Analysis of pathogenetic characteristics,clinical features and their risk factors in children with Mycoplasma pneumoniae pneumonia of different severities

ZHANG Yan; LI Chen; ZHANG Yu; SUN Lu

doi:10.3969/j.issn.1007-8134.2025.03.009

Abstract：Objective This study aimed to comprehensively analyze the etiological characteristics,clinical features,and risk factors of pediatric patients with Mycoplasma pneumoniae pneumonia(MPP)of varying severities and to explore the risk factors associated with severe MPP.The goal was to provide a scientific basis for early diagnosis,rational treatment,and clinical severity assessment of MPP.Methods A total of 587 pediatric patients diagnosed with MPP and admitted to Jiaozhou Central Hospital of Qingdao between January 2022 and January 2024 were enrolled in the study.Based on disease severity,the patients were divided into a severe group(189 cases)and a mild group(398 cases).Etiological characteristics and clinical features were compared between the 2 groups,and risk factors for severe MPP were analyzed.Results There was no statistically differences between the two groups in terms of the proportion of co-infection with bacteria or viruses(P＞0.05).Among the bacterial infections,Gram-negative bacteria were predominant(32.16%),while respiratory syncytial virus(9.37%)and influenza B virus(7.67%)were the most commonly detected viruses.Pleural effusion occurred in 27 children(14.29%)in the severe group,compared to 8 children(2.01%)in the mild group.Respiratory failure was observed in Fifteen children(7.94%)in the severe group whereas no cases were reported in the mild group.The total incidence of complications in the severe group was as high as 37.57%(71/189),while that in the mild group was only 9.55%(38/398),and the difference between the 2 groups was significant(P＜0.05).Logistic regression analysis showed that the presence of dry/wet rales on lung auscultation,White Blood Cell Count(WBC)/Lymphocyte Count(LYM)ratio,and the level of C-Reactive Protein(CRP)were independent risk factors for severe MPP in children.Receiver operating characteristic(ROC)curve analysis further confirmed that the combined assessment of dry/wet rales,WBC/LYM ratio,and CRP provided higher diagnostic value for sever MPP,with an area under the curve(AUC)of 0.976,a sensitivity of 98.2%,and a specificity of 90.6%.Conclusions The etiological profile of pediatric MPP is characterized by the coexistence of bacterial and viral infections.Compared with mild MPP patients,severe MPP patients exhibit significant differences in lung auscultation findings(dry/wet rales),WBC/LYM ratio,and CRP levels.Combined assessment of these indicators can significantly improve the diagnostic accuracy of severe MPP,providing an important basis for early clinical identification and timely intervention.