Risk factors for identifying pulmonary aspergillosis in pediatric patients

ObjectivesThis study aimed to identify the independent risk factors and develop a predictive model for pulmonary aspergillosis (PA) in pediatric populations.MethodsThis retrospective study compromised 97 pediatric patients with pulmonary infections (38 PA cases and 59 non-PA cases) at Children’s Hos...

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Main Authors: Shangmin Yang, Yanmeng Sun, Mengyuan Wang, Huan Xu, Shifu Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Cellular and Infection Microbiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fcimb.2025.1616773/full
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author Shangmin Yang
Shangmin Yang
Yanmeng Sun
Yanmeng Sun
Mengyuan Wang
Mengyuan Wang
Huan Xu
Shifu Wang
Shifu Wang
author_facet Shangmin Yang
Shangmin Yang
Yanmeng Sun
Yanmeng Sun
Mengyuan Wang
Mengyuan Wang
Huan Xu
Shifu Wang
Shifu Wang
author_sort Shangmin Yang
collection DOAJ
description ObjectivesThis study aimed to identify the independent risk factors and develop a predictive model for pulmonary aspergillosis (PA) in pediatric populations.MethodsThis retrospective study compromised 97 pediatric patients with pulmonary infections (38 PA cases and 59 non-PA cases) at Children’s Hospital Affiliated to Shandong University between January 2020 and October 2024. Multivariate binary logistic regression was used to identify PA-associated risk factors. Receiver operating characteristic (ROC) curves, calibration plots, and Brier scoring were used to evaluate the diagnostic model.Results8 clinical variables significantly differed between the PA and non-PA groups. Multivariate binary logistic regression analysis identified six significant independent risk factors: a history of surgery (OR: 9.52; 95% CI: 1.96–46.23; P = 0.005), hematologic diseases (OR: 11.68; 95% CI: 0.89–153.62; P = 0.062), absence of fever (OR: 8.244; 95% CI: 1.84–36.932; P = 0.006), viral coinfection (OR: 15.99; 95% CI: 3.55–72.00; P < 0.001), elevated (1, 3) -β -D-glucan levels (BDG, > 61.28 pg/mL; OR: 7.38; 95% CI: 1.26–43.31; P = 0.027), and shorter symptom-to-admission interval (< 4.5 days; OR: 38.68; 95% CI: 5.38–277.94; P < 0.001) were risk factors for PA. The predictive model demonstrated excellent discrimination (AUC 0.93, 95% CI 0.88-0.98) and calibration (Hosmer-Lemeshow p=0.606, R²=0.96, Brier score 0.097). metagenomic next - generation sequencing (mNGS) revealed significantly higher rates of polymicrobial infections in PA cases (86.84% vs 18.64%, p<0.001).ConclusionsThis study established and validated a high-performance predictive model incorporating six clinically accessible parameters for the diagnosis of pediatric PA.
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spelling doaj-art-badf0585bf8941ba80aade1db33abf442025-08-20T02:35:29ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882025-06-011510.3389/fcimb.2025.16167731616773Risk factors for identifying pulmonary aspergillosis in pediatric patientsShangmin Yang0Shangmin Yang1Yanmeng Sun2Yanmeng Sun3Mengyuan Wang4Mengyuan Wang5Huan Xu6Shifu Wang7Shifu Wang8Department of Microbiology Laboratory, Children’s Hospital Affiliated to Shandong University (Jinan Children’s Hospital), Jinan, ChinaDepartment of Clinical Microbiology, Shandong Provincial Clinical Research Center for Children’s Health and Disease, Jinan, ChinaDepartment of Microbiology Laboratory, Children’s Hospital Affiliated to Shandong University (Jinan Children’s Hospital), Jinan, ChinaDepartment of Clinical Microbiology, Shandong Provincial Clinical Research Center for Children’s Health and Disease, Jinan, ChinaDepartment of Microbiology Laboratory, Children’s Hospital Affiliated to Shandong University (Jinan Children’s Hospital), Jinan, ChinaDepartment of Clinical Microbiology, Shandong Provincial Clinical Research Center for Children’s Health and Disease, Jinan, ChinaDepartment of Scientific Affairs, Vision Medicals Center for Infectious Diseases, Guangzhou, ChinaDepartment of Microbiology Laboratory, Children’s Hospital Affiliated to Shandong University (Jinan Children’s Hospital), Jinan, ChinaDepartment of Clinical Microbiology, Shandong Provincial Clinical Research Center for Children’s Health and Disease, Jinan, ChinaObjectivesThis study aimed to identify the independent risk factors and develop a predictive model for pulmonary aspergillosis (PA) in pediatric populations.MethodsThis retrospective study compromised 97 pediatric patients with pulmonary infections (38 PA cases and 59 non-PA cases) at Children’s Hospital Affiliated to Shandong University between January 2020 and October 2024. Multivariate binary logistic regression was used to identify PA-associated risk factors. Receiver operating characteristic (ROC) curves, calibration plots, and Brier scoring were used to evaluate the diagnostic model.Results8 clinical variables significantly differed between the PA and non-PA groups. Multivariate binary logistic regression analysis identified six significant independent risk factors: a history of surgery (OR: 9.52; 95% CI: 1.96–46.23; P = 0.005), hematologic diseases (OR: 11.68; 95% CI: 0.89–153.62; P = 0.062), absence of fever (OR: 8.244; 95% CI: 1.84–36.932; P = 0.006), viral coinfection (OR: 15.99; 95% CI: 3.55–72.00; P < 0.001), elevated (1, 3) -β -D-glucan levels (BDG, > 61.28 pg/mL; OR: 7.38; 95% CI: 1.26–43.31; P = 0.027), and shorter symptom-to-admission interval (< 4.5 days; OR: 38.68; 95% CI: 5.38–277.94; P < 0.001) were risk factors for PA. The predictive model demonstrated excellent discrimination (AUC 0.93, 95% CI 0.88-0.98) and calibration (Hosmer-Lemeshow p=0.606, R²=0.96, Brier score 0.097). metagenomic next - generation sequencing (mNGS) revealed significantly higher rates of polymicrobial infections in PA cases (86.84% vs 18.64%, p<0.001).ConclusionsThis study established and validated a high-performance predictive model incorporating six clinically accessible parameters for the diagnosis of pediatric PA.https://www.frontiersin.org/articles/10.3389/fcimb.2025.1616773/fullpulmonary aspergillosismetagenomic next-generation sequencingROC curverisk factorspediatrics
spellingShingle Shangmin Yang
Shangmin Yang
Yanmeng Sun
Yanmeng Sun
Mengyuan Wang
Mengyuan Wang
Huan Xu
Shifu Wang
Shifu Wang
Risk factors for identifying pulmonary aspergillosis in pediatric patients
Frontiers in Cellular and Infection Microbiology
pulmonary aspergillosis
metagenomic next-generation sequencing
ROC curve
risk factors
pediatrics
title Risk factors for identifying pulmonary aspergillosis in pediatric patients
title_full Risk factors for identifying pulmonary aspergillosis in pediatric patients
title_fullStr Risk factors for identifying pulmonary aspergillosis in pediatric patients
title_full_unstemmed Risk factors for identifying pulmonary aspergillosis in pediatric patients
title_short Risk factors for identifying pulmonary aspergillosis in pediatric patients
title_sort risk factors for identifying pulmonary aspergillosis in pediatric patients
topic pulmonary aspergillosis
metagenomic next-generation sequencing
ROC curve
risk factors
pediatrics
url https://www.frontiersin.org/articles/10.3389/fcimb.2025.1616773/full
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