Analysis of drug resistance and clinical characteristics of hospitalized children with mycoplasma pneumoniae pneumonia in 2023 in Hunan Province

Objective To investigate the drug resistance and clinical characteristics of children with mycoplasma pneumoniae pneumonia (MPP) in order to provide reference for the accurate diagnosis and treatment of MPP.Methods A retrospective analysis was performed on 125 children with pneumonia who were hospitalized in the pediatric ward of the Second Xiangya Hospital of Central South University from January 1, 2023 to December 31, 2023. They were divided into the non-MPP group (n= 55) and the MPP group (n=70). The clinical data of all children were collected, and the differences between the two groups were compared. tNGS was used to detect the infection and drug resistance of Mycoplasma pneumoniae (MP), and the clinical characteristics and drug resistance of children with MPP were analyzed.Results 70 cases of children with MPP 41 cases of male, female, 29 cases, age (6.5 + 3.45), with 6 or more years old age group (school age and adolescence) is the most rare. Clinical symptoms of fever, cough, for outstanding performance, laboratory examination the WBC, neutrophil count, creatinine, urea, uric acid level is lower than the MPP group, ratio of lymphocytes, the Hb level is higher than the MPP group, the difference was statistically significant (P < 0.05); Severe pneumonia MPP group a total of 12 cases (17.14%), tNGS tests have tips for 23 A2063G sr RNA and (or) A2064G mutations. tNGS detected 60 cases of MPP resistance gene mutation sites (85.71%), including 59 cases of 23Sr RNA A2063G mutation (98.33%) and 1 case of 23Sr RNA A2064G mutation (1.67%). A total of 63 cases (90.00%) children with MPP reference tNGS results guiding anti-infective treatment, 7 cases (70.00%) of the MPP is not associated with drug resistance with reference tNGS results guiding anti-infective treatment, 56 cases (93.33%) of the MPP resistance with reference tNGS resistance results guiding anti-infective treatment. All children with good prognosis, no deaths occurred, length of hospital stay (7, 11) 9 d.Conclusions MPP is an important pathogen of seasonal respiratory tract infection in children in Hunan, and the age distribution is more common in school-age and adolescent children. The drug-resistant mutation sites are concentrated in A2063G and A2064G, mainly A2063G. The drug resistance rate in the 3-year old group and the ≥ 6-year old group was significantly increased. tNGS technology could diagnose MPP early and identify drug resistance mutations, providing an important basis for guiding clinical accurate anti-infection treatment.