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image of Influence of Mycoplasma Resistance Genes on Pediatric Mycoplasma Pneumonia Treatment and Determinants for Second-line Antimicrobial Adjustment

Abstract

Objective

The objective of this study is to evaluate the role of mycoplasma resistance genes in pediatric mycoplasma pneumonia and to identify the factors that necessitate antibiotic adjustments.

Methods

We retrospectively analyzed clinical data from children diagnosed with mycoplasma pneumonia at Chongqing Medical University Children's Hospital (January-October 2023). We categorized patients based on antibiotic treatment adjustments: the antibiotic adjustment group and the no adjustment group. We compared demographic characteristics, clinical outcomes, and the gene resistance rate that point mutations A2063G and A2064G in the 23S rRNA between groups. Logistic regression was employed to determine the factors prompting a switch from macrolides to alternative antibiotics.

Results

The study included 551 cases, with 341 in the no adjustment group and 210 in the antibiotic adjustment group (54 switched to doxycycline, 156 to levofloxacin). There was no significant difference in the prevalence of resistance genes between the groups (71.8% . 71.4%; =0.916). Significant differences were observed in hospital stay duration, C-reactive protein (CRP), D-dimer, fibrinogen, procalcitonin levels, and lung consolidation (<0.05). Logistic regression identified elevated CRP and procalcitonin levels as independent predictors of the need for alternative antibiotics.

Conclusion

Resistance genes do not predict the need for second-line antibiotics in pediatric mycoplasma pneumonia; however, elevated CRP, and procalcitonin levels significantly correlate with this necessity.

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2025-05-22
2025-09-14
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References

  1. Hung H.M. Chuang C.H. Chen Y.Y. Liao W.C. Li S.W. Chang I.Y.F. Chen C.H. Li T.H. Huang Y.Y. Huang Y.C. Chen Y.C. Tsao K.C. Huang Y.C. Chiu C.H. Lin T.Y. Hsieh Y.C. Clonal spread of macrolide-resistant Mycoplasma pneumoniae sequence type-3 and type-17 with recombination on non-p1 adhesin among children in taiwan. Clin. Microbiol. Infect. 2021 27 8 1169.e1 1169.e6 10.1016/j.cmi.2020.09.035 33010445
    [Google Scholar]
  2. Wu T.H. Wang N.M. Liu F.C. Pan H.H. Huang F.L. Fang Y.P. Chiang T.W. Yang Y.Y. Song C.S. Wu H.C. Lee C.Y. Macrolide resistance, clinical features, and cytokine profiles in taiwanese children with Mycoplasma pneumoniae infection. Open Forum Infect. Dis. 2021 8 9 ofab416 10.1093/ofid/ofab416 34557557
    [Google Scholar]
  3. Kutty P.K. Jain S. Taylor T.H. Bramley A.M. Diaz M.H. Ampofo K. Arnold S.R. Williams D.J. Edwards K.M. McCullers J.A. Pavia A.T. Winchell J.M. Schrag S.J. Hicks L.A. Mycoplasma pneumoniae among children hospitalized with community-acquired pneumonia. Clin. Infect. Dis. 2019 68 1 5 12 10.1093/cid/ciy419 29788037
    [Google Scholar]
  4. Block S. Hedrick J. Hammerschlag M.R. Cassell G.H. Craft J.C. Mycoplasma pneumoniae and chlamydia pneumoniae in pediatric community-acquired pneumonia. Pediatr. Infect. Dis. J. 1995 14 6 471 477 10.1097/00006454‑199506000‑00002 7667050
    [Google Scholar]
  5. Medjo B. Atanaskovic-Markovic M. Radic S. Nikolic D. Lukac M. Djukic S. Mycoplasma pneumoniae as a causative agent of community-acquired pneumonia in children: Clinical features and laboratory diagnosis. Ital. J. Pediatr. 2014 40 1 104 10.1186/s13052‑014‑0104‑4 25518734
