Risk factors of severe pneumonia in children with macrolide-resistant Mycoplasma pneumoniae pneumonia and the construction of prediction model

Corresponding author: YUAN Chen, 1243660363@qq.com

DOI: 10.12201/bmr.202409.00021

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  Abstract: Objective To explore potential predictors of macrolide-resistant Mycoplasma pneumoniae pneumonia (MRMP) to severe pneumonia in early stage. Methods A retrospective analysis was conducted on 117 cases of macrolide-resistant Mycoplasma pneumoniae pneumonia hospitalized in our hospital from January 2023 to January 2024. According to the severity of the disease, the patients were divided into two groups, macrolide-resistant severe group and macrolide-resistant mild group. The clinical characteristics of the two groups were compared, and the risk factors affecting the occurrence of severe Mycoplasma pneumoniae pneumonia (SMPP) were analyzed. Results A total of 117 patients with MRMP finished the study and divided into two groups. There were 63 patients in the severe drug-resistant group, including 35 boys and 28 girls, aged 7.0 (5.0~8.0) years. There were 54 patients in the drug-resistant mild group, including 29 boys and 25 girls, aged 7.0(6.0~9.3) years. The duration of fever, cough, white blood cell count (WBC), C-reactive protein (CRP) and lactate dehydrogenase (LDH) in the macrolide-resistant severe group were higher than those in the macrolide-resistant mild group, and the differences were statistically significant (all P<0.05). Logistic regression analysis showed that the duration of fever (OR=3.407, 95% CI 1.821 to 6.374) and CRP(mg/L) (OR=1.258, 95% CI 1.116~1.417), LDH (U/L) (OR=1.04, 95%CI 1.021~1.059) (all P<0.05) were independent risk factors for the development of MRMP to SMPP. The prediction probability P=exp-23.916+1.226×duration of fever (days)+0.229×CRP(mg/L)+0.039×LDH(U/L)/1+exp-23.916+1.226×duration of fever (days)+0.229×CRP(mg/L)+0.039×LDH(U/L). The area under ROC curve of the three combined tests was 0.963 (95%CI 0.935~0.991, P<0.01). Conclusions The predictive probability of macrolide-resistant severe Mycoplasma pneumoniae pneumonia in children can be calculated according to the duration of fever, CRP and LDH levels at the first visit, to achieve the purpose of early prediction.

  Key words: Mycoplasma pneumoniae; Macrolide-resistant; Severe pneumonia; Forecasting; Child

  Submit time: 12 September 2024

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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