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| Analysis of Clinical Characteristics of Drug-Resistant Severe Mycoplasma Pneumoniae Pneumonia in Children of Different Age Groups |
| SUN Hui1, HUANG Han2, DING Xiaofang1, PENG Li1, YU Jingwen1 |
1. Department of Children's Medical Center, the First Affiliated Hospital of Hunan Normal University/Hunan Provincial People's Hospital, Changsha Hunan 410005;
2. Hunan Maternal and Child Health Hospital, Changsha Hunan 410008 |
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Abstract 【Objective】 To analyze the clinical characteristics of drug-resistant severe Mycoplasma pneumoniae pneumonia (MPP) in children of different age groups. 【Methods】 A retrospective analysis was performed on the clinical data of 207 children diagnosed with drug-resistant severe MPP admitted to The First Affiliated Hospital of Hunan Normal University (Hunan Provincial People's Hospital) from August 2023 to April 2024. The enrolled children were divided into three groups according to age: infant group (age<3 years old, n=40), preschool group (age 3-6 years old, n=73) and school-age group (age>6 years old, n=94). The clinical characteristics were compared among the three groups. 【Results】 Fever and cough were the main clinical manifestations in all children. The infant group had a significantly higher incidence of wheezing (32.50%) and single viral or bacterial co-infection rate (60.00%) than the other two groups, with single viral infection (40.00%) as the predominant complication. The levels of serum C-reactive protein, neutrophil-to-lymphocyte ratio and lactate dehydrogenase in the preschool and school-age groups were significantly higher than those in the infant group (P<0.05). The median D-dimer level of the three groups showed no obvious elevation compared with the normal range (P>0.05), while significantly increased D-dimer level (median: 25.72 mg/L) was observed in 5 children complicated with pulmonary embolism. Massive pulmonary consolidation was the main imaging feature in all groups, especially in the preschool and school-age groups, which also had a higher proportion of pleural effusion than the infant group (P<0.05). All 5 cases of pulmonary embolism occurred in preschool and school-age children. Extrapulmonary complications occurred in 99 children (47.83%), mainly including liver dysfunction and myocardial injury, with a higher incidence in the infant group. One school-age child developed multi-site vascular embolism and achieved a good prognosis after treatment. The school-age group had higher proportions of children receiving tetracycline antibiotics and undergoing bronchoscopic lavage for no less than twice (P<0.05). A total of 28 children (13.53%) received immune supportive therapy, most of whom were from the infant and school-age groups (23/28). All children improved and were discharged after treatment. 【Conclusion】 There are significant differences in clinical characteristics of children with drug-resistant severe MPP across different age groups. Clinically, individualized diagnosis and treatment strategies should be optimized based on age stratification characteristics to improve the efficacy of clinical treatment.
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Received: 11 February 2026
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