    [Google Scholar]
  6. Shah S.S. Mycoplasma pneumoniae as a cause of community-acquired pneumonia in children. Clin. Infect. Dis. 2019 68 1 13 14 10.1093/cid/ciy421 29788200
    [Google Scholar]
  7. Urbieta A.D. Barbeito Castiñeiras G. Rivero Calle I. Pardo Seco J. Rodríguez Tenreiro C. Suárez Camacho R. Pérez del Molino Bernal M.L. Martinón Torres F. Mycoplasma pneumoniae at the rise not only in china: Rapid increase of Mycoplasma pneumoniae cases also in spain. Emerg. Microbes Infect. 2024 13 1 2332680 10.1080/22221751.2024.2332680 38497329
    [Google Scholar]
  8. Larcher R. Boudet A. Roger C. Villa F. Loubet P. Mycoplasma pneumoniae is back! is it the next pandemic? Anaesth. Crit. Care Pain Med. 2024 43 1 101338 10.1016/j.accpm.2023.101338 38072068
    [Google Scholar]
  9. Wang X. Li M. Luo M. Luo Q. Kang L. Xie H. Wang Y. Yu X. Li A. Dong M. Huang F. Gong C. Mycoplasma pneumoniae triggers pneumonia epidemic in autumn and winter in beijing: A multicentre, population-based epidemiological study between 2015 and 2020. Emerg. Microbes Infect. 2022 11 1 1508 1517 10.1080/22221751.2022.2078228 35582916
    [Google Scholar]
  10. Zeng Q. Li Y. Yue Y. Wang M. Yang C. Lv X. Epidemiological characteristics and early predict model of children mycoplasma Pneumoniae pneumonia outbreaks after the covid-19 in shandong. Sci. Rep. 2024 14 1 19892 10.1038/s41598‑024‑71010‑4 39192024
    [Google Scholar]
  11. Dekyi X.Y. Xiao Y. Wang X. Feng S. Wang Y. Liao L. Wang S. Deng Y. Zheng J. Zhao D. Predominance of a2063g mutant strains in the Mycoplasma pneumoniae epidemic in children: A clinical and epidemiological study in 2023 in wuhan, china. Int. J. Infect. Dis. 2024 145 107074 10.1016/j.ijid.2024.107074 38734057
    [Google Scholar]
  12. Amza A. Kadri B. Nassirou B. Cotter S.Y. Stoller N.E. West S.K. Bailey R.L. Porco T.C. Keenan J.D. Lietman T.M. Oldenburg C.E. Community-level association between clinical trachoma and ocular chlamydia infection after mass azithromycin distribution in a mesoendemic region of niger. Ophthalmic Epidemiol. 2019 26 4 231 237 10.1080/09286586.2019.1597129 30957594
    [Google Scholar]
  13. Levine A. Kori M. Kierkus J. Sigall Boneh R. Sladek M. Escher J.C. Wine E. Yerushalmi B. Amil Dias J. Shaoul R. Veereman Wauters G. Boaz M. Abitbol G. Bousvaros A. Turner D. Azithromycin and metronidazole Versus metronidazole-based therapy for the induction of remission in mild to moderate paediatric crohn’s disease : A randomised controlled trial. Gut 2019 68 2 239 247 10.1136/gutjnl‑2017‑315199 29420227
    [Google Scholar]
  14. Pereyre S. Goret J. Bébéar C. Mycoplasma pneumoniae: Current knowledge on macrolide resistance and treatment. Front. Microbiol. 2016 7 974 10.3389/fmicb.2016.00974 27446015
    [Google Scholar]
  15. Tsai T.A. Tsai C.K. Kuo K.C. Yu H.R. Rational stepwise approach for Mycoplasma pneumoniae pneumonia in children. J. Microbiol. Immunol. Infect. 2021 54 4 557 565 10.1016/j.jmii.2020.10.002 33268306
    [Google Scholar]
  16. Bébéar C. Pereyre S. Peuchant O. Mycoplasma pneumoniae: Susceptibility and resistance to antibiotics. Future Microbiol. 2011 6 4 423 431 10.2217/fmb.11.18 21526943
    [Google Scholar]
  17. Kim K. Jung S. Kim M. Park S. Yang H.J. Lee E. Global trends in the proportion of macrolide-resistant Mycoplasma pneumoniae infections. JAMA Netw. Open 2022 5 7 e2220949 10.1001/jamanetworkopen.2022.20949 35816304
    [Google Scholar]
  18. Wang G. Wu P. Tang R. Zhang W. Global prevalence of resistance to macrolides in Mycoplasma pneumoniae : A systematic review and meta-analysis. J. Antimicrob. Chemother. 2022 77 9 2353 2363 10.1093/jac/dkac170 35678262
