무기폐를 동반한 소아 마이코플라스마 폐렴의 임상적 특성과 연관 인자
Clinical characteristics and associated factors of Mycoplasma pneumoniae pneumonia with atelectasis in children
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Purpose: Patients with Mycoplasma pneumoniae pneumonia (MPP) can develop atelectasis, and some cases of atelectasis may persist for over 4 weeks. However, the risk factors for the development and persistence of atelectasis (>4 weeks) in children with MPP and their clinical characteristics remain understudied. We aimed to investigate the clinical characteristics and associated factors of MPP with atelectasis in children. Methods: We retrospectively analyzed the medical records of 477 children with MPP treated at Pusan National University Yangsan Hospital from November 2014 to March 2020. Demographics, clinical information, laboratory data, and radiological findings were collected from all patients. The patients were divided into 2 groups according to the presence of atelectasis with MPP. The group with atelectasis was further divided into 2 groups according to whether atelectasis was improved. Results: Among 477 children with MPP, 105 developed atelectasis, and 34 showed persistent atelectasis. Children with atelectasis had longer lengths of hospitalization than children without atelectasis. High lactate dehydrogenase (LDH) levels and whole lobar consolidation were independently associated factors for presenting with atelectasis, and long macrolide therapy duration before admission (>3 days) was related to persistent atelectasis (>4 weeks). Conclusion: High LDH levels and whole lobar consolidation were independent associated factors for presenting with atelectasis, and a long macrolide therapy duration before admission was associated with persistent atelectasis. Careful observation and management of children with these associated factors for atelectasis will improve the prognosis of children with MPP.
Abstract
Purpose: Patients with Mycoplasma pneumoniae pneumonia (MPP) can develop atelectasis, and some cases of atelectasis may persist for over 4 weeks. However, the risk factors for the development and persistence of atelectasis (>4 weeks) in children with MPP and their clinical characteristics remain understudied. We aimed to investigate the clinical characteristics and associated factors of MPP with atelectasis in children. Methods: We retrospectively analyzed the medical records of 477 children with MPP treated at Pusan National University Yangsan Hospital from November 2014 to March 2020. Demographics, clinical information, laboratory data, and radiological findings were collected from all patients. The patients were divided into 2 groups according to the presence of atelectasis with MPP. The group with atelectasis was further divided into 2 groups according to whether atelectasis was improved. Results: Among 477 children with MPP, 105 developed atelectasis, and 34 showed persistent atelectasis. Children with atelectasis had longer lengths of hospitalization than children without atelectasis. High lactate dehydrogenase (LDH) levels and whole lobar consolidation were independently associated factors for presenting with atelectasis, and long macrolide therapy duration before admission (>3 days) was related to persistent atelectasis (>4 weeks). Conclusion: High LDH levels and whole lobar consolidation were independent associated factors for presenting with atelectasis, and a long macrolide therapy duration before admission was associated with persistent atelectasis. Careful observation and management of children with these associated factors for atelectasis will improve the prognosis of children with MPP.
참고문헌 (39)
- Arnold FW, "A worldwide perspective of atypical pathogens in community-acquired pneumonia", Am J Respir Crit Care Med, 175, pp.1086~1093 (2007)
- Lee GE, "National hospitalization trends for pediatric pneumonia and associated complications", Pediatrics, 126, pp.204~213 (2010)
- Khoury T, "Increased rates of intensive care unit admission in patients with Mycoplasma pneumoniae : a retrospective study", Clin Microbiol Infect, 22, pp.711~714 (2016)
- Zheng B, "The clinical characteristics and risk factors for necrotizing pneumonia caused by Mycoplasma pneumoniae in children", BMC Infect Dis, 20, pp.391~ (2020)
- Meyer Sauteur PM, "Frequency and clinical presentation of mucocutaneous disease due to Mycoplasma pneumoniae infection in children with community-acquired pneumonia", JAMA Dermatol, 156, pp.144~150 (2020)
- Waites KB, "Mycoplasma pneumoniae from the respiratory tract and beyond", Clin Microbiol Rev, 30, pp.747~809 (2017)
- Lee E, "Annual and seasonal patterns in etiologies of pediatric community-acquired pneumonia due to respiratory viruses and Mycoplasma pneumoniae requiring hospitalization in South Korea", BMC Infect Dis, 20, pp.132~ (2020)
- 신정은, "Increased risk of refractory Mycoplasma pneumoniae pneumonia in children with atopic sensitization and asthma", Clinical and Experimental Pediatrics, 57(6), pp.271~277 (2014), 대한소아청소년과학회
