Multicenter Study

. 2022 Nov;16(11):756-767.

doi: 10.1111/crj.13549. Epub 2022 Oct 7.

Assessment of variables associated with prolonged admission duration in children with Mycoplasma pneumoniae pneumonia

Myongsoon Sung¹, Eui Jeong Roh², Eun Sil Lee², Ji Young Lee³, Hyo-Bin Kim⁴, Youngmin Ahn⁵, Byung Wook Eun⁵, Ja Kyoung Kim⁶, Hyoung Young Kim⁷, Sung-Su Jung⁷, Minji Kim⁸, Eun Kyeong Kang⁹, Eun-Ae Yang¹⁰, Soo Jin Lee¹¹, Yang Park¹², Ju-Hee Seo¹³, Eun Lee¹⁴, Eun Seok Yang¹⁵, Hyung Min Cho¹⁶, Meeyong Shin¹⁷, Hai Lee Chung¹⁸, Yoon Young Jang¹⁸, Bong Seok Choi¹⁹, Hyeona Kim¹⁹, Jin-A Jung²⁰, Seung Taek You¹², Mi-Hee Lee²¹, Jin Tack Kim²², Bong Seong Kim²³, Yoon Ha Hwang²⁴, Jung Yeon Shim²⁵, Hyeon-Jong Yang²⁶, Man Yong Han²⁷, Hae Young Yew²⁸, Dong Hyeok Kim²⁹, Sang Oun Jeong²⁹, Kyujam Whang²⁹, Eunjoo Lee³⁰, You Hoon Jeon³¹, Eun Hee Chung³²

Affiliations

¹ Department of Pediatrics, Soonchunhyang University Hospital, Gumi, South Korea.
² Department of Pediatrics, Chungnam National University Hospital, Daejeon, South Korea.
³ Department of Pediatrics, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, South Korea.
⁴ Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, South Korea.
⁵ Department of Pediatrics, Eulji University Hospital, Seoul, South Korea.
⁶ Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, South Korea.
⁷ Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, South Korea.
⁸ Department of Pediatrics, Chungnam University Sejeong Hospital, Chungnam National University College of Medicine, Sejong, South Korea.
⁹ Department of Pediatrics, Dongguk University Ilsan Hospital, Goyang, South Korea.
¹⁰ Department of Pediatrics, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, South Korea.
¹¹ Department of Pediatrics, Eulji University Hospital, Daejeon, South Korea.
¹² Department of Pediatrics, Wonkwang University School of Medicine, Iksan, South Korea.
¹³ Department of Pediatrics, Dankook University College of Medicine, Cheonan, South Korea.
¹⁴ Department of Pediatrics, Chonnam National University Hostpital, Chonnam National University Medical School, Gwangju, South Korea.
¹⁵ Department of Pediatrics, College of Medicine, Chosun University, Chosun University Hospital, Gwangju, South Korea, Gwangju, South Korea.
¹⁶ Department of Pediatrics, Presbyterian Medical Center, Jeonju, South Korea.
¹⁷ Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.
¹⁸ Department of Pediatrics, Daegu Catholic University Medical Center, Daegu, South Korea.
¹⁹ Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, South Korea.
²⁰ Department of Pediatrics, Donga-A University College of Medicine, Busan, South Korea.
²¹ Department of Pediatrics, Incheon Medical Center, Incheon, South Korea.
²² Department of Pediatrics, College of Medicine, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Uijeongbu, South Korea.
²³ Department of Pediatrics, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, South Korea.
²⁴ Department of Pediatrics, Busan ST. Mary's Hospital, Busan, South Korea.
²⁵ Department of Pediatrics, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, South Korea.
²⁶ Department of Pediatrics, Soonchunhyang University Hospital, Seoul, South Korea.
²⁷ Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
²⁸ Department of Pediatrics, Kogel Hospital, Daejeon, South Korea.
²⁹ Divison of Bacterial Diseases, Bureau of Infectious Disease Diagnosis Control, Korea Disease Control and Prevention Agency (KDCA), Sejong, South Korea.
³⁰ Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, South Korea.
³¹ Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hwasung, South Korea.
³² Department of Pediatrics, Chungnam National University College of Medicine, Daejeon, South Korea.

PMID: 36205104
PMCID: PMC9629989
DOI: 10.1111/crj.13549

Multicenter Study

Assessment of variables associated with prolonged admission duration in children with Mycoplasma pneumoniae pneumonia

Myongsoon Sung et al. Clin Respir J. 2022 Nov.

. 2022 Nov;16(11):756-767.

doi: 10.1111/crj.13549. Epub 2022 Oct 7.

