{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T06:17:59Z","timestamp":1787897879021,"version":"build-2784847793"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mycoplasma pneumoniae pneumonia (MPP) remains a leading cause of community-acquired pneumonia in children, with respiratory failure occurring in 15%\u201320% of hospitalized cases. Despite advances in understanding MPP pathogenesis, validated tools for early prediction of respiratory failure are lacking. This study aimed to develop and validate a nomogram based on Clinical Pulmonary Infection Score (CPIS) for individualized risk stratification in pediatric MPP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study of 305 children with confirmed MPP admitted to our hospital between July 2020 and December 2024. Patients were categorized into respiratory failure (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200962) and non-respiratory failure (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009243) groups. Demographics, clinical features, laboratory parameters, chest imaging findings, and CPIS were collected. Independent risk factors were identified through multivariate logistic regression, and a nomogram was constructed and validated using ROC curve 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                      Respiratory failure was associated with significantly higher rates of tachypnea (91.9% vs. 16.5%), interstitial changes (87.1% vs. 25.5%), and pleural effusion (74.2% vs. 24.7%) (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). The respiratory failure group exhibited elevated NLR (5.2 vs. 3.7), CRP, D-dimer, and CPIS (7.4 vs. 5.3), with lower SpO\n                      <jats:sub>2<\/jats:sub>\n                      (89.6% vs. 94.3%) (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Multivariate logistic analysis identified interstitial changes (OR\u2009=\u20092.522,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001), NLR (OR\u2009=\u20092.716,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and CPIS (OR\u2009=\u20091.932,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) as independent risk factors, while older age (OR\u2009=\u20090.467,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and higher SpO\n                      <jats:sub>2<\/jats:sub>\n                      (OR\u2009=\u20090.772,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) were protective. The nomogram demonstrated exceptional discriminative ability (AUC\u2009=\u20090.918, 95% CI: 0.880\u20130.956), good calibration (Hosmer-Lemeshow\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.71), and positive net benefit across threshold probabilities of 5%\u201340%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This CPIS-based nomogram provides a highly accurate, clinically practical tool for predicting respiratory failure in pediatric MPP. By integrating radiographic, inflammatory, and physiological parameters, it enables early identification of high-risk patients for enhanced monitoring and preemptive respiratory support, potentially improving outcomes in severe MPP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1891146","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T05:33:47Z","timestamp":1787895227000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prediction of risk factors for respiratory failure in children with mycoplasma pneumoniae pneumonia based on clinical pulmonary infection scores"],"prefix":"10.3389","volume":"14","author":[{"given":"Jiao","family":"Lian","sequence":"first","affiliation":[{"name":"Pediatric Internal Medicine, Yulin City Children\u2019s Hospital, Yuyang District People\u2019s Hospital of Yulin City","place":["Yulin, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiyao","family":"Si","sequence":"additional","affiliation":[{"name":"Pediatric Internal Medicine, Yulin City Children\u2019s Hospital, Yuyang District People\u2019s Hospital of Yulin City","place":["Yulin, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolong","family":"Li","sequence":"additional","affiliation":[{"name":"Pediatric Internal Medicine, Yulin City Children\u2019s Hospital, Yuyang District People\u2019s Hospital of Yulin City","place":["Yulin, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Xue","sequence":"additional","affiliation":[{"name":"Pediatric Internal Medicine, Yulin City Children\u2019s Hospital, Yuyang District People\u2019s Hospital of Yulin City","place":["Yulin, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenying","family":"Liu","sequence":"additional","affiliation":[{"name":"Pediatric Internal Medicine, Yulin City Children\u2019s Hospital, Yuyang District People\u2019s Hospital of Yulin City","place":["Yulin, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1128\/CMR.00114-16","article-title":"Mycoplasma pneumoniae from the respiratory tract and beyond","volume":"30","author":"Waites","year":"2017","journal-title":"Clin Microbiol Rev"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e0074821","DOI":"10.1128\/JCM.00748-21","article-title":"Mycoplasma pneumoniae genotypes and clinical outcome in children","volume":"59","author":"Meyer Sauteur","year":"2021","journal-title":"J Clin 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