Frontiers in pediatrics · 2026
Construction of a nomogram combining CT and serum markers for predicting macrolide resistance gene mutation status in pediatric Mycoplasma pneumoniae pneumonia.
СтатьяНазвание и аннотация: Перевод в очереди
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Yuan Xinhui, Xin Rui, Wang Lifang, Ling Jizu, Li Yumei, Pang Lihong
Аннотация
PURPOSE: To develop and validate a nomogram integrating chest computed tomography (CT) features and serum biomarkers for predicting the mutation status of macrolide resistance genes in pediatric Mycoplasma pneumoniae pneumonia (MPP).
METHODS: This retrospective study enrolled children diagnosed with MPP, genetically stratified into macrolide-resistant (MRMP) and macrolide-sensitive (MSMP) groups based on 23S rRNA gene mutations (A2063G/A2064G). Clinical data, chest CT scans obtained within 48 h of admission, and serum biomarker levels (including C-reactive protein [CRP], procalcitonin [PCT], interleukin-6 [IL-6], D-dimer, neutrophil-to-lymphocyte ratio [NLR], and lactate dehydrogenase to albumin ratio [LAR]) measured within 24 h of admission prior to antibiotic therapy were analyzed.
RESULTS: Compared to the MSMP group (n = 283), the MRMP group (n = 145) had longer fever duration (5.91 vs. 4.85 days) and hospital stay (8.77 vs. 7.32 days), higher rates of shortness of breath (35.86% vs. 24.38%) and oxygen requirement (25.52% vs. 13.78%), elevated serum levels of CRP (39.16 vs. 31.74 mg/L), D-dimer (1.51 vs. 1.32 mg/L FEU), NLR (6.15 vs. 5.22), PCT (0.55 vs. 0.35 ng/mL), IL-6 (28.86 vs. 21.35 pg/mL), and LAR (9.19 vs. 8.42), and more frequent CT findings of lobar consolidation (68.28% vs. 45.23%), bilateral involvement (66.21% vs. 51.59%), pleural effusion (32.41% vs. 14.49%), and higher total severity score (9.22 vs. 7.88). The nomogram based on these independent predictors showed excellent discrimination with an area under the curve of 0.869.
CONCLUSION: A nomogram combining CT imaging characteristics and serum biomarkers predicted mutation status of macrolide resistance genes in pediatric MPP, potentially aiding early clinical decision-making.
METHODS: This retrospective study enrolled children diagnosed with MPP, genetically stratified into macrolide-resistant (MRMP) and macrolide-sensitive (MSMP) groups based on 23S rRNA gene mutations (A2063G/A2064G). Clinical data, chest CT scans obtained within 48 h of admission, and serum biomarker levels (including C-reactive protein [CRP], procalcitonin [PCT], interleukin-6 [IL-6], D-dimer, neutrophil-to-lymphocyte ratio [NLR], and lactate dehydrogenase to albumin ratio [LAR]) measured within 24 h of admission prior to antibiotic therapy were analyzed.
RESULTS: Compared to the MSMP group (n = 283), the MRMP group (n = 145) had longer fever duration (5.91 vs. 4.85 days) and hospital stay (8.77 vs. 7.32 days), higher rates of shortness of breath (35.86% vs. 24.38%) and oxygen requirement (25.52% vs. 13.78%), elevated serum levels of CRP (39.16 vs. 31.74 mg/L), D-dimer (1.51 vs. 1.32 mg/L FEU), NLR (6.15 vs. 5.22), PCT (0.55 vs. 0.35 ng/mL), IL-6 (28.86 vs. 21.35 pg/mL), and LAR (9.19 vs. 8.42), and more frequent CT findings of lobar consolidation (68.28% vs. 45.23%), bilateral involvement (66.21% vs. 51.59%), pleural effusion (32.41% vs. 14.49%), and higher total severity score (9.22 vs. 7.88). The nomogram based on these independent predictors showed excellent discrimination with an area under the curve of 0.869.
CONCLUSION: A nomogram combining CT imaging characteristics and serum biomarkers predicted mutation status of macrolide resistance genes in pediatric MPP, potentially aiding early clinical decision-making.