    [Google Scholar]
  19. Loconsole D. De Robertis A.L. Sallustio A. Centrone F. Morcavallo C. Campanella S. Accogli M. Chironna M. Update on the epidemiology of macrolide-resistant Mycoplasma pneumoniae in europe: A systematic review. Infect. Dis. Rep. 2021 13 3 811 820 10.3390/idr13030073 34562998
    [Google Scholar]
  20. Waites K.B. Ratliff A. Crabb D.M. Xiao L. Qin X. Selvarangan R. Tang Y.W. Zheng X. Dien Bard J. Hong T. Prichard M. Brooks E. Dallas S. Duffy L. Mixon E. Fowler K.B. Atkinson T.P. Macrolide-resistant Mycoplasma pneumoniae in the united states as determined from a national surveillance program. J. Clin. Microbiol. 2019 57 11 e00968-19 10.1128/JCM.00968‑19 31484701
    [Google Scholar]
  21. Rivaya B. Jordana-Lluch E. Fernández-Rivas G. Molinos S. Campos R. Méndez-Hernández M. Matas L. Macrolide resistance and molecular typing of Mycoplasma pneumoniae infections during a 4 year period in spain. J. Antimicrob. Chemother. 2020 75 10 2752 2759 10.1093/jac/dkaa256 32653897
    [Google Scholar]
  22. Oishi T. Ouchi K. Recent trends in the epidemiology, diagnosis, and treatment of macrolide-resistant Mycoplasma pneumoniae. J. Clin. Med. 2022 11 7 1782 10.3390/jcm11071782 35407390
    [Google Scholar]
  23. Kenri T. Suzuki M. Sekizuka T. Ohya H. Oda Y. Yamazaki T. Fujii H. Hashimoto T. Nakajima H. Katsukawa C. Kuroda M. Shibayama K. Periodic genotype shifts in clinically prevalent Mycoplasma pneumoniae strains in japan. Front. Cell. Infect. Microbiol. 2020 10 385 10.3389/fcimb.2020.00385 32850484
    [Google Scholar]
  24. Yamazaki T. Kenri T. Epidemiology of Mycoplasma pneumoniae infections in japan and therapeutic strategies for macrolide-resistant m. pneumoniae. Front. Microbiol. 2016 7 693 10.3389/fmicb.2016.00693 27242718
    [Google Scholar]
  25. Shin S. Koo S. Yang Y.J. Lim H.J. Characteristics of the Mycoplasma pneumoniae epidemic from 2019 to 2020 in korea: Macrolide resistance and co-infection trends. Antibiotics (Basel) 2023 12 11 1623 10.3390/antibiotics12111623 37998825
    [Google Scholar]
  26. Zhao F. Li J. Liu J. Guan X. Gong J. Liu L. He L. Meng F. Zhang J. Antimicrobial susceptibility and molecular characteristics of Mycoplasma pneumoniae isolates across different regions of china. Antimicrob. Resist. Infect. Control 2019 8 1 143 10.1186/s13756‑019‑0576‑5 31463046
    [Google Scholar]
  27. Nelson M.M. Waldron C.L. Bracht J.R. Rapid molecular detection of macrolide resistance. BMC Infect. Dis. 2019 19 1 144 10.1186/s12879‑019‑3762‑4 30755177
    [Google Scholar]
  28. Li X. Atkinson T.P. Hagood J. Makris C. Duffy L.B. Waites K.B. Emerging macrolide resistance in Mycoplasma pneumoniae in children: Detection and characterization of resistant isolates. Pediatr. Infect. Dis. J. 2009 28 8 693 696 10.1097/INF.0b013e31819e3f7a 19633515
    [Google Scholar]
  29. Inamura N. Miyashita N. Hasegawa S. Kato A. Fukuda Y. Saitoh A. Kondo E. Teranishi H. Wakabayashi T. Akaike H. Tanaka T. Ogita S. Nakano T. Terada K. Ouchi K. Management of refractory Mycoplasma pneumoniae pneumonia: Utility of measuring serum lactate dehydrogenase level. J. Infect. Chemother. 2014 20 4 270 273 10.1016/j.jiac.2014.01.001 24486173
    [Google Scholar]
  30. Ling Y. Ning J. Xu Y. Explore the predictive value of peripheral blood cell parameters in refractory Mycoplasma pneumoniae pneumonia in children over 6 years old. Front Pediatr. 2021 9 659677 10.3389/fped.2021.659677 34869089
    [Google Scholar]