Authors

Affiliations

¹ Department of Pediatrics, Soonchunhyang University Hospital, Gumi, South Korea.
² Department of Pediatrics, Chungnam National University Hospital, Daejeon, South Korea.
³ Department of Pediatrics, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, South Korea.
⁴ Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, South Korea.
⁵ Department of Pediatrics, Eulji University Hospital, Seoul, South Korea.
⁶ Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, South Korea.
⁷ Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, South Korea.
⁸ Department of Pediatrics, Chungnam University Sejeong Hospital, Chungnam National University College of Medicine, Sejong, South Korea.
⁹ Department of Pediatrics, Dongguk University Ilsan Hospital, Goyang, South Korea.
¹⁰ Department of Pediatrics, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, South Korea.
¹¹ Department of Pediatrics, Eulji University Hospital, Daejeon, South Korea.
¹² Department of Pediatrics, Wonkwang University School of Medicine, Iksan, South Korea.
¹³ Department of Pediatrics, Dankook University College of Medicine, Cheonan, South Korea.
¹⁴ Department of Pediatrics, Chonnam National University Hostpital, Chonnam National University Medical School, Gwangju, South Korea.
¹⁵ Department of Pediatrics, College of Medicine, Chosun University, Chosun University Hospital, Gwangju, South Korea, Gwangju, South Korea.
¹⁶ Department of Pediatrics, Presbyterian Medical Center, Jeonju, South Korea.
¹⁷ Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.
¹⁸ Department of Pediatrics, Daegu Catholic University Medical Center, Daegu, South Korea.
¹⁹ Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, South Korea.
²⁰ Department of Pediatrics, Donga-A University College of Medicine, Busan, South Korea.
²¹ Department of Pediatrics, Incheon Medical Center, Incheon, South Korea.
²² Department of Pediatrics, College of Medicine, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, Uijeongbu, South Korea.
²³ Department of Pediatrics, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, South Korea.
²⁴ Department of Pediatrics, Busan ST. Mary's Hospital, Busan, South Korea.
²⁵ Department of Pediatrics, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, South Korea.
²⁶ Department of Pediatrics, Soonchunhyang University Hospital, Seoul, South Korea.
²⁷ Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
²⁸ Department of Pediatrics, Kogel Hospital, Daejeon, South Korea.
²⁹ Divison of Bacterial Diseases, Bureau of Infectious Disease Diagnosis Control, Korea Disease Control and Prevention Agency (KDCA), Sejong, South Korea.
³⁰ Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, South Korea.
³¹ Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hwasung, South Korea.
³² Department of Pediatrics, Chungnam National University College of Medicine, Daejeon, South Korea.

PMID: 36205104
PMCID: PMC9629989
DOI: 10.1111/crj.13549

Abstract

Introduction: Macrolide-resistant Mycoplasma pneumoniae (MRMP) has become prevalent in children. This study investigated the clinical and laboratory variables of MRMP and macrolide-sensitive M. pneumoniae (MSMP) and identified factors associated with prolonged hospital admission in children.

Methods: A prospective multicenter study was conducted in 1063 children <18 years old in July 2018-June 2020. The 454 had a positive M. pneumoniae polymerase chain reaction assay.

Results: Most subjects had MRMP (78.4%), and all mutated strains had the A2063G transition. We defined MRMP* (n = 285) as MRMP pneumonia requiring admission and MSMP* (n = 72) as MSMP pneumonia requiring admission. Patients with MRMP pneumonia were older, more likely to have segmental/lobar pneumonia, and had more febrile days than those with MSMP pneumonia. C-reactive protein (CRP), lactate dehydrogenase (LDH), and percentage neutrophils were more strongly associated with MRMP* than MSMP* groups. Percentage neutrophils, CRP, and alanine aminotransferase significantly changed between admission and follow-up measurements in patients with MRMP* (P < 0.05). The duration of admission positively correlated with the number of febrile days after initiation of antibiotic medication and laboratory variables (white blood cell count, CRP, and aspartate aminotransferase [AST]) (P < 0.05). Random forest analysis indicated that the number of febrile days after initiation of antibiotic medication, AST, and percentage neutrophils at admission was over five.

Conclusions: This study indicated that children with M. pneumoniae pneumonia with a higher number of febrile days after initiation of antibiotic medication, AST, and percentage neutrophils at admission were more likely to have prolonged admission duration.

Keywords: M. pneumoniae; aspartate aminotransferase; children; macrolide-resistant M. pneumoniae; neutrophil portion.

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Conflict of interest statement

We declare that there are no real or perceived conflicts of interest to declare related with this submission and that we have no links with industry.

Figures

**FIGURE 1**
Study population. MRMP, macrolide‐resistant *Mycoplasma pneumoniae* ; MSMP, macrolide‐susceptible *M. pneumoniae* ; PCR, polymerase chain reaction

**FIGURE 2**
Factors significantly associated with prolonged length of hospitalization (P < 0.05, except tetracycline or quinolone). Red line: positive correlation; blue line: negative correlation; Rho: correlation coefficient

**FIGURE 3**
Random forest variable importance plot. Mean decrease accuracy measures the model's performance without each variable. A higher value indicates the importance of different variables on prolonged length of hospitalization in children with *Mycoplasma pneumoniae* . Removal of that variables causes the model to lose accuracy in prediction. MRMP, macrolide‐resistant *M. pneumoniae*

See this image and copyright information in PMC

References

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Assessment of variables associated with prolonged admission duration in children with Mycoplasma pneumoniae pneumonia

Affiliations

Assessment of variables associated with prolonged admission duration in children with Mycoplasma pneumoniae pneumonia

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Affiliations

Abstract

Conflict of interest statement

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