ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Infectious Diseases
Volume 13 - 2025 | doi: 10.3389/fped.2025.1604253
Title D-dimer serves as predictor of plastic bronchitis or necrotizing pneumonia in children with Mycoplasma pneumoniae pneumonia
Provisionally accepted
- Hebei Children's Hospital,, Shijiazhuang, China
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Objective: This study aimed to explore risk factors for plastic bronchitis (PB) or necrotizing pneumonia (NP) in children with Mycoplasma pneumoniae pneumonia (MPP). Methods: This is a retrospective, observational cohort study, which was conducted at the Hebei Children's Hospital, Shijiazhuang, Hebei, China. This study compared the clinical characteristics between children with MPP who developed PB or NP and children with MPP who did not develop PB or NP. Variables with a P-value <0.1 in the univariate logistic regression analysis were further analyzed in the multivariate logistic regression analysis. Results: One hundred and seven hospitalized children with MPP were retrospectively enrolled in this study. Three (3/107, 2.80%) patients were admitted with severe pneumonia, and sixty-nine (69/107, 64.49%) patients required for non-invasive ventilation after 2 admission. The incidence of macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) was 39.25% (42/107), and the incidence of refractory Mycoplasma pneumoniae pneumonia (RMPP) was 9.35% (10/107). Thirteen (13/107, 12.15%) patients were diagnosed with PB or NP during hospitalization. Logistic regression analysis showed that the D-dimer (DD) level (odds ratio [OR] 1.28, 95% confidence interval [CI] 1.07-1.61; P =0.013) was independently and positively associated with the risk of PB or NP occurring. Receiver operating characteristic (ROC) analysis showed that the best cutoff point for D-dimer in predicting PB or NP is 2.44 (mg/L) (AUC =0.85, 95% CI 0.76-0.95, sensitivity: 92.31%, specificity: 75.53%, P<0.001*).Conclusions: This study found that the elevated DD level (≥ 2.44 mg/L) has a predicting value for the progression of children with MPP to the composite outcome of PB or NP. However, due to the limited number of PB cases, its specific prediction for PB needs further verification.
Keywords: d-dimer, Plastic bronchitis, Necrotizing pneumonia, Mycoplasma pneumoniae pneumonia, Children
Received: 01 Apr 2025; Accepted: 02 Jul 2025.
Copyright: © 2025 Yue, Lian, Kang, Liu, Geng and Xu. 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: Meixian Xu, Hebei Children's Hospital,, Shijiazhuang, China
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