Changes in coagulation markers in children with Mycoplasma pneumoniae pneumonia and their predictive value for Mycoplasma severity.
Children
Coagulation
Mycoplasma pneumoniae pneumonia
Predictive value
Journal
Italian journal of pediatrics
ISSN: 1824-7288
Titre abrégé: Ital J Pediatr
Pays: England
ID NLM: 101510759
Informations de publication
Date de publication:
20 Oct 2023
20 Oct 2023
Historique:
received:
11
09
2023
accepted:
04
10
2023
medline:
23
10
2023
pubmed:
20
10
2023
entrez:
20
10
2023
Statut:
epublish
Résumé
This study investigates the correlation between coagulation levels and the severity of Mycoplasma pneumoniae pneumonia (MPP) in children. In addition, the study analyses the predictive value of coagulation abnormalities in MPP combined with necrotising pneumonia (NP). A total of 170 children with MPP who underwent treatment between June 2021 and February 2022 were selected for this study. The study population was divided into groups according to the severity of the disease to compare differences in the incidence of coagulation abnormalities between the groups. The participants were also divided into groups according to imaging manifestations to compare the differences in coagulation function among the different groups. All data information was processed for statistical analysis using SPSS Statistics 25.0 and GraphPad Prism 7.0 statistical analysis software. The incidence of coagulation abnormalities in the children in the severe MPP (SMPP) group was significantly higher than that in the normal MPP (NMPP) group (P < 0.05). The multi-factor logistic regression analysis revealed that the D-dimer level is an independent risk factor for the development of NP in SMPP (P < 0.05). The receiver operating characteristic curve analysis revealed statistically significant differences (P < 0.05) in D-dimer, fibrinogen degeneration products (FDP), neutrophils, lactate dehydrogenase and serum ferritin for predicting SMPP combined with NP. Bronchoscopic manifestations of coagulation indicators (D-dimer and FDP levels) were significantly higher in the mucus plug group than in the non-mucus plug group, while the activated partial thromboplastin time levels were lower in the former than in the latter (P < 0.05). The degree of elevated D-dimer and FDP levels was positively correlated with the severity of MPP, with elevated serum D-dimer levels (> 3.705 mg/L) serving as an independent predictor of MPP combined with NP in children.
Sections du résumé
BACKGROUND
BACKGROUND
This study investigates the correlation between coagulation levels and the severity of Mycoplasma pneumoniae pneumonia (MPP) in children. In addition, the study analyses the predictive value of coagulation abnormalities in MPP combined with necrotising pneumonia (NP).
METHODS
METHODS
A total of 170 children with MPP who underwent treatment between June 2021 and February 2022 were selected for this study. The study population was divided into groups according to the severity of the disease to compare differences in the incidence of coagulation abnormalities between the groups. The participants were also divided into groups according to imaging manifestations to compare the differences in coagulation function among the different groups. All data information was processed for statistical analysis using SPSS Statistics 25.0 and GraphPad Prism 7.0 statistical analysis software.
RESULTS
RESULTS
The incidence of coagulation abnormalities in the children in the severe MPP (SMPP) group was significantly higher than that in the normal MPP (NMPP) group (P < 0.05). The multi-factor logistic regression analysis revealed that the D-dimer level is an independent risk factor for the development of NP in SMPP (P < 0.05). The receiver operating characteristic curve analysis revealed statistically significant differences (P < 0.05) in D-dimer, fibrinogen degeneration products (FDP), neutrophils, lactate dehydrogenase and serum ferritin for predicting SMPP combined with NP. Bronchoscopic manifestations of coagulation indicators (D-dimer and FDP levels) were significantly higher in the mucus plug group than in the non-mucus plug group, while the activated partial thromboplastin time levels were lower in the former than in the latter (P < 0.05).
CONCLUSION
CONCLUSIONS
The degree of elevated D-dimer and FDP levels was positively correlated with the severity of MPP, with elevated serum D-dimer levels (> 3.705 mg/L) serving as an independent predictor of MPP combined with NP in children.
