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Objective <p>To investigate the risk factors for refractory Mycoplasma pneumoniae pneumonia (RMPP) in children.</p> Methods <p>Children with Mycoplasma pneumoniae pneumonia who were treated in our hospital from January 1, 2024 to June 1, 2025 were retrospectively collected and divided into the refractory Mycoplasma pneumoniae pneumonia group with 144 cases and the general Mycoplasma pneumoniae pneumonia (GMPP) group with 161 cases according to the occurrence of RMPP. The clinical data and serological indicators of the two groups were compared using the t-test, χ²-test and Logistic regression analysis.</p> Result <p>Leukocyte count (8.62 ± 4.48 vs. 9.84 ± 1.01, <i>P</i> = 0.002), C-reactive protein (21.64 ± 14.76 vs. 26.61 ± 6.71, <i>P</i> &lt; 0.001), D-dimer (0.72 ± 0.10 vs. 1.08 ± 0.60, <i>P</i> &lt; 0.001), lactate dehydrogenase (281.05 ± 80.22 vs. 326.02 ± 43.92, <i>P</i> &lt; 0.001) and neutrophil-to-lymphocyte ratio (NLR, 3.11 ± 2.11 vs. 4.84 ± 0.95, <i>P</i> &lt; 0.001) in the RMPP group were significantly higher than those in the GMPP group. The Clinical Pulmonary Infection Score (CPIS, OR = 2.617, 95%CI:1.603–4.273), D-dimer (OR = 9.891, 95%CI:3.848–25.426), NLR (OR = 1.865, 95%CI:1.490–2.336), presence of pulmonary rales (OR = 5.265, 95%CI:2.305–12.026), abnormal chest imaging findings (<i>P</i> = 0.005), complicated infections (<i>P</i> &lt; 0.001) and positive drug-resistant gene loci (OR = 14.023, 95%CI:5.712–34.426) were identified as independent influencing factors for RMPP infection. NLR yielded the highest area under the curve (AUC) for predicting RMPP infection with an AUC of 0.836 (95%CI:0.788–0.885), followed by the CPIS with an AUC of 0.700 (95%CI:0.640–0.759) and D-dimer with an AUC of 0.691 (95%CI:0.620–0.762).</p> Conclusion <p>The CPIS, D-dimer, NLR, presence of pulmonary rales, abnormal chest imaging findings, complicated infections and positive drug-resistant gene loci are independent influencing factors for RMPP infection, and vigilance for the development of RMPP is warranted in the presence of these factors.</p>

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Independent risk factors for refractory mycoplasma pneumoniae pneumonia in children: a multivariate analysis

  • 期刊论文

  • 发表日期：

    2026年7月29日

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  • Qi Guo,
  • Hui Guo,
  • Jie-Jie Chen,
  • Xian-Zong Da,
  • Xia Xu

摘要

Objective

To investigate the risk factors for refractory Mycoplasma pneumoniae pneumonia (RMPP) in children.

Methods

Children with Mycoplasma pneumoniae pneumonia who were treated in our hospital from January 1, 2024 to June 1, 2025 were retrospectively collected and divided into the refractory Mycoplasma pneumoniae pneumonia group with 144 cases and the general Mycoplasma pneumoniae pneumonia (GMPP) group with 161 cases according to the occurrence of RMPP. The clinical data and serological indicators of the two groups were compared using the t-test, χ²-test and Logistic regression analysis.

Result

Leukocyte count (8.62 ± 4.48 vs. 9.84 ± 1.01, P = 0.002), C-reactive protein (21.64 ± 14.76 vs. 26.61 ± 6.71, P < 0.001), D-dimer (0.72 ± 0.10 vs. 1.08 ± 0.60, P < 0.001), lactate dehydrogenase (281.05 ± 80.22 vs. 326.02 ± 43.92, P < 0.001) and neutrophil-to-lymphocyte ratio (NLR, 3.11 ± 2.11 vs. 4.84 ± 0.95, P < 0.001) in the RMPP group were significantly higher than those in the GMPP group. The Clinical Pulmonary Infection Score (CPIS, OR = 2.617, 95%CI:1.603–4.273), D-dimer (OR = 9.891, 95%CI:3.848–25.426), NLR (OR = 1.865, 95%CI:1.490–2.336), presence of pulmonary rales (OR = 5.265, 95%CI:2.305–12.026), abnormal chest imaging findings (P = 0.005), complicated infections (P < 0.001) and positive drug-resistant gene loci (OR = 14.023, 95%CI:5.712–34.426) were identified as independent influencing factors for RMPP infection. NLR yielded the highest area under the curve (AUC) for predicting RMPP infection with an AUC of 0.836 (95%CI:0.788–0.885), followed by the CPIS with an AUC of 0.700 (95%CI:0.640–0.759) and D-dimer with an AUC of 0.691 (95%CI:0.620–0.762).

Conclusion

The CPIS, D-dimer, NLR, presence of pulmonary rales, abnormal chest imaging findings, complicated infections and positive drug-resistant gene loci are independent influencing factors for RMPP infection, and vigilance for the development of RMPP is warranted in the presence of these factors.