP,providing clinicians with valuable tools for early diagnosis and targeted intervention.展开更多
BACKGROUND Mycoplasma pneumoniae(MP)is a prevalent pathogen that causes respiratory infections in children and adolescents.AIM To assess the differences in the clinical features of MP-associated communityacquired pneu...BACKGROUND Mycoplasma pneumoniae(MP)is a prevalent pathogen that causes respiratory infections in children and adolescents.AIM To assess the differences in the clinical features of MP-associated communityacquired pneumonia(CAP)in children who presented with mild or severe mycoplasma pneumoniae pneumonia(MPP);to identify the incidence of myocardial damage between the two groups.METHODS This work is a retrospective study.We identified children between 2 mo and 16 years of age with clinical and radiological findings consistent with CAP.We admitted patients to the inpatient department of the Second Hospital of Jilin University,Changchun,China,from January 2019 to December 2019.RESULTS A total of 409 hospitalized patients were diagnosed with MPP.Among them were 214(52.3%)males and 195(47.7%)females.The duration of fever and cough was the longest in severe MPP cases.Similarly,plasma levels of highly sensitive Creactive protein(t=-2.834,P<0.05),alanine transaminase(t=-2.511,P<0.05),aspartate aminotransferase(t=-2.939,P<0.05),and lactate dehydrogenase(LDH)(t=-2.939,P<0.05)were all elevated in severe MPP cases compared with mild MPP cases,and these elevations were statistically significant(P<0.05).Conversely,the neutrophil percentage was significantly lower in severe MPP cases than in mild MPP cases.The incidence of myocardial damage was significantly higher in severe MPP cases than in mild MPP cases(χ^(2)=157.078,P<0.05).CONCLUSION Mycoplasma pneumoniae is the main cause of CAP.The incidence of myocardial damage was higher and statistically significant in severe MPP cases than in mild MPP cases.展开更多
Objective:To evaluate the dynamic changes in neutrophil-to-lymphocyte ratio(NLR),interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)levels in children with Mycoplasma pneumoniae pneumonia(MPP)complicate...Objective:To evaluate the dynamic changes in neutrophil-to-lymphocyte ratio(NLR),interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)levels in children with Mycoplasma pneumoniae pneumonia(MPP)complicated by myocardial injury and to determine their predictive value both individually and in combination.Methods:150 children diagnosed with MPP at Jiujiang Maternal and Child Health Hospital between June 2023 and June 2024 were selected.Patients were divided into the myocardial damage group(MD group,n=65)and the non-myocardial damage group(non-MD group,n=85),based on the presence of myocardial injury.Ninety hospitalized children without MPP served as the control group(Con group).Myocardial enzyme profile indicators,including lactate dehydrogenase(LDH),α-hydroxybutyrate dehydrogenase(α-HBDH),aspartate aminotransferase(AST),high-sensitivity cardiac troponin I(hs-cTnI),creatine kinase(CK),and creatine kinase-MB(CK-MB),were measured using a chemiluminescent immunoassay analyzer.Serum NLR,IL-6,CRP,and PCT levels were determined using appropriate analyzers.The correlation between these markers and myocardial enzyme indicators was analyzed using Spearman correlation analysis.Multivariate logistic regression was applied to identify risk factors for myocardial injury in MPP patients.Results:Serum levels of NLR,IL-6,CRP,and PCT in the MD and non-MD groups were significantly higher than in the Con group(P<0.05),with the MD group showing higher levels than the non-MD group(P<0.05).These markers were positively correlated with myocardial enzyme indicators.Logistic regression identified elevated NLR,IL-6,CRP,PCT,LDH,α-HBDH,AST,hs-cTnI,CK,and CK-MB as risk factors for myocardial injury in MPP patients(P<0.05).Conclusion:Elevated levels of NLR,IL-6,CRP,PCT,and myocardial enzymes are significant risk factors for myocardial injury in children with MPP,offering valuable insights for prevention and prognosis.展开更多