  31. Zhang Y. Zhou Y. Li S. Yang D. Wu X. Chen Z. The clinical characteristics and predictors of refractory Mycoplasma pneumoniae pneumonia in children. PLoS One 2016 11 5 e0156465 10.1371/journal.pone.0156465 27227519
    [Google Scholar]
  32. Jeong J.E. Soh J.E. Kwak J.H. Jung H.L. Shim J.W. Kim D.S. Park M.S. Shim J.Y. Increased procalcitonin level is a risk factor for prolonged fever in children with mycoplasma pneumonia. Korean J. Pediatr. 2018 61 8 258 263 10.3345/kjp.2018.61.8.258 30130952
    [Google Scholar]
  33. Xie Q. Zhang X. Cui W. Pang Y. Construction of a nomogram for identifying refractory Mycoplasma pneumoniae pneumonia among macrolide-unresponsive Mycoplasma pneumoniae pneumonia in children. J. Inflamm. Res. 2022 15 6495 6504 10.2147/JIR.S387809 36474517
    [Google Scholar]
  34. Zhu Y. Luo Y. Li L. Jiang X. Du Y. Wang J. Li H. Gu H. Li D. Tang H. Qin H. Xu C. Liu Y. Zhao D. Guo Y. Liu F. Immune response plays a role in Mycoplasma pneumoniae pneumonia. Front. Immunol. 2023 14 1189647 10.3389/fimmu.2023.1189647 37304280
    [Google Scholar]
  35. Nguyen D.D. Ho N.T. Dover L.G. Vo A.H.M. Ly H.T.T. Doan P.M. Nguyen H.T. Luu N.T.T. Pham A.N. Tran H.T.T. Novel variant and known mutation in 23s rrna gene of Mycoplasma pneumoniae, northern vietnam, 2023. Emerg. Infect. Dis. 2024 30 5 1034 1036 10.3201/eid3005.231632 38573165
    [Google Scholar]
  36. Wang N. Xu X. Xiao L. Liu Y. Novel mechanisms of macrolide resistance revealed by in vitro selection and genome analysis in Mycoplasma pneumoniae. Front. Cell. Infect. Microbiol. 2023 13 1186017 10.3389/fcimb.2023.1186017 37284499
    [Google Scholar]
  37. Tong L. Huang S. Zheng C. Zhang Y. Chen Z. Refractory Mycoplasma pneumoniae pneumonia in children: Early recognition and management. J. Clin. Med. 2022 11 10 2824 10.3390/jcm11102824 35628949
    [Google Scholar]
  38. Wang Y.S. Zhou Y.L. Bai G.N. Li S.X. Xu D. Chen L.N. Chen X. Dong X.Y. Fu H.M. Fu Z. Hao C.L. Hong J.G. Liu E.M. Liu H.M. Lu X.X. Luo Z.X. Tang L.F. Tian M. Yin Y. Zhang X.B. Zhang J.H. Zhang H.L. Zhao D.Y. Zhao S.Y. Zhu G.H. Zou Y.X. Lu Q. Zhang Y.Y. Chen Z.M. Expert consensus on the diagnosis and treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children. World J. Pediatr. 2024 20 9 901 914 10.1007/s12519‑024‑00831‑0 39143259
    [Google Scholar]
  39. Ding G. Zhang X. Vinturache A. van Rossum A.M.C. Yin Y. Zhang Y. Challenges in the treatment of pediatric Mycoplasma pneumoniae pneumonia. Eur. J. Pediatr. 2024 183 7 3001 3011 10.1007/s00431‑024‑05519‑1 38634891
    [Google Scholar]
  40. Youn Y.S. Lee K.Y. Hwang J.Y. Rhim J.W. Kang J.H. Lee J.S. Kim J.C. Difference of clinical features in childhood Mycoplasma pneumoniae pneumonia. BMC Pediatr. 2010 10 1 48 10.1186/1471‑2431‑10‑48 20604923
    [Google Scholar]
  41. Søndergaard M.J. Friis M.B. Hansen D.S. Jørgensen I.M. Clinical manifestations in infants and children with Mycoplasma pneumoniae infection. PLoS One 2018 13 4 e0195288 10.1371/journal.pone.0195288 29698412
    [Google Scholar]
  42. Zhou Y. Shan Y. Cui Y. Shi J. Wang F. Miao H. Wang C. Zhang Y. Characteristics and outcome of severe Mycoplasma pneumoniae pneumonia admitted to picu in shanghai: A retrospective cohort study. Crit. Care Explor. 2021 3 3 e0366 10.1097/CCE.0000000000000366 33786442
    [Google Scholar]
  43. McCarthy K.N. Hatcher J. Best T. Increasing number of clinically severe of Mycoplasma pneumoniae infections in children after the covid-19 pandemic: A single centre case series. J. Pediatric Infect. Dis. Soc. 2024 ••• piae132 [pii].
