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Pathogen Distribution and Antimicrobial Resistance Patterns in Pediatric Lower Respiratory Tract Mycoplasma
Boying Wu1, Zhe Zhang1, Chenbo Zhu1
1Department of Pediatrics, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China.
Abstract:
We aimed to characterize the distribution of respiratory pathogens and antimicrobial resistance profiles in children with lower respiratory tract Mycoplasma pneumoniae pneumonia (MPP) and to identify clinical factors associated with multidrug-resistant (MDR) infection. A retrospective analysis of 125 pediatric MPP patients was conducted. Microbiological identification and antimicrobial susceptibility testing were performed on bronchoalveolar lavage fluid isolates. Based on susceptibility results, patients were categorized into an MDR group (n = 25) and a non-MDR group (n = 100). Multivariate logistic regression identified independent predictors of MDR infection. Among Gram-negative isolates, Klebsiella pneumoniae had the highest resistance to cefotaxime (40%), Escherichia coli to piperacillin (50%), and Pseudomonas aeruginosa to aztreonam (54%). For Gram-positive bacteria, resistance to penicillin was most pronounced in Staphylococcus aureus (76%) and Streptococcus pneumoniae (83%). Staphylococcus epidermidis showed elevated resistance to clindamycin, levofloxacin, and penicillin (43% each). Multivariate analysis identified prolonged hospitalization (≥ 14 days), antibiotic exposure for ≥ 7 days, and invasive respiratory procedures as independent risk factors for MDR infection (p < 0.05). Co-isolated bacterial pathogens from children with lower respiratory tract MPP show notable antimicrobial resistance. Routine pathogen testing and susceptibility profiling are crucial for guiding targeted therapy and curbing multidrug resistance.
Insights
Pediatric lower respiratory tract infections caused by Mycoplasma pneumoniae often involve co-infections with bacteria exhibiting significant antimicrobial resistance. Prolonged hospitalization and prior antibiotic use are key risk factors for multidrug-resistant infections in children.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Antimicrobial Resistance
Background:
- Mycoplasma pneumoniae pneumonia (MPP) is a common cause of lower respiratory tract infections in children.
- Understanding the spectrum of co-infecting pathogens and their antimicrobial resistance patterns is crucial for effective treatment.
Purpose of the Study:
- To characterize the distribution of respiratory pathogens and antimicrobial resistance profiles in pediatric MPP.
- To identify clinical factors associated with multidrug-resistant (MDR) infections in these patients.
Main Methods:
- Retrospective analysis of 125 pediatric MPP patients.
- Microbiological identification and antimicrobial susceptibility testing of bronchoalveolar lavage fluid isolates.
- Multivariate logistic regression to identify predictors of MDR infection.
Main Results:
- Notable antimicrobial resistance was observed in co-isolated bacterial pathogens.
- Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa showed high resistance rates to specific antibiotics.
- Staphylococcus aureus and Streptococcus pneumoniae exhibited significant penicillin resistance.
- Staphylococcus epidermidis demonstrated elevated resistance to clindamycin, levofloxacin, and penicillin.
- Prolonged hospitalization (≥14 days), extended antibiotic exposure (≥7 days), and invasive respiratory procedures were independent risk factors for MDR infection (p < 0.05).
Conclusions:
- Co-isolated bacterial pathogens in pediatric MPP contribute to significant antimicrobial resistance.
- Routine pathogen testing and susceptibility profiling are essential for guiding targeted therapy.
- These measures are critical for combating the rise of multidrug resistance in pediatric respiratory infections.
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