Comparative study of clinical characteristics and long-term prognosis between macrolide-resistant and macrolide-sensitive Mycoplasma pneumoniae infections in children: A retrospective case-control study

This study aimed to investigate the long-term health impacts of macrolide-resistant macrolide-resistant Mycoplasma pneumoniae (MRMP) infection in children, identify factors influencing MRMP infection, and provide evidence for clinical decision-making to improve prognosis and address challenges posed by antimicrobial resistance. A case-control study was conducted, enrolling 64 pediatric MRMP-infected patients (research group) and 266 macrolide-sensitive macrolide-sensitive M pneumoniae-infected patients (control group) admitted to our hospital from August 2023 to April 2024. All participants underwent standardized evaluations, including physical examinations, medical history review, complete blood count, blood biochemistry, inflammatory marker assays, and immunological profiling. The research group exhibited a lower incidence of fever compared to the control group (P < .01). Respiratory assessments revealed significantly reduced rates of wet rales, intercostal retractions, and lung consolidation in the research group (P < .001). Hematologically, the research group demonstrated lower white blood cell counts (P < .05). Biochemical analysis indicated decreased alanine aminotransferase and urea levels (P < .05), elevated lactate dehydrogenase (P < .05), and comparable creatine kinase and creatine kinase-MB (CK-MB) levels between groups. C-reactive protein was significantly elevated in the research group (P < .001), while immunoglobulin G (IgG), immunoglobulin A (IgA), and immunoglobulin E (IgE) levels remained comparable. Multivariate logistic regression analysis adjusting for potential confounders identified lung consolidation (OR = 65.79, 95% CI: 20.86-207.49) and alanine aminotransferase levels (OR = 0.90, 95% CI: 0.82-0.99) as independent predictors of MRMP infection (P < .05). MRMP and macrolide-sensitive M pneumoniae infections in children present distinct clinical profiles and long-term prognoses. MRMP-infected children demonstrate elevated risks of recurrent respiratory infections and potential long-term respiratory sequelae, underscoring the necessity for rigorous acute-phase lung consolidation monitoring and extended respiratory function surveillance to optimize outcomes.