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Antigen-Capture Enzyme-Linked Immunosorbent Assay for Specific Detection of Mycoplasma pneumoniae
Published on: February 24, 2023
Critical combination of initial markers for predicting refractory Mycoplasma pneumoniae pneumonia in children: a case
Young-Jin Choi1, Ju-Hee Jeon2, Jae-Won Oh3
1Department of Pediatrics, College of Medicine, Hanyang University Guri Hospital, 249-1 Kyomun-Dong, Guri, Kyunggi-Do, Seoul, 471-701, South Korea.
Background:
It is unclear whether the responses of refractory and common Mycoplasma pneumoniae (MP) pneumonia to macrolides differ. Hence, this study aimed to identify biomarkers that may be used to distinguish refractory and common pneumonias caused by MP in children at hospital admission.
Methods:
The study included 123 children divided into five groups according to infection agent and treatment protocol: Group I included those with MP infection without documented viral infection, treated with only macrolides; Group II included those with MP infection without documented viral infection, treated with a combination of macrolides and methylprednisolone; Group III included those with MP infection and documented viral infection, treated with only macrolides; Group IV included those with viral pneumonia without documented MP infection; Group V was the control group composed of admitted children without MP or a documented viral infection. These five groups were further subdivided into Groups A (including Groups I, III, IV, and V) and B (Group II) according to the responses to macrolide treatment. Concentrations of cytokines interleukin 6, interleukin 17, interleukin 18, and tumor necrosis factor-α, and lactate dehydrogenase, and ferritin of all children were evaluated, and these levels were compared among the groups. Statistical comparisons were made using Kruskal Wallis test and Mann-Whitney U test.
Results:
Serum lactate dehydrogenase, interleukin 18, and ferritin concentrations were significantly higher in Group II than in Groups I, III, IV, and V and were significantly higher in Group B than in Group A. When the serum lactate dehydrogenase concentration was 350 IU/L or higher, the sensitivity and specificity for diagnosing refractory MP pneumonia were 73 and 80%, respectively. When the interleukin 18 level was 360 pg/mL or higher, the sensitivity and specificity for diagnosing refractory MP pneumonia were 93 and 70%, respectively. When the ferritin level was 230 pg/mL or higher, the sensitivity and specificity for diagnosing refractory MP pneumonia were 67 and 67%, respectively.
Conclusion:
These results suggest that serum lactate dehydrogenase, interleukin 18, and ferritin constitute the critical combination of biomarkers useful for predicting refractory MP pneumonia in children at hospital admission.
Insights
Biomarkers like lactate dehydrogenase, interleukin 18, and ferritin can help predict severe Mycoplasma pneumoniae (MP) pneumonia in children. Early identification of refractory MP pneumonia aids in timely treatment and improved outcomes.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Biomarker Discovery
Background:
- Distinguishing refractory Mycoplasma pneumoniae (MP) pneumonia from common MP pneumonia is clinically challenging.
- Understanding differential responses to macrolide treatment is crucial for pediatric respiratory infections.
Purpose of the Study:
- To identify reliable biomarkers for differentiating refractory MP pneumonia in children at hospital admission.
- To compare inflammatory markers in children with varying MP pneumonia severity and treatment responses.
Main Methods:
- A cohort of 123 children was categorized into five groups based on infection type and treatment.
- Serum levels of cytokines (IL-6, IL-17, IL-18, TNF-α), lactate dehydrogenase (LDH), and ferritin were measured.
- Statistical analyses, including Kruskal Wallis and Mann-Whitney U tests, were employed for comparisons.
Main Results:
- Significantly elevated serum LDH, IL-18, and ferritin levels were observed in patients with refractory MP pneumonia (Group II/B).
- LDH >350 IU/L showed 73% sensitivity and 80% specificity for refractory MP pneumonia.
- IL-18 >360 pg/mL demonstrated 93% sensitivity and 70% specificity, while ferritin >230 pg/mL had 67% sensitivity and 67% specificity.
Conclusions:
- Serum LDH, IL-18, and ferritin represent a critical combination of biomarkers for predicting refractory MP pneumonia in pediatric patients.
- These biomarkers can aid in early diagnosis and management of severe MP pneumonia cases.
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