- Li F, "Effects of bronchoalveolar lavage on pediatric refractory mycoplasma pneumoniae pneumonia complicated with atelectasis : a prospective case-control study", Minerva Pediatr(Torino), 73, pp.340~347 (2021)
- Lee E, "Risk factors for the development of post-infectious bronchiolitis obliterans after Mycoplasma pneumoniae pneumonia in the era of increasing macrolide resistance", Respir Med, 175, pp.106209~ (2020)
- Yan C, "Molecular and clinical characteristics of severe Mycoplasma pneumoniae pneumonia in children", Pediatr Pulmonol, 54, pp.1012~1021 (2019)
- John SD, "Spectrum of clinical and radiographic findings in pediatric mycoplasma pneumonia", Radiographics, 21, pp.121~131 (2001)
- Huang L, "Independent predictors for longer radiographic resolution in patients with refractory Mycoplasma pneumoniae pneumonia : a prospective cohort study", BMJ Open, 8, pp.e023719~ (2018)
- Kumar NA, "Bronchiectasis : current clinical and imaging concepts", Semin Roentgenol, 36, pp.41~50 (2001)
- Lindberg P, "Atelectasis and lung function in the postoperative period", Acta Anaesthesiol Scand, 36, pp.546~553 (1992)
- Hopkins E, "Physiology, functional residual capacity" (2022), StatPearls Publications
- 김형영, "소아 마이코플라스마 폐렴: 나이에 따른 임상적 특징과 불응성폐렴의 위험 요인", Allergy Asthma & Respiratory Disease, 6(6), pp.295~302 (2018), 대한 소아알레르기 호흡기학회[DOI]
- Waris ME, "Diagnosis of Mycoplasma pneumoniae pneumonia in children", J Clin Microbiol, 36, pp.3155~3159 (1998)
- Block S, "Mycoplasma pneumoniae and Chlamydia pneumoniae in pediatric community-acquired pneumonia: comparative efficacy and safety of clarithromycin vs. erythromycin ethylsuccinate", Pediatr Infect Dis J, 14, pp.471~477 (1995)
- Mikasa K, "JAID", JSC guidelines for the treatment of respiratory infectious diseases : The Japanese Association for Infectious Diseases, JSC Guide to Clinical Management of Infectious Disease, pp.Guideline-preparing Committee Respiratory Infectious Disease WG, J Infect Chemother[DOI]
- The Korean Academy of Pediatric Allergy and Respiratory Disease, "Guidelines for treating macrolide refractory severe mycoplasma pneumonia in children -2019-", The Korean Academy of Pediatric Allergy and Respiratory Disease, The Korean Society of Pediatric Infectious Diseases, ~ (2020)
- "Guidelines for the antibiotic use in children with lower respiratory tract infections", Korea Disease Control and Prevention Agency, ~ (2017)
- Kim HS, "Efficacy of glucocorticoids for the treatment of macrolide refractory mycoplasma pneumonia in children : meta-analysis of randomized controlled trials", BMC Pulm Med, 19, pp.251~ (2019)
- Zhang Y, "Effects of bronchoalveolar lavage on refractory Mycoplasma pneumoniae pneumonia", Respir Care, 59, pp.1433~1439 (2014)
- Faro A, "Official American Thoracic Society technical standards : flexible airway endoscopy in children", Am J Respir Crit Care Med, 191, pp.1066~1080 (2015)
- Kumar P, "Analysis of cell viability by the lactate dehydrogenase assay", Cold Spring Harb Protoc, 2018(6) (2018)
- Wang M, "Clinical and laboratory profiles of refractory Mycoplasma pneumoniae pneumonia in children", Int J Infect Dis, 29, pp.18~23 (2014)
- Bartlett JG, "Community-acquired pneumonia", N Engl J Med, 333, pp.1618~1624 (1995)
- McIntosh K, "Community-acquired pneumonia in children", N Engl J Med, 346, pp.429~437 (2002)
- Cho YJ, "Correlation between chest radiographic findings and clinical features in hospitalized children with Mycoplasma pneumoniae pneumonia", PLoS One, 14, pp.e0219463~ (2019)
- Johnston C, "Atelectasis : mechanisms, diagnosis and treatment in the pediatric patient", Rev Assoc Med Bras(1992), 54, pp.455~460 (2008)
- 전유훈, "국내 소아 지역획득폐렴의 치료", Allergy Asthma & Respiratory Disease, 5(4), pp.177~184 (2017), 대한 소아알레르기 호흡기학회[DOI]
- Gong H, "The risk factors of children acquiring refractory mycoplasma pneumoniae pneumonia : a meta-analysis", Medicine(Baltimore), 100, pp.e24894~ (2021)
- Han MS, "Contribution of co-detected respiratory viruses and patient age to the clinical manifestations of Mycoplasma pneumoniae pneumonia in children", Pediatr Infect Dis J, 37, pp.531~536 (2018)
- Zhou Y, "Impact of viral coinfection and macrolide-resistant mycoplasma infection in children with refractory Mycoplasma pneumoniae pneumonia", BMC Infect Dis, 20, pp.633~ (2020)
- Gao J, "Human adenovirus coinfection aggravates the severity of Mycoplasma pneumoniae pneumonia in children", BMC Infect Dis, 20, pp.420~ (2020)
- 안세환, "소아에서 마이코플라스마 폐렴과 바이러스 폐렴의 임상적 특징 비교: 다기관 단면연구", Allergy Asthma & Respiratory Disease, 6(3), pp.155~160 (2018), 대한 소아알레르기 호흡기학회[DOI]
- Su DQ, "Pathogen distribution and bacterial resistance in children with severe pneumonia : a single-center retrospective study", Medicine(Baltimore), 100, pp.e27128~ (2021)
- Cao LJ, "Efficacy of early treatment via fiber bronchoscope in children with Mycoplasma pneumoniae pneumonia complicated by airway mucus obstruction", Zhongguo Dang Dai Er Ke Za Zhi, 20, pp.298~302 (2018)