Pathogenic characteristics and T lymphocyte immune features in children with severe mycoplasmal pneumonia complicated by pulmonary fungal infection
ZHAO Yongyan
YAO Jie
Abstract：Objective To investigate the pathogenic characteristics and T lymphocyte immune features in children with severe mycoplasmal pneumonia complicated by pulmonary fungal infection.Methods Retrospective inclusion of 37 children with severe mycoplasmal pneumonia complicated by fungal infection admitted to Taiyuan Central Hospital pediatric department from July 2022 to July 2024 formed Group A.An additional 50 children with severe mycoplasmal pneumonia without complications during the same period formed Group B.Concurrently,50 healthy children undergoing routine physical examinations were randomly selected to form Group C.Pathogenic characteristics of Group A were analyzed.Inflammatory markers[neutrophil-to-lymphocyte ratio(NLR),serum amyloid A(SAA),erythrocyte sedimentation rate(ESR)],pulmonary function indicators[peak expiratory flow(PEF),maximum voluntary ventilation(MVV),forced expiratory volume in one second to forced vital capacity ratio(FEV1/FVC)],T lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+),and nutritional status indicators(vitamin A,vitamin D).Results In Group A,39 fungal strains were detected among 37 children with severe mycoplasmal pneumonia complicated by pulmonary fungal infection.Candida albicans was the most prevalent,followed by Aspergillus fumigatus,Mucorales,Candida parapsilosis,and Pneumocystis.Both Groups A and B exhibited significantly higher levels of NLR,SAA,ESR,and CD8+compared to Group C,with Group A showing significantly higher values than Group B(P＜0.05).The levels of PEF,MVV,FEV1/FVC,CD3+,CD4+,CD4+/CD8+,vitamin A,and vitamin D were significantly lower in Groups A and B than in Group C,with Group A being significantly lower than Group B.All differences were statistically significant(P＜0.05).ROC analysis revealed that NLR,SAA,ESR,PEF,MVV,FEV1/FVC,CD3+,CD4+,CD8+,CD4+/CD8+,vitamin A,and vitamin D levels were statistically significant predictors of pulmonary fungal infection in children with severe mycoplasmal pneumonia(P＜0.05).Conclusion Severe mycoplasmal pneumonia complicated by pulmonary fungal infection is predominantly caused by Candida albicans.Affected children exhibit intense inflammatory responses,immune dysfunction,poor pulmonary function,and malnutrition.Therefore,clinical management requires early monitoring of relevant indicators,prompt implementation of comprehensive therapeutic measures to reduce inflammation and modulate immunity,emphasis on fungal prevention and treatment,and improvement of patient prognosis.
Keywords：severe mycoplasmal pneumoniafungal infectionpathogenic characteristicsT lymphocytesimmunological features
Publication Date：2025-12-28
Online Publishing Date：2026-01-06(First online date of this platform, not the publication date of the document)
Pages：7( 645-651 )