Association between 23S rRNA gene positivity and clinical characteristics in patients with mycoplasma pneumoniae pneumonia

To study the clinical characteristics of children with Mycoplasma pneumoniae pneumonia (MPP) who are positive for 23 S rRNA resistance genes and their correlation with 23 S rRNA resistance genes, providing evidence for the precise diagnosis and treatment of pediatric MPP. A total of 210 pediatric patients diagnosed with MPP and admitted to our hospital between January 2024 and November 2025 were enrolled in this study. Clinical manifestations were compared between patients positive (positive group) and negative (negative group) for the 23 S rRNA gene. Logistic regression analysis was performed to identify independent predictive factors associated with severe MPP (SMPP). The overall drug resistance rate was 27.6%, with 58 of 210 pediatric patients testing positive. The positive group exhibited significantly higher rates of extrapulmonary manifestations, longer duration of fever and cough, and prolonged hospital stays compared to the negative group. Additionally, heparin-binding protein (HBP), creatine kinase-myocardial band (CK-MB), lactate dehydrogenase (LDH), and immunoglobulin levels were significantly higher in the positive group. Logistic regression analysis indicated that elevated HBP and IgG levels, 23 S rRNA gene positivity were independent risk factors for adverse outcomes. Pediatric patients with MPP who are positive for the 23 S rRNA drug-resistance gene are associated with more severe clinical manifestations and heightened inflammatory responses. HBP levels, IgG, and 23 S rRNA gene positivity may serve as important indicators for disease severity assessment.