Identifiants
pubmed: 37858230
doi: 10.1186/s13052-023-01545-1
pii: 10.1186/s13052-023-01545-1
pmc: PMC10588045
doi:
Substances chimiques
Fibrinogen
9001-32-5
Hemostatics
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
143Informations de copyright
© 2023. Società Italiana di Pediatria.
Références
Rogozinski LE, Alverson BK, Biondi EA. Diagnosis and treatment of Mycoplasma pneumoniae in children. Minerva Pediatr. 2017;69(2):156–60. https://doi.org/10.23736/S0026-4946.16.04866-0 .
doi: 10.23736/S0026-4946.16.04866-0
pubmed: 28178776
Zhang W, Zhang X, Gu W, Yan Y, Ji W, Zhu C, Shao X, Hao C, Chen Z. Role of macrolides resistance in children with refractory Mycoplasma pneumoniae pneumonia. Chin J Appl Clin Pediatr. 2021;36(11):822–6. https://doi.org/10.3760/cma.j.cn101070-20200302-00308 .
doi: 10.3760/cma.j.cn101070-20200302-00308
Waites KB, Xiao L, Liu Y, Balish MF, Atkinson TP. Mycoplasma pneumoniae from the respiratory tract and Beyond. Clin Microbiol Rev. 2017;30(3):747–809. https://doi.org/10.1128/CMR.00114-16 .
doi: 10.1128/CMR.00114-16
pubmed: 28539503
pmcid: 5475226
Jeon HE, Kang HM, Yang EA, Han HY, Han SB, Rhim JW, Lee KY. Early confirmation of Mycoplasma pneumoniae infection by two short-term serologic IgM examination. Diagnostics (Basel). 2021;11(2):353. https://doi.org/10.3390/diagnostics11020353 .
doi: 10.3390/diagnostics11020353
pubmed: 33672480
D’Alonzo R, Mencaroni E, Di Genova L, Laino D, Principi N, Esposito S. Pathogenesis and treatment of neurologic Diseases Associated with Mycoplasma pneumoniae infection. Front Microbiol. 2018;9:2751. https://doi.org/10.3389/fmicb.2018.02751 .
doi: 10.3389/fmicb.2018.02751
pubmed: 30515139
pmcid: 6255859
Sarathchandran P, Al Madani A, Alboudi AM, Inshasi J. Mycoplasma pneumoniae infection presenting as stroke and meningoencephalitis with aortic and subclavian aneurysms without pulmonary involvement. BMJ Case Rep. 2018;2018:bcr2017221831. https://doi.org/10.1136/bcr-2017-221831 .
doi: 10.1136/bcr-2017-221831
pubmed: 29326371
pmcid: 5778324
Milenkovic M, Hadzibegovic A, Kovac M, Jovanovic B, Stanisavljevic J, Djikic M, Sijan D, Ladjevic N, Palibrk I, Djukanovic M, Velickovic J, Ratkovic S, Brajkovic M, Popadic V, Klasnja S, Toskovic B, Zdravkovic D, Crnokrak B, Markovic O, Bjekic-Macut J, Aleksic A, Petricevic S, Memon L, Milojevic A, Zdravkovic M. D-dimer, CRP, PCT, and IL-6 levels at admission to ICU can predict In-Hospital mortality in patients with COVID-19 pneumonia. Oxid Med Cell Longev. 2022;2022:8997709. https://doi.org/10.1155/2022/8997709 .
doi: 10.1155/2022/8997709
pubmed: 35237386
pmcid: 8884120
Qiu J, Ge J, Cao L. D-dimer: the risk factor of children’s severe Mycoplasma Pneumoniae Pneumonia. Front Pediatr. 2022;10:828437. https://doi.org/10.3389/fped.2022.828437 .
doi: 10.3389/fped.2022.828437
pubmed: 35498793
pmcid: 9039299
Huang X, Li D, Liu F, Zhao D, Zhu Y, Tang H. Clinical significance of D-dimer levels in refractory Mycoplasma pneumoniae pneumonia. BMC Infect Dis. 2021;21(1):14. https://doi.org/10.1186/s12879-020-05700-5 .
doi: 10.1186/s12879-020-05700-5
pubmed: 33407216
pmcid: 7787414
Zhou Y, Zhong Y. Changes of coagulation function in children with Mycoplasma pneumonia and its clinical significance. Chin J Clinicians:Electronic Ed. 2016;10(019):2962–4.