Background:Severe Mycoplasma pneumoniae pneumonia(MPP)may develop with long-term pulmonary outcomes despite treatment with macrolides.Combined treatment with glucocorticoids can improve this outcome,though the optimal...Background:Severe Mycoplasma pneumoniae pneumonia(MPP)may develop with long-term pulmonary outcomes despite treatment with macrolides.Combined treatment with glucocorticoids can improve this outcome,though the optimal dosage is unknown.The aim of this study was to investigate the effects of low-and high-dose methylprednisolone in reducing the percentage of long-term pulmonary outcomes for children with severe MPP.Methods:A randomized,single-blind,parallel-controlled,multicenter clinical trial,methylprednisolone for children with severe M.pneumoniae pneumonia(MCMP),is being conducted in China.Pediatric patients(≤18 years of age,expected number=402)admitted to the hospital with a clinical diagnosis of severe MPP and fulfilling inclusion and exclusion criteria are randomized(ratio of 1:1)to either a low-dose(2 mg/kg/d)or high-dose(10 mg/kg/d)methylprednisolone treatment group for 3 days followed by tapering of methylprednisolone over 12 days and combined with azithromycin.The primary composite outcome will be incidence of atelectasis,bronchiectasis,or bronchiolitis obliterans at 6-months after treatment.Secondary outcomes include recovery time of patient temperature,proportion of pulmonary lesions absorbed,changes of mucosa identified by bronchoscopy,length of hospital stay,pulmonary function and number of participant(s)needing intensive care.Assessments will be made at baseline,post-treatment and at 1-month,3-month and 6-month follow-ups.Discussion:This is the first randomized clinical trial designed to evaluate the safety and efficacy of low-versus high-dose methylprednisolone for reducing long-term pulmonary outcomes in pediatric patients with severe MPP.The results of this study will provide scientific evidence to guide clinical practice for the treatment of severe MPP.Trial registration:This study is registered at ClinicalTrials.gov(NCT02303587).展开更多
文摘This editorial reflects on the research,which investigates the potential of serum markers to predict the severity of Mycoplasma pneumoniae infections.Mycoplasma pneumoniae pneumonia(MPP)is a prevalent cause of respiratory infections in children,often leading to significant morbidity.Predicting the severity of MPP can significantly enhance patient management and outcomes.This editorial reviews the role of specific laboratory markers:(1)Lactate dehydrogenase;(2)Interleukin(IL)-6;(3)IL-10;(4)Tumor necrosis factor-α;and(5)D-dimer in predicting the severity of MPP in pediatric patients.Elevated levels of these markers are strongly associated with severe cases of MPP,providing clinicians with valuable tools for early diagnosis and targeted intervention.
文摘BACKGROUND Mycoplasma pneumoniae(MP)is a prevalent pathogen that causes respiratory infections in children and adolescents.AIM To assess the differences in the clinical features of MP-associated communityacquired pneumonia(CAP)in children who presented with mild or severe mycoplasma pneumoniae pneumonia(MPP);to identify the incidence of myocardial damage between the two groups.METHODS This work is a retrospective study.We identified children between 2 mo and 16 years of age with clinical and radiological findings consistent with CAP.We admitted patients to the inpatient department of the Second Hospital of Jilin University,Changchun,China,from January 2019 to December 2019.RESULTS A total of 409 hospitalized patients were diagnosed with MPP.Among them were 214(52.3%)males and 195(47.7%)females.The duration of fever and cough was the longest in severe MPP cases.Similarly,plasma levels of highly sensitive Creactive protein(t=-2.834,P<0.05),alanine transaminase(t=-2.511,P<0.05),aspartate aminotransferase(t=-2.939,P<0.05),and lactate dehydrogenase(LDH)(t=-2.939,P<0.05)were all elevated in severe MPP cases compared with mild MPP cases,and these elevations were statistically significant(P<0.05).Conversely,the neutrophil percentage was significantly lower in severe MPP cases than in mild MPP cases.The incidence of myocardial damage was significantly higher in severe MPP cases than in mild MPP cases(χ^(2)=157.078,P<0.05).CONCLUSION Mycoplasma pneumoniae is the main cause of CAP.The incidence of myocardial damage was higher and statistically significant in severe MPP cases than in mild MPP cases.
