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소아 마이코플라스마 폐렴: 나이에 따른 임상적 특징과 불응성폐렴의 위험 요인

Mycoplasma pneumoniae pneumonia in children: Clinical characteristics and risk factors of refractory pneumonia by age

박희주|김형영
대한 소아알레르기 호흡기학회 (The Korean Academy Of Pediatric Allergy And Respiratory Disease)|2018.11|Allergy Asthma & Respiratory Disease (알레르기 천식 호흡기질환)|제6권 제6호|pp. 295-302|DOI https://doi.org/10.4168/aard.2018.6.6.295

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참고문헌

키워드

ChildFerritinMycoplasma pneumoniaeLactate dehydrogenase
주제분류소아과학

초록

Purpose: It is thought that Mycoplasma pneumoniae infection is more prevalent and causes more severe pneumonia in school-age children and young adults than in preschool children; however, recent studies suggest that the infection may be underdiagnosed and more severe in preschool children. This study investigated the clinical characteristics of Mycoplasma pneumoniae pneumonia (MPP) and the risk factors of refractory MPP (RMPP) by age. Methods: We retrospectively reviewed the medical records of 353 children admitted due to MPP from January 2015 to December 2016. Demographics, clinical information, laboratory data and radiological findings were collected from all patients in this study. The patients were divided into 2 groups by the age of 6 years. Also, both preschool (<6 years old) and school-age (≥6 years old) children were divided into RMPP and non-RMPP patients. Results: Total febrile days, febrile days before admission and the duration of macrolide antibiotic therapy were significantly longer in school-age children than in preschool children. School-age children had significantly greater risk of lobar consolidation (P=0.036), pleural effusion (P=0.001) and extrapulmonary complications (P=0.019). Necrotizing pneumonia and bronchiolitis obliterans tended to occur more frequently in preschool children than in school-age children. In both preschool and school-age children, lactate dehydrogenase (LDH) levels were significantly higher in RMPP patients than in non-RMPP patients. In preschool children, LDH >722 IU/L (odds ratio [OR], 3.02; 95% confidence interval [CI], 1.44–6.50) and ferritin >177 ng/mL (OR, 5.38; 95% CI, 1.61–19.49) were significant risk factors for RMPP, while LDH >645 IU/L (OR, 4.12; 95% CI, 1.64–10.97) and ferritin >166 ng/mL (OR, 5.51; 95% CI, 1.59–22.32) were so in school-age children. Conclusion: Clinical features of MPP were significantly different between preschool and school-age children. LDH and ferritin may be significant factors of RMPP in preschool and school-age children.

Abstract

Purpose: It is thought that Mycoplasma pneumoniae infection is more prevalent and causes more severe pneumonia in school-age children and young adults than in preschool children; however, recent studies suggest that the infection may be underdiagnosed and more severe in preschool children. This study investigated the clinical characteristics of Mycoplasma pneumoniae pneumonia (MPP) and the risk factors of refractory MPP (RMPP) by age. Methods: We retrospectively reviewed the medical records of 353 children admitted due to MPP from January 2015 to December 2016. Demographics, clinical information, laboratory data and radiological findings were collected from all patients in this study. The patients were divided into 2 groups by the age of 6 years. Also, both preschool (<6 years old) and school-age (≥6 years old) children were divided into RMPP and non-RMPP patients. Results: Total febrile days, febrile days before admission and the duration of macrolide antibiotic therapy were significantly longer in school-age children than in preschool children. School-age children had significantly greater risk of lobar consolidation (P=0.036), pleural effusion (P=0.001) and extrapulmonary complications (P=0.019). Necrotizing pneumonia and bronchiolitis obliterans tended to occur more frequently in preschool children than in school-age children. In both preschool and school-age children, lactate dehydrogenase (LDH) levels were significantly higher in RMPP patients than in non-RMPP patients. In preschool children, LDH >722 IU/L (odds ratio [OR], 3.02; 95% confidence interval [CI], 1.44–6.50) and ferritin >177 ng/mL (OR, 5.38; 95% CI, 1.61–19.49) were significant risk factors for RMPP, while LDH >645 IU/L (OR, 4.12; 95% CI, 1.64–10.97) and ferritin >166 ng/mL (OR, 5.51; 95% CI, 1.59–22.32) were so in school-age children. Conclusion: Clinical features of MPP were significantly different between preschool and school-age children. LDH and ferritin may be significant factors of RMPP in preschool and school-age children.

참고문헌 (26)

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관련 논문AI추천

무기폐를 동반한 소아 마이코플라스마 폐렴의 임상적 특성과 연관 인자김영아, 이미란, 정성수대한 소아알레르기 호흡기학회 · Allergy Asthma & Respiratory Disease2022 · 제10권 제3호최근 3번의 대유행 동안 한국 소아에서 발생한마이코플라즈마 폐렴의 임상적 특징김덕수, 민동훈, 박문수, 심재원, 심정연, 위화현, 정혜림대한 소아알레르기 호흡기학회 · Allergy Asthma & Respiratory Disease2017 · 제5권 제1호소아에서 치료 불응성 마이코플라스마 폐렴의 위험 인자에 대한 임상적 분석서주희, 이건송, 최규태, 최서열대한 소아알레르기 호흡기학회 · Allergy Asthma & Respiratory Disease2018 · 제6권 제1호소아 마이코플라스마 폐렴의 다양한 임상 양상에 연관된 요인들김수희, 김유나, 김효빈, 박철휘, 유수진대한 소아알레르기 호흡기학회 · Allergy Asthma & Respiratory Disease2013 · 제1권 제4호소아 마이코플라스마 폐렴에서 흉부 방사선 소견에 따른 임상 양상의 차이김창휘, 박가영, 박재옥, 신미용, 이영임대한 소아알레르기 호흡기학회 · Allergy Asthma & Respiratory Disease2013 · 제1권 제4호증가하는 마크로라이드에 반응하지 않는 마이코플라스마 폐렴의 관련 인자와 임상 양상의 변화김효빈, 박진성, 유인경, 정지현, 탕지륭대한 소아알레르기 호흡기학회 · Allergy Asthma & Respiratory Disease2018 · 제6권 제2호

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