Department of Microbiology Laboratory, Children's Hospital Affiliated to Shandong University, Jinan, China.
Department of Clinical Microbiology, Shandong Provincial Clinical Research Center for Children's Health and Disease, Jinan, China.
Front Cell Infect Microbiol. 2024 Oct 23;14:1398152. doi: 10.3389/fcimb.2024.1398152. eCollection 2024.
This study aimed to identify the risk factors and construct the diagnostic model associated with pneumocystis pneumonia (PCP) in pediatric patients.
This retrospective observational study analyzed 34 cases of PCP and 51 cases of other types of pneumonia treated at Children's Hospital Affiliated to Shandong University between January 2021 and August 2023. Multivariate binary logistic regression was used to identify the risk factors associated with PCP. Receiver operating characteristic curves and calibration plots were constructed to evaluate the diagnostic model.
Twenty clinical variables significantly differed between the PCP and non-PCP groups. Multivariate binary logistic regression analysis revealed that dyspnea, body temperature>36.5°C, and age<1.46 years old were risk factors for PCP. The area under the curve of the diagnostic model was 0.958, the -value of Hosmer-Lemeshow calibration test was 0.346, the R of the calibration plot for the actual and predicted probability of PCP was 0.9555 (<0.001), and the mean Brier score was 0.069. In addition, metagenomic next-generation sequencing revealed 79.41% (27/34) and 52.93% (28/53) mixed infections in the PCP and non-PCP groups, respectively. There was significantly more co-infection with cytomegalovirus and in the PCP group than that in the non-PCP group (p<0.05).
Dyspnea, body temperature>36.5°C, and age<1.46 years old were found to be independent risk factors for PCP in pediatric patients. The probability of co-infection with cytomegalovirus and in the PCP group was significantly higher than that in the non-PCP group.
本研究旨在确定与小儿肺炎患者发生肺孢子菌肺炎（PCP）相关的风险因素并构建诊断模型。
本回顾性观察性研究分析了 2021 年 1 月至 2023 年 8 月在山东大学附属儿童医院治疗的 34 例 PCP 和 51 例其他类型肺炎患者。采用多变量二项逻辑回归分析确定与 PCP 相关的风险因素。构建受试者工作特征曲线和校准图以评估诊断模型。
PCP 组和非 PCP 组之间有 20 个临床变量存在显著差异。多变量二项逻辑回归分析显示，呼吸困难、体温>36.5°C 和年龄<1.46 岁是 PCP 的危险因素。诊断模型的曲线下面积为 0.958，Hosmer-Lemeshow 校准检验值为 0.346，PCP 实际和预测概率的校准图的 R 值为 0.9555（<0.001），平均 Brier 评分 0.069。此外，宏基因组下一代测序显示，PCP 组和非 PCP 组分别有 79.41%（27/34）和 52.93%（28/53）的混合感染。PCP 组与巨细胞病毒和 合并感染的比例显著高于非 PCP 组（p<0.05）。
呼吸困难、体温>36.5°C 和年龄<1.46 岁是小儿患者发生 PCP 的独立危险因素。PCP 组与巨细胞病毒和 合并感染的比例显著高于非 PCP 组。
