{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:53:18Z","timestamp":1792788798478,"version":"4.5.0"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"ZiGong Science and Technology Bureau","award":["2023YKYXT06"],"award-info":[{"award-number":["2023YKYXT06"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                    (MP) is the primary causative agent of community-acquired pneumonia. Severe\n                    <jats:italic>mycoplasma pneumoniae<\/jats:italic>\n                    pneumonia (SMPP) can result in multiorgan damage and even respiratory failure or death. This study aimed to evaluate the predictive value of the Systemic Immune-Inflammation Index (SII) for SMPP. This retrospective study included 254 hospitalized children with MP infections (SMPP group, n\u2009=\u2009103; non-SMPP group, n\u2009=\u2009151). Patient data, including complete blood count parameters (white blood cell, absolute neutrophil, absolute lymphocyte, absolute monocyte, and platelet counts), C-reactive protein (CRP), serum amyloid A (SAA), and other markers, were collected. Furthermore, the SII, Systemic Inflammation Response Index (SIRI), neutrophil\/lymphocyte ratio (NLR), monocyte\/lymphocyte ratio (MLR), and platelet\/lymphocyte ratio (PLR) were calculated.\n                    <jats:italic>\n                      <jats:italic>T<\/jats:italic>\n                    <\/jats:italic>\n                    -tests and the Mann\u2013Whitney U test were used to analyze differences between the groups. Logistic regression was applied to analyze the risk factors. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of the SII and CRP for SMPP. The SMPP group exhibited significantly higher CRP and SAA levels, SII, NLR, MLR, PLR, and SIRI than the non-SMPP group (all\n                    <jats:italic>\n                      <jats:italic>P<\/jats:italic>\n                    <\/jats:italic>\n                    \u2009&lt;\u20090.001). Logistic regression revealed that the SII (odds ratio [OR] = 1.006, 95% confidence interval [CI]: 1.001\u20131.010) and CRP (OR = 1.080, 95% CI: 1.041\u20131.120) were independent risk factors. ROC curve of the SII (area under the ROC curve\u2009=\u20090.883, sensitivity\u2009=\u20090.699,\n                    <jats:underline>and<\/jats:underline>\n                    specificity\u2009=\u20090.881) outperformed that of CRP. Thus, SII can serve as an effective biomarker for SMPP prediction. It can be a rapid and cost-effective method when combined with routine blood tests, thereby demonstrating considerable potential for clinical application.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0333267","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:41:50Z","timestamp":1760031710000},"page":"e0333267","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Application value of systemic immune-inflammation index in predicting severe Mycoplasma pneumoniae pneumonia"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3236-7104","authenticated-orcid":true,"given":"Xiaocong","family":"Guo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honglin","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaohui","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2645-8637","authenticated-orcid":true,"given":"Xiaoya","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongcan","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"issue":"1","key":"pone.0333267.ref001","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/S1473-3099(01)00170-0","article-title":"Estimates 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occurrence","volume":"23","author":"EA Dziedzic","year":"2022","journal-title":"Int J Mol Sci"},{"key":"pone.0333267.ref022","doi-asserted-by":"crossref","first-page":"577043","DOI":"10.3389\/fonc.2021.577043","article-title":"Dynamic Changes in the Systemic Inflammation Response Index Predict the Outcome of Resectable Gastric Cancer Patients","volume":"11","author":"Z Liu","year":"2021","journal-title":"Front Oncol"},{"issue":"1","key":"pone.0333267.ref023","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/ped4.12469","article-title":"Evidence-based guideline for the diagnosis and treatment of Mycoplasma pneumoniae pneumonia in children (2023)","volume":"9","author":"Subspecialty Group of Respiratory, the Society of Pediatrics, Chinese Medical Association, China National Clinical Research Center of Respiratory Diseases, Editorial Board, Chinese Journal of Pediatrics","year":"2025","journal-title":"Pediatr 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population-based study","volume":"14","author":"J Ke","year":"2023","journal-title":"Front Immunol"},{"issue":"2","key":"pone.0333267.ref027","doi-asserted-by":"crossref","first-page":"123","DOI":"10.3390\/pathogens10020119","article-title":"Mycoplasma pneumoniae infections: pathogenesis and vaccine development","volume":"10","author":"Z Jiang","year":"2021","journal-title":"Pathogens"},{"issue":"4","key":"pone.0333267.ref028","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.jmii.2020.03.030","article-title":"Altered chemokine profile in refractory Mycoplasma pneumoniae pneumonia infected children","volume":"54","author":"YC Lee","year":"2021","journal-title":"J Microbiol Immunol Infect"},{"issue":"12","key":"pone.0333267.ref029","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1111\/cmi.12613","article-title":"Mycoplasma lipoproteins are major determinants of neutrophil extracellular trap formation","volume":"18","author":"C Cacciotto","year":"2016","journal-title":"Cell Microbiol"},{"key":"pone.0333267.ref030","doi-asserted-by":"crossref","first-page":"1052020","DOI":"10.3389\/fcimb.2023.1052020","article-title":"Interaction between alveolar macrophages and epithelial cells during Mycoplasma pneumoniae infection","volume":"13","author":"Y Xue","year":"2023","journal-title":"Front Cell Infect Microbiol"},{"key":"pone.0333267.ref031","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.3389\/fimmu.2018.01777","article-title":"Alveolar Macrophages in the Resolution of Inflammation, Tissue Repair, and Tolerance to Infection","volume":"9","author":"B Allard","year":"2018","journal-title":"Front Immunol"},{"issue":"2","key":"pone.0333267.ref032","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1378\/chest.09-0998","article-title":"Thrombocytopenia and thrombocytosis at time of hospitalization predict mortality in patients with community-acquired pneumonia","volume":"137","author":"M Mirsaeidi","year":"2010","journal-title":"Chest"},{"key":"pone.0333267.ref033","doi-asserted-by":"crossref","first-page":"828437","DOI":"10.3389\/fped.2022.828437","article-title":"D-dimer: The Risk Factor of Children\u2019s Severe Mycoplasma Pneumoniae Pneumonia","volume":"10","author":"J Qiu","year":"2022","journal-title":"Front Pediatr"},{"issue":"6","key":"pone.0333267.ref034","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1177\/1753425918789255","article-title":"Start a fire, kill the bug: The role of platelets in inflammation and infection","volume":"24","author":"C Deppermann","year":"2018","journal-title":"Innate Immun"},{"issue":"1","key":"pone.0333267.ref035","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1002\/rth2.12266","article-title":"The dual role of platelet-innate immune cell interactions in thrombo-inflammation","volume":"4","author":"J Rayes","year":"2020","journal-title":"Res Pract Thromb 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