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. 2023 Oct 27;10(11):1744.
doi: 10.3390/children10111744.

The Role of Mannose-Binding Lectin and Inflammatory Markers in Establishing the Course and Prognosis of Community-Acquired Pneumonia in Children

Roxana Taraș  1   2 , Beatrice Mahler  3   4 , Mihaela Bălgrădean  1   2 , Diana Derewicz  1   2 , Miruna Ioana Lazăr  2 , Ruxandra Vidlescu  1   2 , Florian Berghea  5   6
Affiliations

The Role of Mannose-Binding Lectin and Inflammatory Markers in Establishing the Course and Prognosis of Community-Acquired Pneumonia in Children

Roxana Taraș et al. Children (Basel). .

Abstract

Background: Community-acquired pneumonia (CAP) is one of the most significant childhood diseases worldwide and a leading infectious cause of death in children. This study aimed to evaluate the prognostic value of the inflammatory markers-C-reactive protein (CRP) and procalcitonin (PCT)-and the polymorphic glycoprotein mannose-binding lectin (MBL), deficiency of which is associated with severe infections, in the determination of the optimal type and timing of therapeutic intervention for CAP in childhood.

Methods: Retrospective evaluation was conducted on a cohort of 204 children aged 4 months-17 years hospitalized with CAP. Their levels of CRP, PCT, and MBL were assessed for their association with a variety of outcomes, including the incidence of local and systemic complications, admission to the ICU, duration of antibiotic treatment and hospital stay, and death.

Results: CRP and PCT proved to be better predictors of complications of CAP than MBL. The area under the curve (AUC) value was highest for PCT as a predictor of systemic complications (AUC = 0.931, 95%CI 0.895-0.967), while CRP (AUC = 0.674, 95%CI 0.586-0.761) performed best as a predictor of local complications (AUC = 0.674, 95%CI 0.586-0.761). Regarding admission to the ICU, CRP was the weakest predictor (AUC = 0.741), while PCT performed the best (AUC = 0.833), followed by MBL (AUC = 0.797). Sensitivity and specificity were calculated for the optimal threshold generated by receiver operating characteristic (ROC) curves, rendering sensitivity of 90% and specificity of 87% for PCT in assessing the risk of systemic complications, compared to sensitivity of 83% and specificity of 90% for CRP. MBL showed relatively high sensitivity (96%) but low specificity (25%) for predicting the need for ICU admission.

Conclusions: Early measurement of CRP, PCT, and MBL provides clinicians with important information regarding the course and prognosis of children diagnosed with CAP, thus ensuring prompt, optimal therapeutic management.

Keywords: C-reactive protein; community-acquired pneumonia; mannose-binding lectin; procalcitonin.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study of children hospitalized with community-acquired pneumonia (CAP) between 2018 and 2020. MBL: mannose-binding lectin, CRP: C-reactive protein, PCT: procalcitonin.
Figure 2
Figure 2
Box plot of the distribution of levels of C-reactive protein (CRP) in children hospitalized with community-acquired pneumonia (N = 204). The “×” sign indicates the mean value.
Figure 3
Figure 3
Receiver operating characteristic (ROC) curves for C-reactive protein (CRP) as a predictor of local (A) and systemic (B) complications of pneumonia and admission to ICU (C) in children hospitalized for community-acquired pneumonia (N = 204).
Figure 4
Figure 4
Box plot of the distribution of levels of procalcitonin (PCT) in children hospitalized with community-acquired pneumonia (N = 204). The “×” sign indicates the mean value.
Figure 5
Figure 5
Receiver operating characteristic (ROC) curves for procalcitonin (PCT) as a predictor of local (A) and systemic (B) complications of pneumonia and admission to ICU (C) in children hospitalized for community-acquired pneumonia (N = 204).
Figure 6
Figure 6
Box plot of the distribution of levels of mannose-binding lectin (MBL) in children hospitalized with community-acquired pneumonia (N = 204). The “×” sign indicates the mean value.
Figure 7
Figure 7
Receiver operating characteristic (ROC) curves for mannose-binding lectin (MBL) as a predictor of local (A) and systemic (B) complications of pneumonia and admission to ICU (C) in children hospitalized for community-acquired pneumonia (N = 204).
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References

    1. Wilmott R., Bush A., Deterding R., Ratjen F., Sly P., Zar H., Li A.P. Disorders of the Respiratory Tract in Children. 9th ed. Elsevier; Amsterdam, The Netherlands: 2019. pp. 1596–1644.
    1. Ionescu M.D., Popescu N.A., Stănescu D., Enculescu A., Bălgrădean M., Căpitănescu G.M., Bumbăcea D. The Challenging Diagnosis of Interstitial Lung Disease in Children—One Case Report and Literature Review. J. Clin. Med. 2022;11:6736. doi: 10.3390/jcm11226736. - DOI - PMC - PubMed
    1. Tuomanen E., Kaplan S., Olarte L.C. Pneumococcal Pneumonia in Children. UpToDate; Waltham, MA, USA: 2017.
    1. Ionescu M.D., Balgradean M., Cirstoveanu C.G., Balgradean I., Popa L.I., Pavelescu C., Capitanescu A., Berghea E.C., Filip C. Myopericarditis Associated with COVID-19 in a Pediatric Patient with Kidney Failure Receiving Hemodialysis. Pathogens. 2021;10:486. doi: 10.3390/pathogens10040486. - DOI - PMC - PubMed
    1. Pomerantz W.J., Weiss S.L. Systemic Inflammatory Response Syndrome (SIRS) and Sepsis in Children: Definitions, Epidemiology, Clinical Manifestations, and Diagnosis—UpToDate. 2022. [(accessed on 26 June 2023)]. Available online: https://www.uptodate.com/contents/systemic-inflammatory-response-syndrom....