肺炎支原体社区获得性肺炎患儿的组合宿主反应生物标志物特征（BV 评分）及其亚分析物 TRAIL、IP-10 和 C 反应蛋白。

Combinatorial Host-Response Biomarker Signature (BV Score) and Its Subanalytes TRAIL, IP-10, and C-Reactive Protein in Children With Mycoplasma pneumoniae Community-Acquired Pneumonia.

机构信息

Center for Infectious Diseases, Institute of Medical Microbiology and Hygiene, Homburg, Saarland University, Germany.

Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany.

出版信息

J Infect Dis. 2024 Aug 16;230(2):e247-e253. doi: 10.1093/infdis/jiad573.

DOI:10.1093/infdis/jiad573

PMID:38092364

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11326813/

Abstract

BACKGROUND

Host-response biomarkers to differentiate bacterial from viral etiology in children with respiratory infections have shown high accuracies, but are understudied in Mycoplasma pneumoniae (Mp) infections.

METHODS

We compared BV scores (0-34 indicating viral etiology, and 66-100 indicating bacterial etiology), tumor necrosis factor-related apoptosis-inducing ligand (TRAIL; pg/mL), interferon-γ inducible protein 10 (IP-10; pg/mL), and C-reactive protein (CRP; mg/L) serum levels between Mp-positive (Mp+) and Mp-negative (Mp-) community-acquired pneumonia (CAP) patients. We performed receiver operating characteristic (ROC) curve analyses for clinical features and biomarkers.

RESULTS

Of 80 CAP patients (median age, 6.3 years; 57.5% male), 26 had Mp+CAP. In Mp+CAP patients, compared to Mp-CAP patients, BV scores were lower (14.0 [3.0-27.8] vs 54.0 [12.0-84.8]; P = .0008), TRAIL levels were higher (86.5 [67.4-123.0] vs 65.5 [42.5-103.9]; P = .025), CRP levels were lower (12.9 [4.0-22.3] vs 36.7 [13.0-132.8]; P = .0019), and IP-10 levels were comparable (366.0 [150.2-603.8] vs 331.0 [154.3-878.8]; P = .73) (all median [interquartile range]). ROC analyses yielded a comparable discriminatory accuracy for the combination of age, fever duration, and duration of respiratory symptoms, with either procalcitonin or BV score (area under the ROC curve, 0.87 vs 0.86; P = .94).

CONCLUSIONS

Children with Mp+CAP have atypically low, viral levels of the BV score, underscoring the complementary role of microbiological testing.

摘要

背景

区分儿童呼吸道感染中细菌和病毒病因的宿主反应生物标志物已显示出较高的准确性，但在肺炎支原体（Mp）感染中的研究较少。

方法

我们比较了阳性（Mp+）和阴性（Mp-）社区获得性肺炎（CAP）患者的支气管肺泡灌洗液（BV）评分（0-34 提示病毒病因，66-100 提示细菌病因）、肿瘤坏死因子相关凋亡诱导配体（TRAIL；pg/mL）、γ-干扰素诱导蛋白 10（IP-10；pg/mL）和 C 反应蛋白（CRP；mg/L）血清水平。我们对临床特征和生物标志物进行了受试者工作特征（ROC）曲线分析。

结果

在 80 例 CAP 患者（中位年龄 6.3 岁；57.5%为男性）中，26 例为 Mp+CAP。与 Mp-CAP 患者相比，Mp+CAP 患者的 BV 评分较低（14.0[3.0-27.8]与 54.0[12.0-84.8]；P=.0008），TRAIL 水平较高（86.5[67.4-123.0]与 65.5[42.5-103.9]；P=.025），CRP 水平较低（12.9[4.0-22.3]与 36.7[13.0-132.8]；P=.0019），IP-10 水平相当（366.0[150.2-603.8]与 331.0[154.3-878.8]；P=.73）（所有中位数[四分位数间距]）。ROC 分析表明，年龄、发热持续时间和呼吸道症状持续时间的组合与降钙素原或 BV 评分的鉴别能力相当（ROC 曲线下面积，0.87 与 0.86；P=.94）。