Clinical Characteristics of Macrolide-Refractory Mycoplasma pneumoniae Pneumonia in Korean Children: A Multicenter Retrospective Study

Mycoplasma pneumoniae is a major causative pathogen of community-acquired pneumonia in children, and the treatment of choice is macrolides. There is an increasing trend in reports of refractory clinical responses despite macrolide treatment due to the emergence of macrolide-resistant M. pneumoniae. Early discrimination of macrolide-refractory M. pneumoniae pneumonia (MrMP) from macrolide-sensitive M. pneumoniae pneumonia (MSMP) is vital; however, testing for macrolide susceptibility at the time of admission is not feasible. This study aimed to identify the characteristics of MrMP in Korean children, in comparison with those of MSMP. In this multicenter study, board-certified pediatric pulmonologists at 22 tertiary hospitals reviewed the medical records from 2010 to 2015 of 5294 children who were hospitalized with M. pneumoniae pneumonia and administered macrolides as the initial treatment. One-way analysis of variance and the Kruskal-Wallis test were used to compare differences between groups. Of 5294 patients (mean age, 5.6 years) included in this analysis, 240 (4.5%), 925 (17.5%), and 4129 (78.0%) had MrMP, macrolide-less effective M. pneumoniae pneumonia, and MSMP, respectively. Compared with the MSMP group, the MrMP group had a longer fever duration, overall (13.0 days) and after macrolide use (8.0 days). A higher proportion of MrMP patients had respiratory distress, pleural effusion, and lobar pneumonia. The mean aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and C-reactive protein levels were the highest in the MrMP group, along with higher incidences of extrapulmonary manifestations and atelectasis (during and post infection). Pre-existing conditions were present in 17.4% (n = 725/4159) of patients, with asthma being the most common (n = 334/4811, 6.9%). This study verified that MrMP patients show more severe initial radiographic findings and clinical courses than MSMP patients. MrMP should be promptly managed by agents other than macrolides.

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Chlamydia pneumoniae and Mycoplasma pneumoniae pneumonia: comparison of clinical, epidemiological characteristics and laboratory profiles

Epidemiology and Infection ◽

10.1017/s0950268805005522 ◽

2005 ◽

Vol 134 (3) ◽

pp. 548-555 ◽

Cited By ~ 19

Author(s):

I. PULJIZ ◽

I. KUZMAN ◽

O. DAKOVIC-RODE ◽

N. SCHÖNWALD ◽

B. MISE

Keyword(s):

Pleural Effusion ◽

Mycoplasma Pneumoniae ◽

Aspartate Aminotransferase ◽

Chlamydia Pneumoniae ◽

Clinical Findings ◽

Community Acquired Pneumonia ◽

C Reactive Protein ◽

Reactive Protein ◽

Epidemiological Characteristics ◽

Mycoplasma Pneumoniae Pneumonia

The purpose of our retrospective 3-year study was to analyse and compare clinical and epidemiological characteristics in hospitalized patients older than 6 years with community-acquired pneumonia (CAP) caused by Chlamydia pneumoniae (87 patients) and Mycoplasma pneumoniae (147 patients). C. pneumoniae and M. pneumoniae infection was confirmed by serology. C. pneumoniae patients were older (42·12 vs. 24·64 years), and were less likely to have a cough, rhinitis, and hoarseness (P<0·001). C. pneumoniae patients had higher levels of C-reactive protein (CRP), and aspartate aminotransferase (AST) than M. pneumoniae patients (P<0·001). Pleural effusion was recorded more frequently in patients with M. pneumoniae (8·84 vs. 3·37%). There were no characteristic epidemiological and clinical findings that would distinguish CAP caused by M. pneumoniae from C. pneumoniae. However, some factors are indicative for C. pneumoniae such as older age, lack of cough, rhinitis, hoarseness, and higher value of CRP, and AST.

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Environmental and occupational respiratory diseases – 1060. Clinical responses to methylprednisolone pulse therapy in children with severe refractory mycoplasma pneumoniae pneumonia

World Allergy Organization Journal ◽

10.1186/1939-4551-6-s1-p58 ◽

2013 ◽

Vol 6 ◽

pp. P58

Author(s):

Jae Ho Lee ◽

Sun Young You ◽

Eun Ae Yang ◽

You Sook Youn ◽

Hong Ryang Gil

Keyword(s):

Mycoplasma Pneumoniae ◽

Respiratory Diseases ◽

Pulse Therapy ◽

Methylprednisolone Pulse Therapy ◽

Methylprednisolone Pulse ◽

Clinical Responses ◽

Mycoplasma Pneumoniae Pneumonia

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Correlation between chest radiographic findings and clinical features in hospitalized children with Mycoplasma pneumoniae pneumonia

PLoS ONE ◽

10.1371/journal.pone.0219463 ◽

2019 ◽

Vol 14 (8) ◽

pp. e0219463 ◽

Cited By ~ 5

Author(s):

Yeon Jin Cho ◽

Mi Seon Han ◽

Woo Sun Kim ◽

Eun Hwa Choi ◽

Young Hun Choi ◽

...

