Objective To analyze the clinical characteristics of children with Mycoplasma pneumoniae pneumonia (MPP) carrying the 23S rRNA V region A2063G mutation and to explore predictive factors for macrolide treatment efficacy. Methods A total of 194 hospitalized children with MPP harboring this mutation were enrolled. Based on their response to macrolide treatment, they were divided into a macrolide-unresponsive MPP (MUMPP) group (n=137) and a macrolide-responsive MPP (MRMPP) group (n=57). Clinical data and laboratory findings were compared between the two groups. Results Compared to the MRMPP group, the MUMPP group had significantly longer duration of fever, higher levels of C-reactive protein (CRP), lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR), and higher incidences of lobar consolidation and severe bronchoscopic lesions (erosions, plastic bronchitis, mucus plugs). However, the presence of an air bronchogram within lobar consolidation was significantly less frequent in the MUMPP group. Logistic regression analysis identified duration of fever, CRP, and NLR as independent risk factors for MUMPP, while the presence of an air bronchogram was a protective factor. ROC curve analysis showed that the combination of fever duration, CRP, and NLR had an AUC of 0.923 (95% CI: 0.862-0.956, P<0.05) for predicting clinical efficacy. Conclusion The combination of fever duration, CRP, and NLR serves as a valuable predictor of macrolide treatment efficacy in children with A2063G-mutated MPP, facilitating early clinical intervention.
Key words
children /
23S rRNA V region A2063G /
mycoplasma pneumoniae pneumonia /
macrolide-unresponsive /
early prediction
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