Respiratory Branch of Chinese Pediatric Society of Chinese Medical Association,Editorial Board of Chinese Journal ofApplied Clinical Pediatrics. Expert consensus on diagnosis and treatment of Mycoplasma pneumoniae pneumonia in children (2015). Chin J Appl Clin Pediatr. 2015;30(17):1304–8. https://doi.org/10.3760/cma.j.issn.2095-428X.2015.17.005 .
doi: 10.3760/cma.j.issn.2095-428X.2015.17.005
Masters IB, Isles AF, Grimwood K. Necrotizing pneumonia: an emerging problem in children? Pneumonia (Nathan). 2017;9:11. https://doi.org/10.1186/s41479-017-0035-0 .
doi: 10.1186/s41479-017-0035-0
pubmed: 28770121
National Health Commission of the People’s Republic of China, State Administration of Traditional Chinese Medicine. Guideline for diagnosis and treatment of community-acquired pneumonia in children (2019 version). Chin J Clin Infect Dis. 2019;12(1):6–13. https://doi.org/10.3760/cma.j.issn.1674-2397.2019.01.002 .
doi: 10.3760/cma.j.issn.1674-2397.2019.01.002
Yang EA, Kang HM, Rhim JW, Kang JH, Lee KY. Early corticosteroid therapy for Mycoplasma pneumoniae pneumonia irrespective of used antibiotics in children. J Clin Med. 2019;8(5):726. https://doi.org/10.3390/jcm8050726 .
doi: 10.3390/jcm8050726
pubmed: 31121867
pmcid: 6572103
Experts Group of Pediatric Respiratory Endoscopy, Talent Exchange Service Center of National Health Commission, Committee E, Pediatric Section of Chinese Medical Doctor Association, Pediatric Respiratory Endoscopy Committee, Endoscopists Section of Chinese Medical Doctor Association, Pediatric Interventional Respirology Group, Maternal and Pediatric Minimally Invasive Section of Chinese Maternal and Child Health Association. Bronchoscopy collaboration subgroup of Respirology Group, Pediatric Section of Chinese Medical Association. Guideline of pediatric flexible bronchoscopy in China(2018 version). Chin J Appl Clin Pediatr. 2018;33(13):983–9. https://doi.org/10.3760/cma.j.issn.2095-428X.2018.13.006 .
doi: 10.3760/cma.j.issn.2095-428X.2018.13.006
Choi YJ, Jeon JH, Oh JW. Critical combination of initial markers for predicting refractory Mycoplasma pneumoniae pneumonia in children: a case control study. Respir Res. 2019;20(1):193. https://doi.org/10.1186/s12931-019-1152-5 .
doi: 10.1186/s12931-019-1152-5
pubmed: 31443650
pmcid: 6706904
de Groot RCA, Meyer Sauteur PM, Unger WWJ, van Rossum AMC. Things that could be Mycoplasma pneumoniae. J Infect. 2017;74(Suppl 1):95–S100. https://doi.org/10.1016/S0163-4453(17)30198-6 .
doi: 10.1016/S0163-4453(17)30198-6
Narita M. Classification of Extrapulmonary Manifestations due to Mycoplasma pneumoniae infection on the basis of possible pathogenesis. Front Microbiol. 2016;7:23. https://doi.org/10.3389/fmicb.2016.00023 .
doi: 10.3389/fmicb.2016.00023
pubmed: 26858701
pmcid: 4729911
Li T, Yu H, Hou W, Li Z, Han C, Wang L. Evaluation of variation in coagulation among children with Mycoplasma pneumoniae pneumonia: a case-control study. J Int Med Res. 2017;45(6):2110–8. https://doi.org/10.1177/0300060517709613 .
doi: 10.1177/0300060517709613
pubmed: 28643533
pmcid: 5805204
Wang J, Mao J, Chen G, Huang Y, Zhou J, Gao C, Jin D, Zhang C, Wen J, Sun J. Evaluation on blood coagulation and C-reactive protein level among children with Mycoplasma pneumoniae pneumonia by different chest imaging findings. Med (Baltim). 2021;100(3):e23926. https://doi.org/10.1097/MD.0000000000023926 .
