Han Shuzhen, Fang Qiaoxin, Wu Xia, Ye Yingzi, Ye Lijing, Xu Jun, Yu Hui
Department of infectious diseases, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China.
BMC Infect Dis. 2025 Jul 1;25(1):854. doi: 10.1186/s12879-025-11234-5.
To analyze the clinical characteristics and antibiotic resistance of Mycoplasma pneumoniae pneumonia (MPP) children, and explore the clinical features associated with macrolides resistance in MPP patients.
We retrospectively collected clinical data of children with MMP from August 2023 to November 2023 at the Department of Infectious Diseases, Children's Hospital, Fudan University, Shanghai, China. General information, clinical presentation, imaging findings, laboratory findings, and treatment were recorded. We divided our patients into < 5-year-old group or ≥ 5-year-old group, with complication group or without complication group, and gene-mutated group or non-mutated group based on clinical characteristics and compared the differences between groups. Then, we investigated the clinical features associated with macrolides resistance of MPP.
Of 285 children who had MPP, 161 cases (71.9%) aged ≥ 5 years were more likely to be associated with pleural effusion (P < 0.05), while those aged < 5 years were more prone to exhibit gastrointestinal symptoms (P < 0.05). Among the 250 children (87.7%) with complications, hyperlactatemia was the most common, occurring in 58.6% of cases. In the drug-resistant group, which comprised 224 cases (78.6%), children aged ≥ 5 years accounted for 71.9%. The incidence of hyperlactatemia in the drug-resistant group was 62.5%, and the rate of second-line anti-MP drug usage was 84.8%, both of which were higher than in the non-resistant group (P < 0.05). Being aged ≥ 5 years and having hyperlactatemia may be associated with the risk of macrolides resistance in MMP children, aOR 95%CI: 1.95(1.07, 3.57), 2.28(1.25, 4.17), respectively. But fever was not associated with the risk of macrolides resistance after adjusting factors.
In conclusion, pediatric cases of MPP were more frequently observed in children aged five years and older, with a notable 78.6% exhibiting drug-resistance gene mutation. The management of patients with resistant cases often involved combination therapy with second-line antibiotics and corticosteroids for the treatment of Mycoplasma pneumoniae. Aged ≥ 5 years and having hyperlactatemia may be associated with the risk of macrolides resistance in MMP children.
Not applicable.
分析肺炎支原体肺炎（MPP）患儿的临床特征及抗生素耐药情况，探讨MPP患者大环内酯类耐药相关的临床特点。
回顾性收集2023年8月至2023年11月在上海复旦大学附属儿科医院感染科就诊的MPP患儿的临床资料。记录一般信息、临床表现、影像学检查结果、实验室检查结果及治疗情况。根据临床特征将患者分为<5岁组或≥5岁组、有并发症组或无并发症组、基因变异组或无变异组，并比较组间差异。然后，研究MPP大环内酯类耐药相关的临床特征。
285例MPP患儿中，161例（71.9%）年龄≥5岁者更易合并胸腔积液（P<0.05），而<5岁者更易出现胃肠道症状（P<0.05）。250例（87.7%）有并发症的患儿中，高乳酸血症最为常见，发生率为58.6%。在224例（78.6%）耐药组患儿中，年龄≥5岁者占71.9%。耐药组高乳酸血症发生率为62.5%，二线抗MP药物使用率为84.8%，均高于非耐药组（P<0.05）。年龄≥5岁和高乳酸血症可能与MPP患儿大环内酯类耐药风险有关[校正后比值比（aOR）95%可信区间（CI）：分别为1.95（1.07，3.57）、2.28（1.25，4.17）]。但校正相关因素后，发热与大环内酯类耐药风险无关。
总之，MPP儿科病例在5岁及以上儿童中更为常见，78.6%的患儿存在耐药基因突变。耐药病例的治疗常需二线抗生素联合糖皮质激素治疗肺炎支原体。年龄≥5岁和高乳酸血症可能与MPP患儿大环内酯类耐药风险有关。
不适用。