    [Google Scholar]
  44. Park S.J. Pai K.S. Kim A.R. Lee J.H. Shin J.I. Lee S.Y. Fulminant and fatal multiple organ failure in a 12-year-old boy with Mycoplasma pneumoniae infection. Allergy Asthma Immunol. Res. 2012 4 1 55 57 10.4168/aair.2012.4.1.55 22211173
    [Google Scholar]
  45. Taylor-Robinson D. Bébéar C. Antibiotic susceptibilities of mycoplasmas and treatment of mycoplasmal infections. J. Antimicrob. Chemother. 1997 40 5 622 630 10.1093/jac/40.5.622 9421309
    [Google Scholar]
  46. Waites K.B. Xiao L. Liu Y. Balish M.F. Atkinson T.P. Mycoplasma pneumoniae from the respiratory tract and beyond. Clin. Microbiol. Rev. 2017 30 3 747 809 10.1128/CMR.00114‑16 28539503
    [Google Scholar]
  47. Han R. Yu Q. Zhang G. Li B. Han S. Li G. Comparison of azithromycin and erythromycin in the treatment of mycoplasma pneumonia in children. Pak. J. Med. Sci. 2020 36 2 156 159 32063951
    [Google Scholar]
  48. Yang H.J. Song D.J. Shim J.Y. Mechanism of resistance acquisition and treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children. Korean J. Pediatr. 2017 60 6 167 174 10.3345/kjp.2017.60.6.167 28690643
    [Google Scholar]
  49. Poddighe D. Comi E.V. Brambilla I. Licari A. Bruni P. Marseglia G.L. Increased total serum immunoglobulin e in children developing Mycoplasma pneumoniae related extra-pulmonary diseases. Iran. J. Allergy Asthma Immunol. 2018 17 5 490 496 10.18502/ijaai.v17i5.307 30518191
    [Google Scholar]
  50. Ha S.G. Oh K.J. Ko K.P. Sun Y.H. Ryoo E. Tchah H. Jeon I.S. Kim H.J. Ahn J.M. Cho H.K. Therapeutic efficacy and safety of prolonged macrolide, corticosteroid, doxycycline, and levofloxacin against macrolide-unresponsive Mycoplasma pneumoniae pneumonia in children. J. Korean Med. Sci. 2018 33 43 e268 10.3346/jkms.2018.33.e268 30344461
    [Google Scholar]
  51. Kawai Y. Miyashita N. Yamaguchi T. Saitoh A. Kondoh E. Fujimoto H. Teranishi H. Inoue M. Wakabayashi T. Akaike H. Ogita S. Kawasaki K. Terada K. Kishi F. Ouchi K. Clinical efficacy of macrolide antibiotics against genetically determined macrolide‐resistant Mycoplasma pneumoniae pneumonia in paediatric patients. Respirology 2012 17 2 354 362 10.1111/j.1440‑1843.2011.02102.x 22077195
    [Google Scholar]
  52. Li P. Wang W. Zhang X. Pan J. Gong L. Observational retrospective clinical study on clinical features of macrolide-resistant Mycoplasma pneumoniae pneumonia in chinese pediatric cases. Sci. Rep. 2024 14 1 5632 10.1038/s41598‑024‑55311‑2 38453960
    [Google Scholar]
  53. Chen X. Wang S. Cai H. Xia X. The predictive values of c-reactive protein-neutrophil to lymphocyte ratio for the risk of refractory Mycoplasma pneumoniae pneumonia in children: A retrospective cohort study. Epidemiol. Infect. 2024 152 e158 10.1017/S0950268824001134 39635861
    [Google Scholar]
  54. Wen J. Su Y. Sun H. Zhang H. Li H. The combination of initial markers to predict refractory Mycoplasma pneumoniae pneumonia in chinese children: A case control study. Respir. Res. 2021 22 1 89 10.1186/s12931‑020‑01577‑9 33752670
    [Google Scholar]
  55. Yang B. Zhang W. Gu W. Zhang X. Wang M. Huang L. Zhu C. Yan Y. Ji W. Ni H. Chen Z. Differences of clinical features and prognosis between Mycoplasma pneumoniae necrotizing pneumonia and non-mycoplasma pneumoniae necrotizing pneumonia in children. BMC Infect. Dis. 2021 21 1 797 10.1186/s12879‑021‑06469‑x 34376156
