Objective To explore the risk factors of severe Mycoplasma pneumoniae pneumonia(SMPP) in children,and to provide reference for early diagnosis and treatment of SMPP for clinicians.Methods The clinical data of 399 pediatric patients with Mycoplasma pneumoniae pneumonia(MPP) who were admitted to Department of Pediatrics,the People's Hospital of Guangxi Zhuang Autonomous Region from April 2023 to June 2024 and tested positive for Mycoplasma pneumoniae(MP) DNA by using bronchoalveolar lavage fluid(BALF) were retrospectively analyzed.The pediatric patients were divided into severe group(230 cases) and mild group(169 cases) according to disease condition.The differences in laboratory indicators,MP-DNA loads in BALF and positive rate of mutation in MP drug-resistant gene 23S rRNA locus(A2063G) were compared between the two groups.The risk factors affecting the occurrence of SMPP were analyzed.Results The levels of percentage of neutrophils( NEU％),neutrophil-to-lymphocyte ratio( NLR),C-reactive protein( CRP),procalcitonin(PCT),interleukin-6(IL-6),lactate dehydrogenase(LDH),D-dimer(D-D) and positive rate of mutation in MP drug-resistant gene 23S rRNA locus(A2063G) in the pediatric patients of the severe group were higher than those in the pediatric patients of the mild group,and the levels of percentage of lymphocytes( LYM％) and albumin( ALB) in the pediatric patients of the severe group were lower than those in the pediatric patients of the mild group,and differences were significant(P＜0.05).The results of multivariate logistic regression analysis showed that the elevated levels of CRP[OR(95％CI):1.085(1.051-1.120)],LDH[OR(95％CI):1.031(1.022-1.040)],and D-D[OR(95％CI):40.359(9.417-172.975)],as well as the mutation in MP drug-resistant gene 23S rRNA locus(A2063G)[OR(95％CI):2.677(1.372-5.222)]were independent risk factors for SMPP(P＜0.05),and the results of receiver operating characteristic(ROC) curve analysis showed that CRP(AUC=0.761),LDH(AUC=0.809),and D-D(AUC=0.817) had moderate diagnostic value for SMPP.Conclusion The inflammatory indicators of SMPP pediatric patients are significantly elevated,and the elevated levels of CRP,LDH and D-D,as well as the mutation in MP drug-resistant gene locus(A2063G) are risk factors for SMPP,which have reference value for the diagnosis of SMPP.
Severe Mycoplasma pneumoniae pneumonia(SMPP)ChildrenRisk factorsBronchoalveolar lavage fluid(BALF)Inflammatory indicatorsGenetic mutation
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