Related Experiment Video
Updated: Jan 9, 2026
A Non-invasive and Technically Non-intensive Method for Induction and Phenotyping of Experimental Bacterial Pneumonia in Mice
Published on: September 28, 2016
Development of a nomogram for predicting refractory Mycoplasma pneumoniae pneumonia in children: a prospective study
1Department of Pediatrics, The Second People's Hospital of Changzhou, the Third Affiliated Hospital of Nanjing Medical University, Changzhou, China.
Insights
This study developed a nomogram to predict refractory Mycoplasma pneumoniae pneumonia (RMPP) in children. Early identification of RMPP risk factors like fever duration and YKL-40 levels aids timely intervention.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Clinical Prediction Modeling
Background:
- Refractory Mycoplasma pneumoniae pneumonia (RMPP) poses a significant clinical challenge in children, with potential for severe complications.
- Accurate early prediction of RMPP is crucial for timely clinical intervention and improved outcomes.
- Existing risk factors require a validated tool for early RMPP identification.
Purpose of the Study:
- To identify clinical risk factors associated with RMPP in children.
- To develop and validate a nomogram model for the early prediction of RMPP.
Main Methods:
- A prospective study of children diagnosed with Mycoplasma pneumoniae pneumonia (MPP) was conducted.
- Independent risk factors for RMPP were identified using multivariate logistic regression.
- A predictive nomogram was constructed and its performance evaluated using AUC, calibration curves, and DCA.
Main Results:
- Fever duration, duration of glucocorticoid use, and YKL-40 levels were identified as independent risk factors for RMPP.
- The nomogram demonstrated excellent predictive performance with an AUC of 0.92.
- The nomogram showed excellent calibration and clinical utility across a wide range of threshold probabilities.
Conclusions:
- A nomogram incorporating fever duration, glucocorticoid use duration, and YKL-40 levels shows promise for early RMPP prediction in children.
- This tool can aid clinicians in identifying children at high risk for RMPP, facilitating prompt management.
Background:
Refractory Mycoplasma pneumoniae pneumonia (RMPP) presents a significant clinical challenge due to its potential for severe complications and long-term sequelae in children. While several risk factors have been identified, an accurate and early predictive tool to guide timely clinical intervention is urgently needed. This study aimed to identify the clinical risk factors and develop a nomogram model for the early prediction of RMPP.
Methods:
This prospective study enrolled children diagnosed with Mycoplasma pneumoniae pneumonia (MPP) who visited The Second People's Hospital of Changzhou from June to December 2024. RMPP was defined as persistent fever and progressive pulmonary infiltrates despite ≥7 days of standard macrolide therapy. Baseline demographic and clinical variables were assessed at admission. Independent risk factors for RMPP were identified using multivariate logistic regression and were used to construct a predictive nomogram. The performance of the nomogram model was assessed by calibration curves, area under the receiver operating characteristic (ROC) curves (AUC), and the decision curve analysis (DCA).
Results:
A total of 210 children were included, among whom 105 were diagnosed with RMPP. The median age was 7.0 years (interquartile range, 5.0-8.5 years), and 42.4% of participants were male. No significant differences in age or sex were observed between groups (P<0.05). Multivariate analysis identified fever duration [odds ratio (OR) =2.15, P<0.001], duration of glucocorticoid use (OR =1.56, P<0.001), and YKL-40 levels (OR =1.01, P=0.001) as independent risk factors for RMPP. The nomogram incorporating these three factors demonstrated excellent discrimination with an AUC of 0.92 (95% confidence interval: 0.88-0.96). Calibration curve and Hosmer-Lemeshow test (P>0.99) indicated excellent calibration. DCA confirmed the clinical utility of the nomogram, showing net benefit across a wide threshold probability range (0.04-0.94).
Conclusions:
The nomogram constructed based on fever duration, glucocorticoid use duration, and YKL-40 level shows promise for early prediction of RMPP in children.
Related Concept Videos
01:23Dosage Regimen Designs: Nomograms and Tabulations
01:30Pneumonia III: Complications and Assessment
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion