{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T23:20:03Z","timestamp":1793920803943,"version":"4.8.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T00:00:00Z","timestamp":1621296000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T00:00:00Z","timestamp":1621296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pulm Med"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To identify patients with\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      pneumonia (MPP) with a risk of prolonged fever while on macrolides.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was performed with 716 children admitted for MPP. Refractory MPP (RMPP-3) was defined as fever persisting for\u2009&gt;\u200972\u00a0h without improvement in clinical and radiologic findings after macrolide antibiotics (RMPP-3) or when fever persisted for\u2009&gt;\u2009120\u00a0h (RMPP-5) without improvement in clinical and radiologic findings. Radiological data, laboratory data, and fever profiles were compared between the RMPP and non-RMPP groups. Fever profiles included the highest temperature, lowest temperature, and frequency of fever. Prediction models for RMPP were created using the logistic regression method and deep neural network. Their predictive values were compared using receiver operating characteristic curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 716 patients were randomly divided into two groups: training and test cohorts for both RMPP-3 and RMPP-5. For the prediction of RMPP-3, a conventional logistic model with radiologic grouping showed increased sensitivity (63.3%) than the model using laboratory values. Adding laboratory values in the prediction model using radiologic grouping did not contribute to a meaningful increase in sensitivity (64.6%). For the prediction of RMPP-5, laboratory values or radiologic grouping showed lower sensitivities ranging from 12.9 to 16.1%. However, prediction models using predefined fever profiles showed significantly increased sensitivity for predicting RMPP-5, and neural network models using 12 sequential fever data showed a greatly increased sensitivity (64.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RMPP-5 could not be effectively predicted using initial laboratory and radiologic data, which were previously reported to be predictive. Further studies using advanced mathematical models, based on large-sized easily accessible clinical data, are anticipated for predicting RMPP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12890-021-01534-2","type":"journal-article","created":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T01:03:31Z","timestamp":1621299811000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Prediction model for prolonged fever in patients with Mycoplasma pneumoniae pneumonia: a retrospective study of 716 pediatric patients"],"prefix":"10.1186","volume":"21","author":[{"given":"Min Sik","family":"Jang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bit Gyeol","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihye","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,18]]},"reference":[{"key":"1534_CR1","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1093\/cid\/cir769","volume":"54","author":"TR Kannan","year":"2011","unstructured":"Kannan TR, Hardy RD, Coalson JJ, Cavuoti DC, Siegel JD, Cagle M, et al. Fatal outcomes in family transmission of Mycoplasma pneumoniae. Clin Infect Dis. 2011;54:225\u201331.","journal-title":"Clin Infect Dis"},{"key":"1534_CR2","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.1086\/317498","volume":"31","author":"M Radisic","year":"2000","unstructured":"Radisic M, Torn A, Gutierrez P, Defranchi HA, Pardo P. Severe acute lung injury caused by Mycoplasma pneumoniae: potential role for steroid pulses in treatment. Clin Infect Dis. 2000;31:1507\u201311.","journal-title":"Clin Infect Dis"},{"key":"1534_CR3","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1128\/CMR.17.4.697-728.2004","volume":"17","author":"KB Waites","year":"2004","unstructured":"Waites KB, Talkington DF. Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev. 2004;17:697\u2013728.","journal-title":"Clin Microbiol Rev."},{"key":"1534_CR4","first-page":"151","volume":"60","author":"E Lee","year":"2017","unstructured":"Lee E, Cho H-J, Hong S-J, Lee J, Sung H, Yu J. Prevalence and clinical manifestations of macrolide resistant Mycoplasma pneumoniae pneumonia in Korean children. Clin Exp Pediatr. 2017;60:151\u20137.","journal-title":"Clin Exp Pediatr"},{"key":"1534_CR5","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.3201\/eid1908.121455","volume":"19","author":"KB Hong","year":"2013","unstructured":"Hong KB, Choi EH, Lee HJ, Lee SY, Cho EY, Choi JH, et al. Macrolide resistance of Mycoplasma pneumoniae, South Korea, 2000\u20132011. Emerg Infect Dis. 2013;19:1281.","journal-title":"Emerg Infect Dis"},{"key":"1534_CR6","doi-asserted-by":"publisher","first-page":"4046","DOI":"10.1128\/AAC.00663-13","volume":"57","author":"Y Kawai","year":"2013","unstructured":"Kawai Y, Miyashita N, Kubo M, Akaike H, Kato A, Nishizawa Y, et al. Nationwide surveillance of macrolide-resistant Mycoplasma pneumoniae infection in pediatric patients. Antimicrob Agents Chemother. 2013;57:4046\u20139.","journal-title":"Antimicrob Agents Chemother"},{"key":"1534_CR7","doi-asserted-by":"publisher","first-page":"1521","DOI":"10.1128\/AAC.02060-12","volume":"57","author":"F Zhao","year":"2013","unstructured":"Zhao F, Liu G, Wu J, Cao B, Tao X, He L, et al. Surveillance of macrolide-resistant Mycoplasma pneumoniae in Beijing, China, from 2008 to 2012. Antimicrob Agents Chemother. 2013;57:1521\u20133.","journal-title":"Antimicrob Agents Chemother"},{"key":"1534_CR8","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.jinf.2008.06.012","volume":"57","author":"A Tamura","year":"2008","unstructured":"Tamura A, Matsubara K, Tanaka T, Nigami H, Yura K, Fukaya T. Methylprednisolone pulse therapy for refractory Mycoplasma pneumoniae pneumonia in children. J Infect. 2008;57:223\u20138.","journal-title":"J Infect"},{"key":"1534_CR9","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1128\/AAC.50.2.709-712.2006","volume":"50","author":"S Suzuki","year":"2006","unstructured":"Suzuki S, Yamazaki T, Narita M, Okazaki N, Suzuki I, Andoh T, et al. Clinical evaluation of macrolide-resistant Mycoplasma pneumoniae. Antimicrob Agents Chemother. 2006;50:709\u201312.","journal-title":"Antimicrob Agents Chemother"},{"key":"1534_CR10","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1128\/CMR.17.4.697-728.2004","volume":"17","author":"KB Waites","year":"2004","unstructured":"Waites KB, Talkington DF. Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev. 2004;17:697\u2013728.","journal-title":"Clin Microbiol Rev"},{"key":"1534_CR11","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1097\/00006454-199703000-00015","volume":"16","author":"C-C Chiou","year":"1997","unstructured":"Chiou C-C, Liu Y-C, Lin H-H, Hsieh K-S. Mycoplasma pneumoniae infection complicated by lung abscess, pleural effusion, thrombocytopenia and disseminated intravascular coagulation. Pediatr Infect Dis J. 1997;16:327\u20139.","journal-title":"Pediatr Infect Dis J"},{"key":"1534_CR12","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1097\/01.inf.0000130074.56368.4b","volume":"23","author":"R-S Wang","year":"2004","unstructured":"Wang R-S, Wang S-Y, Hsieh K-S, Chiou Y-H, Huang I-F, Cheng M-F, et al. Necrotizing pneumonitis caused by Mycoplasma pneumoniae in pediatric patients: report of five cases and review of literature. Pediatr Infect Dis J. 2004;23:564\u20137.","journal-title":"Pediatr Infect Dis J"},{"key":"1534_CR13","first-page":"133","volume":"162","author":"ED Chan","year":"1995","unstructured":"Chan ED, Welsh CH. Fulminant Mycoplasma pneumoniae pneumonia. West J Med. 1995;162:133\u201342.","journal-title":"West J Med"},{"key":"1534_CR14","doi-asserted-by":"publisher","first-page":"e20121","DOI":"10.1097\/MD.0000000000020121","volume":"99","author":"J-L Qiu","year":"2020","unstructured":"Qiu J-L, Huang L, Shao M-Y, Chai Y-N, Zhang H-J, Li X-F, et al. Efficacy and safety of azithromycin combined with glucocorticoid on refractory Mycoplasma pneumoniae pneumonia in children: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2020;99:e20121.","journal-title":"Medicine (Baltimore)"},{"key":"1534_CR15","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1186\/s12931-019-1152-5","volume":"20","author":"Y-J Choi","year":"2019","unstructured":"Choi Y-J, Jeon J-H, Oh J-W. Critical combination of initial markers for predicting refractory Mycoplasma pneumoniae pneumonia in children: a case control study. Respir Res. 2019;20:193.","journal-title":"Respir Res"},{"key":"1534_CR16","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1016\/j.jiac.2014.01.001","volume":"20","author":"N Inamura","year":"2014","unstructured":"Inamura N, Miyashita N, Hasegawa S, Kato A, Fukuda Y, Saitoh A, et al. Management of refractory Mycoplasma pneumoniae pneumonia: utility of measuring serum lactate dehydrogenase level. J Infect Chemother. 2014;20:270\u20133.","journal-title":"J Infect Chemother"},{"key":"1534_CR17","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.jiac.2014.10.008","volume":"21","author":"N Miyashita","year":"2015","unstructured":"Miyashita N, Kawai Y, Inamura N, Tanaka T, Akaike H, Teranishi H, et al. Setting a standard for the initiation of steroid therapy in refractory or severe Mycoplasma pneumoniae pneumonia in adolescents and adults. J Infect Chemother. 2015;21:153\u201360.","journal-title":"J Infect Chemother"},{"key":"1534_CR18","doi-asserted-by":"publisher","first-page":"e0156465","DOI":"10.1371\/journal.pone.0156465","volume":"11","author":"Y Zhang","year":"2016","unstructured":"Zhang Y, Zhou Y, Li S, Yang D, Wu X, Chen Z. The clinical characteristics and predictors of refractory Mycoplasma pneumoniae pneumonia in children. PLoS ONE. 2016;11:e0156465.","journal-title":"PLoS ONE"},{"key":"1534_CR19","doi-asserted-by":"publisher","first-page":"e9364","DOI":"10.1097\/MD.0000000000009364","volume":"96","author":"L Wang","year":"2017","unstructured":"Wang L, Lu S, Feng Z, Li L, Niu B, Shuai J, et al. The early examination of combined serum and imaging data under flexible fiberoptic bronchoscopy as a novel predictor for refractory Mycoplasma pneumoniae pneumonia diagnosis. Medicine (Baltimore). 2017;96:e9364.","journal-title":"Medicine (Baltimore)"},{"key":"1534_CR20","doi-asserted-by":"publisher","first-page":"37037","DOI":"10.1038\/srep37037","volume":"6","author":"Y Zhang","year":"2016","unstructured":"Zhang Y, Mei S, Zhou Y, Huang M, Dong G, Chen Z. Cytokines as the good predictors of refractory Mycoplasma pneumoniae pneumonia in school-aged children. Sci Rep. 2016;6:37037.","journal-title":"Sci Rep"},{"key":"1534_CR21","doi-asserted-by":"publisher","first-page":"2252","DOI":"10.1128\/AAC.00048-13","volume":"57","author":"Y Kawai","year":"2013","unstructured":"Kawai Y, Miyashita N, Kubo M, Akaike H, Kato A, Nishizawa Y, et al. Therapeutic efficacy of macrolides, minocycline, and tosufloxacin against macrolide-resistant Mycoplasma pneumoniae pneumonia in pediatric patients. Antimicrob Agents Chemother. 2013;57:2252\u20138.","journal-title":"Antimicrob Agents Chemother"},{"key":"1534_CR22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12890-018-0755-9","volume":"19","author":"HS Kim","year":"2019","unstructured":"Kim HS, Sol IS, Li D, Choi M, Choi YJ, Lee KS, et al. Efficacy of glucocorticoids for the treatment of macrolide refractory mycoplasma pneumonia in children: meta-analysis of randomized controlled trials. BMC Pul Med. 2019;19:1\u201314.","journal-title":"BMC Pul Med"},{"key":"1534_CR23","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1007\/s10156-011-0265-7","volume":"17","author":"T Oishi","year":"2011","unstructured":"Oishi T, Narita M, Matsui K, Shirai T, Matsuo M, Negishi J, et al. Clinical implications of interleukin-18 levels in pediatric patients with Mycoplasma pneumoniae pneumonia. J Infect Chemother. 2011;17:803\u20136.","journal-title":"J Infect Chemother"},{"key":"1534_CR24","doi-asserted-by":"publisher","first-page":"1180","DOI":"10.1086\/591915","volume":"198","author":"C Tagliabue","year":"2008","unstructured":"Tagliabue C, Salvatore CM, Techasaensiri C, Mejias A, Torres JP, Katz K, et al. The impact of steroids given with macrolide therapy on experimental Mycoplasma pneumoniae respiratory infection. J Infect Dis. 2008;198:1180\u20138.","journal-title":"J Infect Dis"},{"key":"1534_CR25","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1186\/s12879-017-2500-z","volume":"17","author":"IA Yoon","year":"2017","unstructured":"Yoon IA, Hong KB, Lee HJ, Yun KW, Park JY, Choi YH, et al. Radiologic findings as a determinant and no effect of macrolide resistance on clinical course of Mycoplasma pneumoniae pneumonia. BMC Infect Dis. 2017;17:402.","journal-title":"BMC Infect Dis"},{"key":"1534_CR26","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1183\/09031936.96.09040669","volume":"9","author":"H Tanaka","year":"1996","unstructured":"Tanaka H, Koba H, Honma S, Sugaya F, Abe S. Relationships between radiological pattern and cell-mediated immune response in Mycoplasma pneumoniae pneumonia. Eur Respir J. 1996;9:669\u201372.","journal-title":"Eur Respir J"},{"key":"1534_CR27","doi-asserted-by":"publisher","first-page":"695","DOI":"10.3389\/fmicb.2016.00695","volume":"7","author":"H Tanaka","year":"2016","unstructured":"Tanaka H. Correlation between radiological and pathological findings in patients with Mycoplasma pneumoniae pneumonia. Front Microbiol. 2016;7:695.","journal-title":"Front Microbiol"},{"key":"1534_CR28","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1002\/ppul.20445","volume":"42","author":"M Narita","year":"2007","unstructured":"Narita M, Tanaka H. Cytokines involved in the severe manifestations of pulmonary diseases caused by Mycoplasma pneumoniae. Pediatr Pulmonol. 2007;42:397.","journal-title":"Pediatr Pulmonol"},{"key":"1534_CR29","doi-asserted-by":"publisher","first-page":"S178","DOI":"10.1086\/317513","volume":"31","author":"MG Netea","year":"2000","unstructured":"Netea MG, Kullberg BJ, Van der Meer JWM. Circulating cytokines as mediators of fever. Clin Infect Dis. 2000;31:S178\u201384.","journal-title":"Clin Infect Dis"},{"key":"1534_CR30","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1007\/s10156-009-0715-7","volume":"15","author":"K Matsubara","year":"2009","unstructured":"Matsubara K, Okada T, Matsushima T, Komiyama O, Iwata S, Morozumi M, et al. A comparative clinical study of macrolide-sensitive and macrolide-resistant Mycoplasma pneumoniae infections in pediatric patients. J Infect Chemother. 2009;15:380\u20133.","journal-title":"J Infect Chemother"},{"key":"1534_CR31","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1128\/AAC.00779-07","volume":"52","author":"M Morozumi","year":"2008","unstructured":"Morozumi M, Iwata S, Hasegawa K, Chiba N, Takayanagi R, Matsubara K, et al. Increased macrolide resistance of Mycoplasma pneumoniae in pediatric patients with community-acquired pneumonia. Antimicrob Agents Chemother. 2008;52:348\u201350.","journal-title":"Antimicrob Agents Chemother"}],"container-title":["BMC Pulmonary Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-021-01534-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12890-021-01534-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-021-01534-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T01:03:37Z","timestamp":1621299817000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpulmmed.biomedcentral.com\/articles\/10.1186\/s12890-021-01534-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,18]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1534"],"URL":"https:\/\/doi.org\/10.1186\/s12890-021-01534-2","relation":{},"ISSN":["1471-2466"],"issn-type":[{"value":"1471-2466","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,18]]},"assertion":[{"value":"13 December 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was designed and conducted using the format recommended by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The study protocol was approved by the institutional review board of Kangdong Sacred Heart Hospital (reference number: 2020\u201311-007). The review board waived the requirement for informed consent for this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"168"}}