    [Google Scholar]
  56. Zheng B. Zhao J. Cao L. The clinical characteristics and risk factors for necrotizing pneumonia caused by Mycoplasma pneumoniae in children. BMC Infect. Dis. 2020 20 1 391 10.1186/s12879‑020‑05110‑7 32487034
    [Google Scholar]
  57. Li Y. Zhang J. Wang M. Ma Y.M. Zhi K. Dai F.L. Li S. Changes in coagulation markers in children with Mycoplasma pneumoniae pneumonia and their predictive value for mycoplasma severity. Ital. J. Pediatr. 2023 49 1 143 10.1186/s13052‑023‑01545‑1 37858230
    [Google Scholar]
  58. Qiu J. Ge J. Cao L. D-dimer: The risk factor of children’s severe Mycoplasma pneumoniae pneumonia. Front Pediatr. 2022 10 828437 10.3389/fped.2022.828437 35498793
    [Google Scholar]
  59. Zheng Y. Hua L. Zhao Q. Li M. Huang M. Zhou Y. Wang Y. Chen Z. Zhang Y. The level of d-dimer is positively correlated with the severity of Mycoplasma pneumoniae pneumonia in children. Front. Cell. Infect. Microbiol. 2021 11 687391 10.3389/fcimb.2021.687391 34336714
    [Google Scholar]
  60. John S.D. Ramanathan J. Swischuk L.E. Spectrum of clinical and radiographic findings in pediatric mycoplasma pneumonia. Radiographics 2001 21 1 121 131 10.1148/radiographics.21.1.g01ja10121 11158648
    [Google Scholar]
  61. Ocak M. Öz F.N. Çınar H.G. Tanır G. Clinical and radiologic manifestations of Mycoplasma pneumoniae infection in children. Turk. J. Pediatr. 2022 64 6 1031 1040 10.24953/turkjped.2022.545 36583885
    [Google Scholar]
  62. Fan F. Lv J. Yang Q. Jiang F. Clinical characteristics and serum inflammatory markers of community‐acquired mycoplasma pneumonia in children. Clin. Respir. J. 2023 17 7 607 617 10.1111/crj.13620 37142438
    [Google Scholar]
  63. Su D.Q. Li J.F. Zhuo Z.Q. Clinical analysis of 122 cases with mycoplasma pneumonia complicated with atelectasis: A retrospective study. Adv. Ther. 2020 37 1 265 271 10.1007/s12325‑019‑01129‑8 31707714
    [Google Scholar]
  64. Huang X. Gu H. Wu R. Chen L. Lv T. Jiang X. Li H. Guo B. Liu J. Li D. Zhao D. Liu F. Chest imaging classification in Mycoplasma pneumoniae pneumonia is associated with its clinical features and outcomes. Respir. Med. 2024 221 107480 10.1016/j.rmed.2023.107480 38043865
    [Google Scholar]
  65. Deng H. Rui J. Zhao D. Liu F. Mycoplasma pneumoniae 23s rrna a2063g mutation does not influence chest radiography features in children with pneumonia. J. Int. Med. Res. 2018 46 1 150 157 10.1177/0300060517716312 28760082
    [Google Scholar]
  66. He W. Yin J. Wan Y. Correlations of different serological parameters with the severity and prognosis of pneumonia in children infected with Mycoplasma pneumoniae. Clin. Lab. 2022 68 12/2022 10.7754/Clin.Lab.2022.211132 36546752
    [Google Scholar]
  67. Liu F. Chen L. Wang M.Y. Shi W.J. Wang X.P. Exploring high-risk factors for the prediction of severe mycoplasma pneumonia in children. Transl. Pediatr. 2024 13 11 2003 2011 10.21037/tp‑24‑293 39649650
    [Google Scholar]
  68. Chen Q. Hu T. Wu L. Chen L. Clinical features and biomarkers for early prediction of refractory Mycoplasma pneumoniae pneumonia in children. Emerg. Med. Int. 2024 2024 1 7 10.1155/2024/9328177 38222094
    [Google Scholar]
