Serum CXCL5 and CCL20 Are Associated With Treatment Failure in Pediatric Mycoplasma pneumoniae Pneumonia Receiving...

This study evaluated CXC motif chemokine 5 (CXCL5) and C-C motif chemokine ligand 20 (CCL20) as predictors of azithromycin failure in pediatric Mycoplasma pneumoniae pneumonia (MPP). Procalcitonin (PCT), CXCL5, CCL20, interleukin-6 (IL-6), and C-reactive protein (CRP) were assayed in 318 patients and 100 controls. Favorable outcome was symptomatic remission with >50% radiological absorption; poor outcome was persistent/worsening symptoms, no radiological absorption or progression, or complications requiring additional intervention. Patients were stratified by 7-day outcomes (poor, n = 62; favorable, n = 256). Multivariable logistic regression and receiver operating characteristic analysis showed prolonged fever, higher clinical pulmonary infection score (CPIS), and elevated PCT, lactate dehydrogenase, CXCL5, and CCL20 predicted poor prognosis (P < .05). Procalcitonin, CXCL5, and CCL20 area under the curve (AUC) were 0.755, 0.714, and 0.745, respectively; combined AUC was 0.863. Pretreatment CXCL5 and CCL20 positively correlated with CPIS, IL-6, and CRP (P < .05). CXCL5 and CCL20 are robust additive biomarkers for azithromycin-refractory MPP.