{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T06:14:03Z","timestamp":1783577643011,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":188,"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"}],"funder":[{"DOI":"10.13039\/100008648","name":"Pfizer Foundation","doi-asserted-by":"publisher","award":["76080151"],"award-info":[{"award-number":["76080151"]}],"id":[{"id":"10.13039\/100008648","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mediators of Inflammation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      The objective of this study is to develop an early warning model that combines the age\u2010adjusted Charlson comorbidity index (aCCI) with serum lactate (Lac) and C\u2010reactive protein (CRP) levels to predict the progression of early methicillin\u2010resistant\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      (MRSA) pneumonia into severe pneumonia (SP).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was a retrospective case\u2013control analysis. Sixty\u2010four inpatients diagnosed with MRSA pneumonia at the First Affiliated Hospital of Soochow University from November 2023 to August 2024 were selected as study subjects. They were divided into two groups: the SP group (SP group) and the non\u2010SP (nSP) group, based on established diagnostic criteria for SP. Demographic, clinical, and laboratory data of the patients were collected and statistically analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010four patients (37.5%) developed SP, and the aCCI score was significantly higher in the SP group compared to the nSP group, with a statistically significant difference between the two groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009 &lt; 0.05). Hospital\u2010associated pneumonia caused by hospital\u2010acquired MRSA (HA\u2010MRSA) was more prevalent in the nSP group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009 &lt; 0.05). However, the differences between the SP and nSP groups were not statistically significant for laboratory indicators such as white blood cell (WBC) count, lymphocyte (LY) count, neutrophil (NE) count, and platelet (PLT) count (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009 &gt; 0.05). The levels of CRP and serum Lac in the SP group were significantly higher than those in the nSP group, with statistically significant differences (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009 &lt; 0.05). Multifactorial logistic regression analysis indicated that HA\u2010MRSA was an independent protective factor against MRSA\u2010associated SP, while the aCCI score, CRP, and serum Lac levels were identified as risk factors for the progression of MRSA to SP. The combination of these three factors demonstrated good predictive efficacy, with an area under the curve (AUC) of 0.913 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009 &lt; 0.001, 95% CI: 0.841, 0.985).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MRSA strains associated with SP demonstrate a lack of specificity in their clinical manifestations. HA\u2010MRSA is less likely to lead to SP compared to community\u2010acquired MRSA (CA\u2010MRSA). An aCCI score \u22657, in conjunction with elevated levels of early CRP and serum Lac, can serve as effective early indicators that MRSA pneumonia may progress to a severe form.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/mi\/8850275","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:22:46Z","timestamp":1783574566000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Application of Blood Lactate, C\u2010Reactive Protein, and the Age\u2010Adjusted Charlson Comorbidity Index in Predictive Assessment of Malignant Risk of MRSA Pneumonia"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9627-655X","authenticated-orcid":false,"given":"Heqing","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2293-0024","authenticated-orcid":false,"given":"Hong","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0099-6408","authenticated-orcid":false,"given":"Yiling","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5151-4932","authenticated-orcid":false,"given":"Qiongfang","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9640-9523","authenticated-orcid":false,"given":"Yalu","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1488-1924","authenticated-orcid":false,"given":"Zutao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1134-0103","authenticated-orcid":false,"given":"Jie","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkad078"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30267-5"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1709992"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/resp.13218"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-018-5213-x"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1159\/000521288"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw353"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201908-1581ST"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-60825-6"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.1086\/651094"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2020.12.009"},{"key":"e_1_2_12_12_2","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.1093\/cid\/cit614","article-title":"Methicillin-Resistant Staphylococcus aureus Therapy: Past, Present, and Future","volume":"58","author":"Rodvold K. 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