ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1604102
Title Atelectasis Predicts Poor Prognosis in Pediatric Macrolides-Unresponsive Mycoplasma pneumoniae Pneumonia with A2063/2064G Mutations Treated with Azithromycin
Provisionally accepted
- 1Children‘s Hospital of Chongqing Medical University, Chongqing, China
- 2Chongqing YouYouBaoBei Women's and Children's Hospital, Chonqing, China
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Objective: We aimed to investigate prognostic indicators for pediatric macrolides-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) cases with A2063/2064G mutations with azithromycin therapy. Methods: This was a retrospective observational cohort study conducted at the Children's Hospital of Chongqing Medical University. Children with macrolide-resistant mutations (A2063/2064G) diagnosed as MUMPP who received only anti-Mycoplasma pneumoniae (MP) treatment with azithromycin were retrospectively enrolled. Logistic regression analysis was used to identify potential risk factors for predicting short-term (refractory Mycoplasma pneumoniae pneumonia [RMPP]) and long-term (bronchiolitis obliterans [BO] or bronchiectasis) adverse prognosis. The results were visualized using forest plots. Results: This study retrospectively included 82 children with MUMPP, and all received only azithromycin for anti-MP treatment. The incidence of pulmonary consolidation, pleural effusion, and atelectasis was 80.49% (66/82), 34.15% (28/82), and 24.39% (20/82), respectively. 29.27% (24/82) of patients diagnosed with RMPP, and 14.63% (12/82) of patients diagnosed with bronchiolitis obliterans (BO) or bronchiectasis diagnosed within one year after discharge. Logistic analysis showed that atelectasis was independently associated with short-term (RMPP) and long-term (BO or bronchiectasis) adverse prognosis (odds ratio [OR] 4.02, 95% confidence interval [CI] 1.03-16.00, P = 0.043; OR 5.62, 95% CI 1.04-32.80, P = 0.045; respectively). Conclusion: Atelectasis predicts a poor prognosis for children with A2063/2064G MUMPP. The occurrence of atelectasis may indicate an increased risk of failure of current azithromycin treatment. Combined with the results of drug-resistant mutations, it is recommended to strengthen disease monitoring and individualized intervention evaluation.
Keywords: Atelectasis, Mycoplasma pneumoniae pneumonia, A2063/2064G mutation, Azithromycin, Children
Received: 01 Apr 2025; Accepted: 12 Jun 2025.
Copyright: © 2025 Cheng, Liu, Guangli, Li, Tian, Liping and Luo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhengxiu Luo, Children‘s Hospital of Chongqing Medical University, Chongqing, China
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