Keyword(s):

Clinical Features ◽

Mycoplasma Pneumoniae ◽

Hospitalized Children ◽

Radiographic Findings ◽

Mycoplasma Pneumoniae Pneumonia

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Association of serum procalcitonin and C-reactive protein levels with CURB-65 criteria among patients with community-acquired pneumonia

International Journal of General Medicine ◽

10.2147/ijgm.s165190 ◽

2018 ◽

Vol Volume 11 ◽

pp. 217-223 ◽

Cited By ~ 5

Author(s):

Fariba Keramat ◽

Hamid Reza Ghasemi Basir ◽

Elham Abdoli ◽

Arghavan Shafiee Aghdam ◽

Jalal Poorolajal

Keyword(s):

Community Acquired Pneumonia ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein

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Role of Plasma Presepsin, Procalcitonin and C-reactive Protein Levels in Determining the Severity and Mortality of Community-Acquired Pneumonia in the Emergency Department

10.22514/sv.2020.16.0034 ◽

2020 ◽

Keyword(s):

Emergency Department ◽

Community Acquired Pneumonia ◽

C Reactive Protein ◽

Pneumonia Severity ◽

Protein Levels ◽

Reactive Protein ◽

Imaging Results ◽

Severity Scores ◽

Significant Difference

Objective: In this study, we aimed to explore the role of the plasma presepsin level in patients with community-acquired pneumonia during admission to the emergency department in assessing the diagnosis, severity, and prognosis of the disease. In addition, we wanted to investigate the relationship of presepsinin with procalcitonin, C-reactive protein and pneumonia severity scores. Methods: One hundred twenty-three patients over the age of 18 who presented with a diagnosis of pneumonia to the emergency department were included in the study. The vital signs, symptoms, examination findings, background information, laboratory results, and radiological imaging results of the patients were recorded. The 30-day mortality rates of the patients were determined. Results: A statistically significant difference was found between the presepsin levels of the patients diagnosed with pneumonia and those of healthy subjects (p < 0.05). The plasma presepsin levels of the patients who died (8.63 ± 6.46) were significantly higher than those of the patients who lived (5.82 ± 5.97) (p < 0.05). The plasma procalcitonin and C-reactive protein levels of the dead patients were significantly higher than those living (p < 0.05). A presepsin cut-off value of 3.3 ng/mL for 30-day mortality was established (AUROC, 0.65; specificity, 45%; sensitivity, 82%). Procalcitonin is the most successful biomarker in the determination of mortality (AUROC, 0.70). A significant correlation was available between presepsin and lactate, C-reactive protein and procalcitonin (p < 0.05). There was a significant correlation between the Pneumonia Severity Index values and presepsin levels (p < 0.001, r = 0.311). Conclusion: The plasma presepsin level can be utilized for diagnosing community-acquired pneumonia. Plasma presepsin, procalcitonin and C-reactive protein levels can be used to predict the severity and mortality of community-acquired pneumonia.

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Sequential Mycoplasma pneumoniae pneumonia and Chromobacterium violaceum skin abscess in a pediatric patient

The Journal of Infection in Developing Countries ◽

10.3855/jidc.8878 ◽

2017 ◽

Vol 11 (08) ◽

pp. 656-661 ◽

Cited By ~ 1

Author(s):

Weizhen Guo ◽

Iris Wai Sum Li ◽

Xi Li ◽

Hua Xu ◽

Dongrong Lu ◽

...

Keyword(s):

Mycoplasma Pneumoniae ◽

Pediatric Patients ◽

Community Acquired Pneumonia ◽

Chromobacterium Violaceum ◽

Respiratory Pathogen ◽

First Case ◽

History Of ◽

The Right ◽

Super Infection ◽

Mycoplasma Pneumoniae Pneumonia

Mycoplasma pneumoniae is a common atypical respiratory pathogen causing community-acquired pneumonia in children. Co-infection with other respiratory viruses is common in pediatric patients but super-infection with bacteria other than Streptococcus pneumoniae and Haemophilus influenzae is rare. The first case of Chromobacterium violaceum infection incubated during and manifested after pneumonia caused by Mycoplasma pneumoniae in a 12-month old girl without any known history of immunodeficiency is here reported. The patient developed fever with redness and swelling over the middle phalanx of the right hand index finger which progressed to the formation of skin abscess. Following a course of intravenous meropenem and surgical drainage of the skin abscess, the patient fully recovered and was discharged.

