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Development of a Prediction Model for Severe Pediatric Mycoplasma pneumoniae Pneumonia: A Single-Center Retrospective

Zeyu Zeng1,2, Guang Li3, Yanbing Xu3

  • 1Department of Pulmonology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China.

Infection and Drug Resistance
|June 2, 2026
PubMed
Abstract

Insights

A new model predicts severe pediatric pneumonia caused by macrolide-resistant Mycoplasma pneumoniae (MRMP) with high accuracy. Early use of tetracyclines/fluoroquinolones may improve outcomes for children with A2063/2064G-mutated infections.

Area of Science:

  • Pediatric infectious diseases
  • Respiratory medicine
  • Molecular diagnostics

Background:

  • Mycoplasma pneumoniae pneumonia (MPP) is common in children, with severe cases (SMPP) occurring in 10-40%.
  • Macrolide-resistant MRMP (MRMP) with A2063/2064G mutation is linked to severe disease and treatment failure.
  • Effective early prediction and personalized treatment for MRMP infections are critical clinical needs.

Purpose of the Study:

  • To develop an early prediction model for severe pediatric Mycoplasma pneumoniae pneumonia (SMPP).
  • To explore personalized treatment strategies for children with A2063/2064G-mutated MRMP infections.

Main Methods:

  • Retrospective analysis of 2381 children with MPP.
  • Development of a predictive model using multivariate logistic regression and ROC analysis.
  • Assessment of medication patterns and hospital stay for mutation-positive patients.

Main Results:

  • A seven-indicator model (fever duration, LDH, ALB, CK-MB, Neu%, WBC, D-dimer) accurately predicted SMPP (AUC=0.899).
  • The A2063/2064G mutation was more prevalent in SMPP cases (54.7% vs. 27.5%).
  • Early use of tetracyclines/fluoroquinolones (TCs/FQs) in mutation-positive patients with predicted SMPP shortened hospital stay.

Conclusions:

  • The developed model effectively identifies children at risk for SMPP.
  • Combining the prediction model with mutation status guides personalized treatment decisions.
  • Early TCs/FQs administration shows promise for children with A2063/2064G-mutated MRMP and predicted SMPP.
Keywords:
A2063/2064G mutationMycoplasma pneumoniae pneumoniaclinical prediction modelmacrolide resistancepersonalized treatment

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