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Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Application Value of Lung Ultrasound in Children With Macrolide-Unresponsive Mycoplasma pneumoniae Pneumonia
Jie Zhou1, Xinxin Guo1, Rong Wu1
1Ordos School of Clinical Medicine, Inner Mongolia Medical University, Hohhot, China.
Objective:
The incidence of macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) has markedly increased, primarily owing to resistance mediated by mutations in the pathogen's 23S rRNA gene. Because macrolide susceptibility testing is impractical at admission, this study aimed to delineate the clinical characteristics of MUMPP in children and to evaluate the predictive utility of laboratory parameters and lung ultrasound features for identifying MUMPP.
Methods:
A retrospective analysis was performed on 163 children hospitalized with Mycoplasma pneumoniae pneumonia (MPP) at the Department of Pediatrics, Ordos Central Hospital, from January 1, 2023, to December 31, 2024. Patients were stratified into the MUMPP group (n = 49) and the macrolide-sensitive Mycoplasma pneumoniae pneumonia (MSMP) group (n = 114) according to their response to macrolide antibiotics.
Results:
Compared with the MSMP group, patients in the MUMPP group were older, had longer hospital stays, and had higher body temperatures. d-dimer levels and neutrophil-to-lymphocyte ratios (NLRs) were elevated in the MUMPP group. On lung ultrasound, the MUMPP group exhibited larger areas of lung consolidation at admission and after treatment, higher rates of pleural effusion, greater bilateral pulmonary involvement, and a higher proportion of consolidations without air bronchograms.
Conclusion:
Children with MUMPP present with more severe clinical features and lung ultrasound manifestations than those with MSMP. Early initiation of non-macrolide alternative therapies is therefore critical for effective management of MUMPP.
Insights
Macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) in children presents with more severe symptoms and distinct lung ultrasound findings compared to macrolide-sensitive cases. Early identification of MUMPP is crucial for timely alternative treatment.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Diagnostic Imaging
Background:
- Macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) is increasing due to 23S rRNA gene mutations.
- Macrolide susceptibility testing is not feasible at initial patient assessment.
Purpose of the Study:
- To characterize the clinical features of MUMPP in children.
- To assess the predictive value of laboratory markers and lung ultrasound for identifying MUMPP.
Main Methods:
- Retrospective analysis of 163 children with Mycoplasma pneumoniae pneumonia (MPP).
- Stratification into MUMPP (n=49) and macrolide-sensitive MPP (MSMP) (n=114) groups based on antibiotic response.
Main Results:
- MUMPP patients were older, had longer hospital stays, and higher fevers than MSMP patients.
- Elevated d-dimer and neutrophil-to-lymphocyte ratios (NLRs) were observed in the MUMPP group.
- Lung ultrasound revealed larger consolidations, higher pleural effusion rates, and more bilateral involvement in MUMPP cases.
Conclusions:
- Children with MUMPP exhibit more severe clinical and lung ultrasound findings.
- Prompt initiation of non-macrolide therapies is essential for managing MUMPP effectively.
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