doi: 10.1097/MD.0000000000023926
Liu J, He R, Wu R, Wang B, Xu H, Zhang Y, Li H, Zhao S. Mycoplasma pneumoniae pneumonia associated thrombosis at Beijing Children’s hospital. BMC Infect Dis. 2020;20(1):51. https://doi.org/10.1186/s12879-020-4774-9 .
doi: 10.1186/s12879-020-4774-9
pubmed: 31948402
pmcid: 6966865
Zhang Y, Dai L, Zhou Y, Yang D, Tang L, Chen Z. Comparative analysis of clinical characteristics and prognosis between bacterial necrotizing pneumonia and Mycoplasma pneumoniae necrotizing pneumonia in children. Chin J Pediatr. 2019;57(8):625–30. https://doi.org/10.3760/cma.j.issn.0578-1310.2019.08.011 .
doi: 10.3760/cma.j.issn.0578-1310.2019.08.011
Zheng B, Zhao J, Cao L. The clinical characteristics and risk factors for necrotizing pneumonia caused by Mycoplasma pneumoniae in children. BMC Infect Dis. 2020;20(1):391. https://doi.org/10.1186/s12879-020-05110-7 .
doi: 10.1186/s12879-020-05110-7
pubmed: 32487034
pmcid: 7268704
Qian J, Wei YJ, Cheng YJ, Zhang Y, Peng B, Zhu CM. [Analysis of clinical features and risk factors of necrotizing pneumonia in children]. Beijing Da Xue Xue Bao Yi Xue Ban. 2022;54(3):541–7. https://doi.org/10.19723/j.issn.1671-167X.2022.03.021 . Chinese.
doi: 10.19723/j.issn.1671-167X.2022.03.021
pubmed: 35701133
Wang L, Xie Q, Xu S, Li H, Zhang L, Ai J, Liu Q, Chu C, Zhang X, Zhang W, Huang L. The role of flexible bronchoscopy in children with Mycoplasma pneumoniae pneumonia. Pediatr Res. 2023;93(1):198–206. https://doi.org/10.1038/s41390-021-01874-z .
doi: 10.1038/s41390-021-01874-z
pubmed: 35459766
Cao LJ, Liu JH, Shuai JF, Niu B, Lu SK, Huang KL. [Efficacy of early treatment via fiber bronchoscope in children with Mycoplasma pneumoniae pneumonia complicated by airway mucus obstruction]. Zhongguo Dang Dai Er Ke Za Zhi. 2018;20(4):298–302. https://doi.org/10.7499/j.issn.1008-8830.2018.04.009 . Chinese.
doi: 10.7499/j.issn.1008-8830.2018.04.009
pubmed: 29658455
Zhang H, Yang J, Zhao W, Zhou J, He S, Shang Y, Cheng Q. Clinical features and risk factors of plastic bronchitis caused by refractory Mycoplasma pneumoniae pneumonia in children: a practical nomogram prediction model. Eur J Pediatr. 2023 Jan;12. https://doi.org/10.1007/s00431-022-04761-9 .
Shi X, Luan H, Zhang H, Shang Y. Bronchoscopic characteristics of Mycoplasma pneumoniae in children and the level of inflammatory factors in bronchoalveolar lavage fluid. Int J Pediatr. 2017;44(12):867–71. https://doi.org/10.3760/cma.j.issn.1673-4408.2017.12.014 .
doi: 10.3760/cma.j.issn.1673-4408.2017.12.014
Cheng Q, Zhang H, Shang Y, Zhao Y, Zhang Y, Zhuang D, Cai X, Chen N. Clinical features and risk factors analysis of bronchitis obliterans due to refractory Mycoplasma pneumoniae pneumonia in children: a nomogram prediction model. BMC Infect Dis. 2021;21(1):1085. https://doi.org/10.1186/s12879-021-06783-4 .
doi: 10.1186/s12879-021-06783-4
pubmed: 34674642
pmcid: 8529771