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Sequential C-reactive protein: a cheap and a valuable biomarker in patients with sepsis

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20191687 ◽

2019 ◽

Vol 7 (5) ◽

pp. 1837

Author(s):

Vinod Dhakad ◽

Sushma Trikha ◽

Neelima Singh ◽

Archana Kansal

Keyword(s):

Diabetes Mellitus ◽

Protein A ◽

Response To Therapy ◽

Age Group ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

Patients With Diabetes ◽

Observational Cohort ◽

Time Of Admission

Background: C-reactive protein (CRP) is a valuable biomarker of sepsis. Levels of CRP increase very rapidly in response to infection, and decrease just as rapidly with the resolution of the condition. The aim of the research was to study, C-reactive protein levels in patients of sepsis and to study the pattern of CRP levels in patients of Sepsis with hypertension, diabetes, smokers and alcoholics.Methods: This prospective observational cohort study was conducted from December 2016 to September 2018 in 100 cases of sepsis. Patients presenting in emergency with sepsis were included as subjects. C- reactive protein was measured in every patient at the time of admission and after 72 hours. Facts related to history, clinical examination and biochemical parameters were recorded in a pretyped proforma. Data were analyzed using SPSS software.Results: Males outnumbered females. Most of the patients40(40%) were in the age group of less than 30 years age group. CRP levels were markedly elevated in patients with diabetes mellitus (92.2±102.63) as compared to patients with hypertension (36.66±26.97) or both (24.20±12.87). CRP levels were higher in alcoholics (60.59±44.20) as compared to smokers (13.37±10.96). CRP levels decreased significantly after 72 hours compared to CRP levels at the time of admission (p <0.001) across all patients suggestive of acute infection.Conclusions: Serial CRP measurement, rather than a single determination at the time of admission, is cheap and valuable in the diagnosis of sepsis and in monitoring the response to therapy. CRP levels shows exaggerated response in diabetes mellitus and alcoholics with sepsis in this study.

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Prediction Model for Severe Mycoplasma Pneumoniae Pneumonia in Pediatric Patients by Admission Laboratory Indicators

10.21203/rs.3.rs-403591/v1 ◽

2021 ◽

Author(s):

Qing Chang ◽

Hong-Lin Chen ◽

Neng-Shun Wu ◽

Yan-Min Gao ◽

Rong Yu ◽

...

Keyword(s):

Prediction Model ◽

Mycoplasma Pneumoniae ◽

Eosinophil Count ◽

Goodness Of Fit ◽

Pediatric Patients ◽

Community Acquired Pneumonia ◽

Goodness Of Fit Test ◽

Independent Risk Factors ◽

Mycoplasma Pneumoniae Pneumonia ◽

Actual Incidence

Abstract Objective The purpose of this study was to develop a model for predicting severe mycoplasma pneumoniae pneumonia (SMMP) in pediatric patients with MMP on admission by laboratory indicators. Methods Pediatric patients with MPP from January 2019 to December 2020 in our hospital were enrolled in this study. SMMP was diagnosed according to guideline for diagnosis and treatment of community acquired pneumonia in children (2019 version). Prediction model was developed according to the admission laboratory indicators. ROC curve and Goodness of fit test were analyzed for the predictive value. Results A total of 233 MMP patients were included in the study, with 121 males and 112 females, aged 4.541 (1–14) years. Among them, 84 (36.1%, 95% CI 29.9%-42.6%) pediatric patients were diagnosed as SMPP. Some admission laboratory indicators (IgM, eosinophil proportion, eosinophil count, hemoglobin, ESR, total protein, albumin and prealbumin) were found statistically different (P < 0.05) between non-SMMP group and SMMP group. Logistic regress analysis showed IgM, eosinophil proportion, eosinophil count, ESR, and prealbumin were independent risk factors for SMMP. According to these five admission laboratory indicators, Nomograph prediction model was developed. The AUC of the Nomograph prediction model was 0.777, and the goodness of fit test showed that the predicted incidence of the model was consistent with the actual incidence (χ2 = 244.51, P = 0.203). Conclusion We developed a model for predicting SMMP in pediatric patients by admission laboratory indicators. This model has good discrimination and calibration, which provides a basis for the early identification SMMP on admission.

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