Respiratory investigation · 2026
Verification of the JRS adult pneumonia clinical practice guidelines 2024: Sensitivity and specificity of the mycoplasma pneumonia diagnostic prediction score.
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Miyashita Naoyuki, Ogata Makoto, Fukuda Naoki, Yamura Akihisa, Ito Tomoki
Аннотация
BACKGROUND: The Japanese Respiratory Society Adult Pneumonia Clinical Practice Guidelines 2024 replaced the Atypical Pneumonia Diagnostic Prediction Score with a new diagnostic prediction score to differentiate between mycoplasmal and bacterial pneumonia. This study compared mycoplasmal and bacterial pneumonia to calculate the sensitivity and specificity of the Mycoplasma Pneumonia Diagnostic Prediction Score.
METHODS: The study was conducted at five hospitals during a mycoplasmal disease outbreak and analyzed 156 cases of mycoplasmal pneumonia and 162 cases of bacterial pneumonia.
RESULTS: All six items included in the diagnostic prediction score were more frequently observed in the mycoplasmal pneumonia group than in the bacterial pneumonia group. Patients in the mycoplasmal pneumonia group were significantly younger (p < 0.0001), and the prevalence of underlying diseases was significantly lower (p < 0.0001). Sputum, which was excluded from the diagnostic criteria in this study, was present in over 60% of the two groups, with no significant difference (p = 0.2957). The median white blood cell count was normal in the mycoplasmal pneumonia group and elevated in the bacterial pneumonia group (p < 0.0001). When five or more of the six diagnostic criteria were defined, the sensitivity for predicting mycoplasmal pneumonia was 71.8% and the specificity was 99.4%. Of the 44 mycoplasmal pneumonia cases that did not meet the diagnostic criteria, 38 were suspected of having mycoplasmal pneumonia based on chest computed tomography (CT) findings.
CONCLUSIONS: The Mycoplasma Pneumonia Diagnostic Prediction Score was newly established as a method that emphasizes specificity, with a sensitivity of 71.8% and a specificity of 99.4%.
METHODS: The study was conducted at five hospitals during a mycoplasmal disease outbreak and analyzed 156 cases of mycoplasmal pneumonia and 162 cases of bacterial pneumonia.
RESULTS: All six items included in the diagnostic prediction score were more frequently observed in the mycoplasmal pneumonia group than in the bacterial pneumonia group. Patients in the mycoplasmal pneumonia group were significantly younger (p < 0.0001), and the prevalence of underlying diseases was significantly lower (p < 0.0001). Sputum, which was excluded from the diagnostic criteria in this study, was present in over 60% of the two groups, with no significant difference (p = 0.2957). The median white blood cell count was normal in the mycoplasmal pneumonia group and elevated in the bacterial pneumonia group (p < 0.0001). When five or more of the six diagnostic criteria were defined, the sensitivity for predicting mycoplasmal pneumonia was 71.8% and the specificity was 99.4%. Of the 44 mycoplasmal pneumonia cases that did not meet the diagnostic criteria, 38 were suspected of having mycoplasmal pneumonia based on chest computed tomography (CT) findings.
CONCLUSIONS: The Mycoplasma Pneumonia Diagnostic Prediction Score was newly established as a method that emphasizes specificity, with a sensitivity of 71.8% and a specificity of 99.4%.