Application Value of Lung Ultrasound in Children With Macrolide-Unresponsive Mycoplasma pneumoniae Pneumonia

IF 1.3 4区医学 Q3 ACOUSTICS

Journal of Clinical Ultrasound Pub Date : 2026-10-06 Epub Date: 2026-06-08 DOI:10.1002/jcu.70293

Jie Zhou, Xinxin Guo, Rong Wu

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引用次数: 0

Abstract

Objective

The incidence of macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) has markedly increased, primarily owing to resistance mediated by mutations in the pathogen's 23S rRNA gene. Because macrolide susceptibility testing is impractical at admission, this study aimed to delineate the clinical characteristics of MUMPP in children and to evaluate the predictive utility of laboratory parameters and lung ultrasound features for identifying MUMPP.

Methods

A retrospective analysis was performed on 163 children hospitalized with Mycoplasma pneumoniae pneumonia (MPP) at the Department of Pediatrics, Ordos Central Hospital, from January 1, 2023, to December 31, 2024. Patients were stratified into the MUMPP group (n = 49) and the macrolide-sensitive Mycoplasma pneumoniae pneumonia (MSMP) group (n = 114) according to their response to macrolide antibiotics.

Results

Compared with the MSMP group, patients in the MUMPP group were older, had longer hospital stays, and had higher body temperatures. d-dimer levels and neutrophil-to-lymphocyte ratios (NLRs) were elevated in the MUMPP group. On lung ultrasound, the MUMPP group exhibited larger areas of lung consolidation at admission and after treatment, higher rates of pleural effusion, greater bilateral pulmonary involvement, and a higher proportion of consolidations without air bronchograms.

Conclusion

Children with MUMPP present with more severe clinical features and lung ultrasound manifestations than those with MSMP. Early initiation of non-macrolide alternative therapies is therefore critical for effective management of MUMPP.

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肺超声在儿童大环内酯无反应肺炎支原体肺炎中的应用价值。

目的：大环内酯无反应肺炎支原体肺炎（MUMPP）的发病率显著增加，主要是由于病原体23S rRNA基因突变介导的耐药性。由于入院时进行大环内酯药敏试验是不切实际的，本研究旨在描述儿童MUMPP的临床特征，并评估实验室参数和肺部超声特征对识别MUMPP的预测效用。方法：对2023年1月1日至2024年12月31日在鄂尔多斯中心医院儿科住院的163例肺炎支原体肺炎（MPP）患儿进行回顾性分析。根据患者对大环内酯类抗生素的反应，将患者分为MUMPP组（n = 49）和大环内酯敏感性肺炎支原体肺炎组（n = 114）。结果：与MSMP组相比，MUMPP组患者年龄更大，住院时间更长，体温更高。MUMPP组d-二聚体水平和中性粒细胞与淋巴细胞比值（NLRs）升高。在肺部超声检查中，MUMPP组在入院时和治疗后表现出更大的肺实变面积，更高的胸腔积液率，更大的双侧肺受累率，以及更高比例的无支气管充气征的实变。结论：MUMPP患儿比MSMP患儿有更严重的临床特征和肺部超声表现。因此，早期开始非大环内酯类替代疗法对于有效管理MUMPP至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Ultrasound 医学-核医学

CiteScore

1.90

自引率

0.00%

发文量

248

审稿时长

6 months

期刊介绍： The Journal of Clinical Ultrasound (JCU) is an international journal dedicated to the worldwide dissemination of scientific information on diagnostic and therapeutic applications of medical sonography. The scope of the journal includes--but is not limited to--the following areas: sonography of the gastrointestinal tract, genitourinary tract, vascular system, nervous system, head and neck, chest, breast, musculoskeletal system, and other superficial structures; Doppler applications; obstetric and pediatric applications; and interventional sonography. Studies comparing sonography with other imaging modalities are encouraged, as are studies evaluating the economic impact of sonography. Also within the journal''s scope are innovations and improvements in instrumentation and examination techniques and the use of contrast agents. JCU publishes original research articles, case reports, pictorial essays, technical notes, and letters to the editor. The journal is also dedicated to being an educational resource for its readers, through the publication of review articles and various scientific contributions from members of the editorial board and other world-renowned experts in sonography.