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ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Pulmonology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1521954
Risk Factor Analysis of Plastic Bronchitis among 126 Children with Macrolide-Resistant Mycoplasma pneumoniae Pneumonia with Mutations at the A2063G Site After Bronchoscopy Examination: A Nomogram Prediction Model
Provisionally accepted- 1 School of Medicine, Shihezi University, Shihezi, China
- 2 First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang Uyghur Region, China
- 3 Jining First People's Hospital, Jining, Shandong, China
Objective: To determine the risk factors for plastic bronchitis (PB) in children diagnosed with macrolide-resistant Mycoplasma pneumoniae (MRMP) pneumonia associated with the A2064G variant.The clinical data of 126 children diagnosed with MRMP pneumonia (all with mutations at the A2063G site) who underwent bronchoscopy from May 2023 to April 2024 were retrospectively collected. Based on bronchoscopic findings, patients were classified into the PB and non-PB groups. The study compared the general and clinical features, laboratory indicators, imaging features, bronchoscopic manifestations, treatment, and prognosis between the two groups. A nomogram model, based on logistic regression, was developed to estimate the risks of developing PB in children with MRMP pneumonia caused by mutations at the A2063G site.We included 68 boys and 58 girls in this study, with 32 (25.4%) belonging to the PB group. The nomogram model constructed in this study indicated that three risk factors⎯Atelectasis, Mycoplasma pneumoniae genome copies (throat swab) >10 5 , and D-dimer levels⎯could be used for the early identification of MRMP pneumonia-induced PB. The area under the receiver operating characteristic curve for the predictive model was 0.832 (95% confidence interval: 0.743-0.922). The Hosmer-Lemeshow goodness-of-fit test demonstrated good calibration of the nomogram (P=0.227, R 2 =0.403). Decision curve analyses revealed that the model has clinical value. Regarding treatment, second-line drugs and the frequency of bronchoscopy were significantly higher in the PB group than in the non-PB group.Early risk factor identification and bronchoscopy can improve the outcomes of children with PB associated with MRMP pneumonia caused by mutations at the A2063G site.
Keywords: Children, Plastic bronchitis, Macrolide-resistant Mycoplasma pneumoniae pneumonia, A2063G site, nomogram model Children, Nomogram model
Received: 03 Nov 2024; Accepted: 12 Feb 2025.
Copyright: © 2025 Ran, Bai, Yuan, Zhang, Li, Ma and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ting Bai, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, 832008, Xinjiang Uyghur Region, China
Bo Yuan, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, 832008, Xinjiang Uyghur Region, China
Li Zhang, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, 832008, Xinjiang Uyghur Region, China
Shan Shan Li, Jining First People's Hospital, Jining, Shandong, China
Hua Lan Ma, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, 832008, Xinjiang Uyghur Region, China
Wei Zhang, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, 832008, Xinjiang Uyghur Region, China
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