  69. Huang X. Li D. Liu F. Zhao D. Zhu Y. Tang H. Clinical significance of d-dimer levels in refractory Mycoplasma pneumoniae pneumonia. BMC Infect. Dis. 2021 21 1 14 10.1186/s12879‑020‑05700‑5 33407216
    [Google Scholar]
  70. Zhang Y. Li Y. Wang Y. Ren Y. Yang Y. Qi J. Yang H. Liang X. Zhang R. Prospective cohort study on the clinical significance of interferon-γ, d-dimer, LDH, and CRP tests in children with severe mycoplasma pneumonia. Medicine (Baltimore) 2024 103 41 e39665 10.1097/MD.0000000000039665 39465799
    [Google Scholar]
  71. Wang C. Li L. Xiao G. Chen Y. Wang Y. Chen Z. Zhou Y. Characteristics and outcomes of Mycoplasma pneumoniae pneumonia associated with pulmonary embolism and necrotizing pneumonia in children. Infect. Drug Resist. 2024 17 1961 1969 10.2147/IDR.S459626 38779350
    [Google Scholar]
  72. Song S. Xu Y. A retrospective study of the clinical characteristics of 9 children with pulmonary embolism associated with Mycoplasma pneumoniae pneumonia. BMC Pediatr. 2023 23 1 370 10.1186/s12887‑023‑04188‑7 37474910
    [Google Scholar]
  73. Zhan X.W. Deng L.P. Wang Z.Y. Zhang J. Wang M.Z. Li S.J. Correlation between Mycoplasma pneumoniae drug resistance and clinical characteristics in bronchoalveolar lavage fluid of children with refractory Mycoplasma pneumoniae pneumonia. Ital. J. Pediatr. 2022 48 1 190 10.1186/s13052‑022‑01376‑6 36435821
    [Google Scholar]
  74. Lee H. Yun K.W. Lee H.J. Choi E.H. Antimicrobial therapy of macrolide-resistant Mycoplasma pneumoniae pneumonia in children. Expert Rev. Anti Infect. Ther. 2018 16 1 23 34 10.1080/14787210.2018.1414599 29212389
    [Google Scholar]
  75. Sánchez A.R. Rogers R.S. III Sheridan P.J. Tetracycline and other tetracycline‐derivative staining of the teeth and oral cavity. Int. J. Dermatol. 2004 43 10 709 715 10.1111/j.1365‑4632.2004.02108.x 15485524
    [Google Scholar]
  76. Patel K. Goldman J.L. Safety concerns surrounding quinolone use in children. J. Clin. Pharmacol. 2016 56 9 1060 1075 10.1002/jcph.715 26865283
    [Google Scholar]
  77. Dai F. Liu F. Chen X. Yang J. Wang K. Guo C. The treatment of macrolide‐resistant Mycoplasma pneumoniae pneumonia in children. J. Clin. Pharm. Ther. 2021 46 3 705 710 10.1111/jcpt.13331 33403672
    [Google Scholar]
  78. Cai F. Li J. Liang W. Wang L. Ruan J. Effectiveness and safety of tetracyclines and quinolones in people with Mycoplasma pneumonia: A systematic review and network meta-analysis. EClinicalMedicine 2024 71 102589 10.1016/j.eclinm.2024.102589 38596615
    [Google Scholar]
  79. Miyashita N. Akaike H. Teranishi H. Ouchi K. Okimoto N. Macrolide-resistant Mycoplasma pneumoniae pneumonia in adolescents and adults: Clinical findings, drug susceptibility, and therapeutic efficacy. Antimicrob. Agents Chemother. 2013 57 10 5181 5185 10.1128/AAC.00737‑13 23896480
    [Google Scholar]
  80. Kawai Y. Miyashita N. Kubo M. Akaike H. Kato A. Nishizawa Y. Saito A. Kondo E. Teranishi H. Ogita S. Tanaka T. Kawasaki K. Nakano T. Terada K. Ouchi K. Therapeutic efficacy of macrolides, minocycline, and tosufloxacin against macrolide-resistant Mycoplasma pneumoniae pneumonia in pediatric patients. Antimicrob. Agents Chemother. 2013 57 5 2252 2258 10.1128/AAC.00048‑13 23459497
    [Google Scholar]
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