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Atelectasis predicts poor prognosis in pediatric macrolides-unresponsive Mycoplasma pneumoniae pneumonia with
Jie Cheng1, Ya Liu2, Guangli Zhang3
1Department of Emergency, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Intelligent Application of Big Data in Pediatrics Engineering Research Center of Chongqing Education Commission of China, Children's Hospital of Chongqing Medical University, Chongqing, China.
Objective:
We aimed to investigate prognostic indicators for pediatric macrolides-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) cases with A2063/2064G mutations with azithromycin therapy.
Methods:
This was a retrospective observational cohort study conducted at the Children's Hospital of Chongqing Medical University. Children with macrolide-resistant mutations (A2063/2064G) diagnosed as MUMPP who received only anti-Mycoplasma pneumoniae (MP) treatment with azithromycin were retrospectively enrolled. Logistic regression analysis was used to identify potential risk factors for predicting short-term (refractory Mycoplasma pneumoniae pneumonia [RMPP]) and long-term (bronchiolitis obliterans [BO] or bronchiectasis) adverse prognosis. The results were visualized using forest plots.
Results:
This study retrospectively included 82 children with MUMPP, and all received only azithromycin for anti-MP treatment. The incidence of pulmonary consolidation, pleural effusion, and atelectasis was 80.49% (66/82), 34.15% (28/82), and 24.39% (20/82), respectively. 29.27% (24/82) of patients diagnosed with RMPP, and 14.63% (12/82) of patients diagnosed with bronchiolitis obliterans (BO) or bronchiectasis diagnosed within one year after discharge. Logistic analysis showed that atelectasis was independently associated with short-term (RMPP) and long-term (BO or bronchiectasis) adverse prognosis (odds ratio [OR] 4.02, 95% confidence interval [CI] 1.03-16.00, P = 0.043; OR 5.62, 95% CI 1.04-32.80, P = 0.045; respectively).
Conclusion:
Atelectasis predicts a poor prognosis for children with A2063/2064G MUMPP. The occurrence of atelectasis may indicate an increased risk of failure of current azithromycin treatment. Combined with the results of drug-resistant mutations, it is recommended to strengthen disease monitoring and individualized intervention evaluation.
Insights
Atelectasis is a key indicator of poor prognosis in pediatric macrolides-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) with A2063/2064G mutations. Early detection of atelectasis can help predict treatment failure and guide individualized interventions for better outcomes.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Clinical Microbiology
Background:
- Macrolides-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) with specific mutations (A2063/2064G) poses a treatment challenge in children.
- Azithromycin is a common treatment, but resistance necessitates identifying prognostic indicators for adverse outcomes.
Purpose of the Study:
- To investigate prognostic indicators for pediatric MUMPP cases with A2063/2064G mutations treated with azithromycin.
- To identify risk factors for short-term (refractory MUMPP) and long-term (bronchiolitis obliterans or bronchiectasis) adverse prognosis.
Main Methods:
- Retrospective observational cohort study of 82 children with MUMPP and A2063/2064G mutations treated with azithromycin.
- Logistic regression analysis was employed to identify independent risk factors for adverse outcomes.
- Results were visualized using forest plots.
Main Results:
- Atelectasis was independently associated with both short-term (refractory MUMPP) and long-term (bronchiolitis obliterans or bronchiectasis) adverse prognosis.
- The odds ratio for atelectasis predicting short-term adverse prognosis was 4.02 (95% CI 1.03-16.00, P=0.043).
- The odds ratio for atelectasis predicting long-term adverse prognosis was 5.62 (95% CI 1.04-32.80, P=0.045).
Conclusions:
- Atelectasis is a significant predictor of poor prognosis in pediatric patients with A2063/2064G MUMPP.
- The presence of atelectasis may signal an increased risk of azithromycin treatment failure.
- Enhanced disease monitoring and individualized intervention strategies are recommended for patients with atelectasis and drug-resistant MUMPP.
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