Differentiate Clinical Characteristics Between Viral Pneumonia and Mycoplasma pneumoniae and Nomograms for Predicting Mycoplasma pneumoniae : A Retrospective Study in Primary Hospitals.
Journal
The Pediatric infectious disease journal
ISSN: 1532-0987
Titre abrégé: Pediatr Infect Dis J
Pays: United States
ID NLM: 8701858
Informations de publication
Date de publication:
01 12 2023
01 12 2023
Historique:
medline:
27
11
2023
pubmed:
11
10
2023
entrez:
11
10
2023
Statut:
ppublish
Résumé
To identify the difference in clinical characteristics between viral pneumonia and Mycoplasma pneumoniae , providing cues on their differential diagnosis for primary hospitals with the insufficient pathogen detection capacity. We retrospectively reviewed the medical records of hospitalized children with acute respiratory tract infections, and pathogenic microbes test results were analyzed. Clinical characteristics, routine blood parameters and hospitalization duration and fee were compared between M. pneumoniae and viral pneumonia. We used in the multivariable logistic regression to predict the probability of children with M. pneumoniae and graphically represented by a dynamic nomogram. The discrimination and clinical utility of the model were confirmed by receiver operating characteristic and decision curve analysis curves. A total of 375 children with community-acquired pneumonia were included. Mycoplasma infection accounted for the largest proportion (22.13%). The incidence of both hypothermia and vomiting was lower in M. pneumoniae compared to viral pneumonia (hypothermia: 10.50% vs. 0.00%; vomiting: 7.90% vs. 0.00%). The prevalence of hyperthermia was higher in M. pneumoniae (hyperthermia: 89.5% vs. 100%). Procalcitonin, peripheral blood white blood cell count and lymphocyte levels were higher in the viral pneumonia group, and eosinophil levels were conversely lower. As for the duration of illness, the mean length of stay was 5.20 ± 2.12 (viral pneumonia) and 6.27 ± 2.48 days ( M. pneumoniae ). Children with M. pneumoniae had higher overall hospital costs and required more medical treatment. The above were all statistically significant with a P < 0.05. The scoring system was established based on the above results. Receiver operating characteristic curves showed good model-discrimination ability with 0.844 of the area under the curve in the training set and 0.778 in the test set. Decision curve analysis curves demonstrated the discriminative superiority of this model. The web-based dynamic nomogram calculator is accessible at https://zhxylxy0160128.shinyapps.io/Nomogram/ . Nomograms have satisfactory discrimination, and clinical utility may benefit in predicting the probability of developing M. pneumoniae in children. Children with M. pneumoniae have a higher burden than those with viral pneumonia and may require more intensive in-hospital monitoring.
Identifiants
pubmed: 37820276
doi: 10.1097/INF.0000000000004082
pii: 00006454-202312000-00002
pmc: PMC10629606
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1035-1040Subventions
Organisme : National Administration of Traditional Chinese Medicine
ID : ZYYCXTU-D-202206
Organisme : Guangdong science and technology innovation talent project
ID : 2021TQ060189
Organisme : Emergency Key Program of Guangzhou Laboratory
ID : EKPG21-06, TL22-13
Organisme : Macao Science and Technology Development Fund
ID : 0172/2019/A3, 0022/2021/A1
Organisme : Guangzhou Science and Technology Bureau research and development projects
ID : 202201020449, 202201020523
Organisme : Guangzhou key laboratory for clinical rapid diagnosis and early warning of infectious diseases
ID : 202102100003
Organisme : China Association for Science and Technology Young Talent Lifting Project
ID : 2020-2022QNRC001, 2020-2022QNRC002
Organisme : The Open Project of State Key Laboratory of Component Traditional Chinese Medicine
ID : CBCM2020101, CBCM2021102
Informations de copyright
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
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