{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T05:51:08Z","timestamp":1785909068818,"version":"3.56.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":215,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Canadian Respiratory Journal"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      This study aimed to identify factors that predict progression to necrotizing pneumonia (NP) in children with\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      pneumonia (MPP) who fail to respond to initial therapy and to develop a predictive model to support early clinical decision\u2010making.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed clinical and laboratory data of children with macrolide\u2010unresponsive\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      pneumonia (MUMPP) admitted to Tianjin Children\u2019s Hospital from January 2021 to January 2025. MUMPP was defined as persistent fever (\u2265\u200938.5\u00b0C, lasting \u2265\u20094\u2009h\/day) after \u2265\u200972\u2009h of standardized intravenous macrolide therapy. Patients were classified into an observation group (\n                      <jats:italic>n<\/jats:italic>\n                      = 106, those who developed NP) and a control group (\n                      <jats:italic>n<\/jats:italic>\n                      = 130, those who did not). Independent predictors of NP were identified by multivariable logistic regression and incorporated into a nomogram. Model performance was evaluated using ROC analysis, calibration plots, and decision curve analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In multivariable analysis, increased white blood cell (WBC) count (OR\u2009=\u20092.484, 95% CI: 1.406\u20134.613), longer fever duration (OR\u2009=\u20091.618, 95% CI: 1.217\u20132.193), pleural effusion (OR\u2009=\u20093.955, 95% CI: 1.664\u201310.00), and elevated C\u2010reactive protein (CRP) (OR\u2009=\u20092.152, 95% CI: 1.547\u20133.074) were independently associated with NP among children with MPP after initial treatment failure. Calibration curves indicated close agreement between predicted and observed risks in both the derivation cohort (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.588) and the validation cohort (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.424). The model showed good discrimination, with an AUC of 0.848 (95% CI: 0.789\u20130.908) in the derivation cohort and 0.889 (95% CI: 0.815\u20130.963) in the validation cohort. Decision curve analysis suggested net clinical benefit across relevant threshold probabilities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among children with MUMPP, higher WBC count, prolonged fever, pleural effusion, and higher CRP identify increased risk of NP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/carj\/3623045","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T05:32:11Z","timestamp":1785907931000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Prediction of Necrotizing Pneumonia in Children With\n                    <i>Mycoplasma pneumoniae<\/i>\n                    : A Model Based on Early Response to Therapy"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5677-2227","authenticated-orcid":false,"given":"Jia Feng","family":"Zheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5553-9421","authenticated-orcid":false,"given":"Meng Yao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han Quan","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2105-8009","authenticated-orcid":false,"given":"Bo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5064-9284","authenticated-orcid":false,"given":"Yong Sheng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"e_1_2_15_1_2","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn112140-20240728-00523"},{"key":"e_1_2_15_2_2","doi-asserted-by":"publisher","DOI":"10.21037\/tp-20-149"},{"key":"e_1_2_15_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy419"},{"key":"e_1_2_15_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/14787210.2018.1414599"},{"key":"e_1_2_15_5_2","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn112140-20240722-00503"},{"key":"e_1_2_15_6_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.92977"},{"key":"e_1_2_15_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmu022"},{"key":"e_1_2_15_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-023-00914-x"},{"key":"e_1_2_15_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12519-018-0162-6"},{"key":"e_1_2_15_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13052-025-02006-7"},{"key":"e_1_2_15_11_2","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn112140-20200304-00176"},{"key":"e_1_2_15_12_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2016.00414"},{"key":"e_1_2_15_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2022.106894"},{"key":"e_1_2_15_14_2","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2015.2491"},{"key":"e_1_2_15_15_2","doi-asserted-by":"publisher","DOI":"10.19723\/j.issn.1671-167X.2022.03.021"},{"key":"e_1_2_15_16_2","doi-asserted-by":"publisher","DOI":"10.2147\/idr.S419294"},{"key":"e_1_2_15_17_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00099807"},{"key":"e_1_2_15_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41479-017-0035-0"},{"key":"e_1_2_15_19_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2024.1428402"},{"key":"e_1_2_15_20_2","doi-asserted-by":"publisher","DOI":"10.2147\/jir.S413161"},{"key":"e_1_2_15_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.26020"},{"key":"e_1_2_15_22_2","doi-asserted-by":"publisher","DOI":"10.7499\/j.issn.1008-8830.2016.05.003"}],"container-title":["Canadian 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