文摘Objective:To evaluate the dynamic changes in neutrophil-to-lymphocyte ratio(NLR),interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)levels in children with Mycoplasma pneumoniae pneumonia(MPP)complicated by myocardial injury and to determine their predictive value both individually and in combination.Methods:150 children diagnosed with MPP at Jiujiang Maternal and Child Health Hospital between June 2023 and June 2024 were selected.Patients were divided into the myocardial damage group(MD group,n=65)and the non-myocardial damage group(non-MD group,n=85),based on the presence of myocardial injury.Ninety hospitalized children without MPP served as the control group(Con group).Myocardial enzyme profile indicators,including lactate dehydrogenase(LDH),α-hydroxybutyrate dehydrogenase(α-HBDH),aspartate aminotransferase(AST),high-sensitivity cardiac troponin I(hs-cTnI),creatine kinase(CK),and creatine kinase-MB(CK-MB),were measured using a chemiluminescent immunoassay analyzer.Serum NLR,IL-6,CRP,and PCT levels were determined using appropriate analyzers.The correlation between these markers and myocardial enzyme indicators was analyzed using Spearman correlation analysis.Multivariate logistic regression was applied to identify risk factors for myocardial injury in MPP patients.Results:Serum levels of NLR,IL-6,CRP,and PCT in the MD and non-MD groups were significantly higher than in the Con group(P<0.05),with the MD group showing higher levels than the non-MD group(P<0.05).These markers were positively correlated with myocardial enzyme indicators.Logistic regression identified elevated NLR,IL-6,CRP,PCT,LDH,α-HBDH,AST,hs-cTnI,CK,and CK-MB as risk factors for myocardial injury in MPP patients(P<0.05).Conclusion:Elevated levels of NLR,IL-6,CRP,PCT,and myocardial enzymes are significant risk factors for myocardial injury in children with MPP,offering valuable insights for prevention and prognosis.
文摘Background:Severe Mycoplasma pneumoniae pneumonia(MPP)may develop with long-term pulmonary outcomes despite treatment with macrolides.Combined treatment with glucocorticoids can improve this outcome,though the optimal dosage is unknown.The aim of this study was to investigate the effects of low-and high-dose methylprednisolone in reducing the percentage of long-term pulmonary outcomes for children with severe MPP.Methods:A randomized,single-blind,parallel-controlled,multicenter clinical trial,methylprednisolone for children with severe M.pneumoniae pneumonia(MCMP),is being conducted in China.Pediatric patients(≤18 years of age,expected number=402)admitted to the hospital with a clinical diagnosis of severe MPP and fulfilling inclusion and exclusion criteria are randomized(ratio of 1:1)to either a low-dose(2 mg/kg/d)or high-dose(10 mg/kg/d)methylprednisolone treatment group for 3 days followed by tapering of methylprednisolone over 12 days and combined with azithromycin.The primary composite outcome will be incidence of atelectasis,bronchiectasis,or bronchiolitis obliterans at 6-months after treatment.Secondary outcomes include recovery time of patient temperature,proportion of pulmonary lesions absorbed,changes of mucosa identified by bronchoscopy,length of hospital stay,pulmonary function and number of participant(s)needing intensive care.Assessments will be made at baseline,post-treatment and at 1-month,3-month and 6-month follow-ups.Discussion:This is the first randomized clinical trial designed to evaluate the safety and efficacy of low-versus high-dose methylprednisolone for reducing long-term pulmonary outcomes in pediatric patients with severe MPP.The results of this study will provide scientific evidence to guide clinical practice for the treatment of severe MPP.Trial registration:This study is registered at ClinicalTrials.gov(NCT02303587).
