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Background&#xa0; <p>In recent years, macrolide-resistant Mycoplasma pneumoniae (MRMP) has been increasingly reported worldwide, with a macrolide resistance rate of &gt;90% in China , leading to a rise in severe Mycoplasma pneumoniae pneumonia(MPP) incidence annually, which poses a significant threat to children’s health. This study aimed to explore the predictive value of Interleukin-6, C-reactive protein, and lactate dehydrogenase levels in macrolide-resistant severe Mycoplasma pneumoniae pneumonia infection (macrolide-resistant SMPP) in children and provide a reference for its early diagnosis.&#xa0;</p> Methods <p>The clinical data of 208 children with macrolide-resistant MPP, who were hospitalized in the Department of Pediatrics of Zibo Central Hospital between January and September 2024, were retrospectively analyzed. Based on disease severity, the patients were divided into a macrolide-resistant severe group (<i>n</i> = 119) and a macrolide-resistant general (<i>n</i> = 89) group. The differences in the general condition and laboratory indicators between the two groups were compared. In addition, statistical analyses were performed, and indicators with statistical significance were included in the multivariate logistic regression analysis. A receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic value of laboratory indices for macrolide-resistant SMPP.</p> Results <p>The levels of IL-6, CRP, LDH, erythrocyte sedimentation rate and fibrinogen were higher in the severe macrolide-resistant group than in the normal group (<i>P</i> &lt; 0.05). Multivariate logistic regression analysis showed that IL-6 (odds ratio [OR] = 1.200, 95% confidence interval [CI] 1.130–1.274), CRP (OR = 1.107, 95% CI 1.039–1.178), and LDH (OR = 1.012, 95% CI 1.005–1.019) levels were independent indicators for macrolide-resistant SMPP (<i>P</i> &lt; 0.05). ROC curve analysis showed that both IL-6 and the combination of IL-6 with LDH provided high diagnostic value for SMPP, with the combined approach showing best predictive value.The AUC of IL-6 was 0.830, the best cut-off value was 11.75pg/ml, the sensitivity was 0.748, and the specificity was 0.845. The combination of IL-6 and LDH in the diagnosis of drug-resistant SMPP showed that the AUC was 0.870, the sensitivity was 0.807, and the specificity was 0.809.</p> Conclusions <p>IL-6, CRP and LDH are independent indicators for macrolide-resistant SMPP. The combination of IL-6 and LDH is the best predictor of macrolide-resistant SMPP.</p>

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Correlation between Interleukin-6, C-reactive protein, and lactate dehydrogenase levels and macrolide-resistant severe mycoplasma pneumoniae infection in children

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  • 发表日期：

    2025年12月10日

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  • Mingchen Zhang,
  • Dong Liu,
  • Yuanyuan Song,
  • Jie Zhao

摘要

Background 

In recent years, macrolide-resistant Mycoplasma pneumoniae (MRMP) has been increasingly reported worldwide, with a macrolide resistance rate of >90% in China , leading to a rise in severe Mycoplasma pneumoniae pneumonia(MPP) incidence annually, which poses a significant threat to children’s health. This study aimed to explore the predictive value of Interleukin-6, C-reactive protein, and lactate dehydrogenase levels in macrolide-resistant severe Mycoplasma pneumoniae pneumonia infection (macrolide-resistant SMPP) in children and provide a reference for its early diagnosis. 

Methods

The clinical data of 208 children with macrolide-resistant MPP, who were hospitalized in the Department of Pediatrics of Zibo Central Hospital between January and September 2024, were retrospectively analyzed. Based on disease severity, the patients were divided into a macrolide-resistant severe group (n = 119) and a macrolide-resistant general (n = 89) group. The differences in the general condition and laboratory indicators between the two groups were compared. In addition, statistical analyses were performed, and indicators with statistical significance were included in the multivariate logistic regression analysis. A receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic value of laboratory indices for macrolide-resistant SMPP.

Results

The levels of IL-6, CRP, LDH, erythrocyte sedimentation rate and fibrinogen were higher in the severe macrolide-resistant group than in the normal group (P < 0.05). Multivariate logistic regression analysis showed that IL-6 (odds ratio [OR] = 1.200, 95% confidence interval [CI] 1.130–1.274), CRP (OR = 1.107, 95% CI 1.039–1.178), and LDH (OR = 1.012, 95% CI 1.005–1.019) levels were independent indicators for macrolide-resistant SMPP (P < 0.05). ROC curve analysis showed that both IL-6 and the combination of IL-6 with LDH provided high diagnostic value for SMPP, with the combined approach showing best predictive value.The AUC of IL-6 was 0.830, the best cut-off value was 11.75pg/ml, the sensitivity was 0.748, and the specificity was 0.845. The combination of IL-6 and LDH in the diagnosis of drug-resistant SMPP showed that the AUC was 0.870, the sensitivity was 0.807, and the specificity was 0.809.

Conclusions

IL-6, CRP and LDH are independent indicators for macrolide-resistant SMPP. The combination of IL-6 and LDH is the best predictor of macrolide-resistant SMPP.