Assessment of variables associated with prolonged admission duration in children with Mycoplasma pneumoniae pneumonia
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Updated: Aug 26, 2025
Antigen-Capture Enzyme-Linked Immunosorbent Assay for Specific Detection of Mycoplasma pneumoniae
Published on: February 24, 2023
Myongsoon Sung1, Eui Jeong Roh2, Eun Sil Lee2
1Department of Pediatrics, Soonchunhyang University Hospital, Gumi, South Korea.
Introduction:
Macrolide-resistant Mycoplasma pneumoniae (MRMP) has become prevalent in children. This study investigated the clinical and laboratory variables of MRMP and macrolide-sensitive M. pneumoniae (MSMP) and identified factors associated with prolonged hospital admission in children.
Methods:
A prospective multicenter study was conducted in 1063 children <18 years old in July 2018-June 2020. The 454 had a positive M. pneumoniae polymerase chain reaction assay.
Results:
Most subjects had MRMP (78.4%), and all mutated strains had the A2063G transition. We defined MRMP* (n = 285) as MRMP pneumonia requiring admission and MSMP* (n = 72) as MSMP pneumonia requiring admission. Patients with MRMP pneumonia were older, more likely to have segmental/lobar pneumonia, and had more febrile days than those with MSMP pneumonia. C-reactive protein (CRP), lactate dehydrogenase (LDH), and percentage neutrophils were more strongly associated with MRMP* than MSMP* groups. Percentage neutrophils, CRP, and alanine aminotransferase significantly changed between admission and follow-up measurements in patients with MRMP* (P < 0.05). The duration of admission positively correlated with the number of febrile days after initiation of antibiotic medication and laboratory variables (white blood cell count, CRP, and aspartate aminotransferase [AST]) (P < 0.05). Random forest analysis indicated that the number of febrile days after initiation of antibiotic medication, AST, and percentage neutrophils at admission was over five.
Conclusions:
This study indicated that children with M. pneumoniae pneumonia with a higher number of febrile days after initiation of antibiotic medication, AST, and percentage neutrophils at admission were more likely to have prolonged admission duration.
Insights
Macrolide-resistant Mycoplasma pneumoniae (MRMP) in children often leads to longer hospital stays. Key indicators for prolonged admission include persistent fever after antibiotics and elevated lab markers like AST and neutrophils.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Clinical research
Background:
- Macrolide-resistant Mycoplasma pneumoniae (MRMP) is increasingly prevalent in pediatric populations.
- Understanding the clinical and laboratory differences between MRMP and macrolide-sensitive M. pneumoniae (MSMP) is crucial.
Purpose of the Study:
- To investigate clinical and laboratory variables in children with MRMP and MSMP.
- To identify factors associated with prolonged hospital admission in pediatric patients with M. pneumoniae pneumonia.
Main Methods:
- A prospective multicenter study involved 1063 children under 18 years old.
- M. pneumoniae detection was performed using polymerase chain reaction (PCR) assays.
- 454 participants tested positive for M. pneumoniae.
Main Results:
- MRMP was identified in 78.4% of cases, with the A2063G mutation being common.
- MRMP pneumonia patients were older and had more febrile days than MSMP patients.
- Higher C-reactive protein (CRP), lactate dehydrogenase (LDH), and neutrophil percentages were associated with MRMP.
Conclusions:
- Prolonged hospital admission in children with M. pneumoniae pneumonia correlates with persistent fever post-antibiotics, aspartate aminotransferase (AST), and neutrophil percentage.
- These factors, including number of febrile days after antibiotic initiation, AST, and neutrophils, are key predictors of extended hospital stays.
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