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Abstract：
This study aimed to investigate differences in clinical characteristics and laboratory findings between children infected with Macrolide-Sensitive Mycoplasma pneumoniae (MSMP) and Macrolide-Resistant Mycoplasma pneumoniae (MRMP). Additionally, the research sought to identify laboratory markers for rapidly distinguishing refractory Mycoplasma pneumoniae pneumonia (RMPP) from ordinary Mycoplasma pneumoniae pneumonia (OMPP). In total, 265 Mycoplasma pneumoniae (MP) patients were included, with MRMP identified by specific point mutations in domain V of the 23S rRNA gene. A retrospective analysis compared the clinical courses and laboratory data, revealing that MRMP patients experienced prolonged febrile days (P = 0.004), elevated CRP levels (P < 0.001), and higher MP DNA loads than MSMP patients (P = 0.037). Based on clinical symptoms, MRMP was divided into RMPP (n = 56) and OMPP (n = 70), with RMPP demonstrating significantly increased IL-18, community-acquired respiratory distress syndrome (CARDS) toxins in nasopharyngeal aspirate, and serum CRP levels (P < 0.001; P = 0.006; P < 0.001). In conclusion, timely recognition of RMPP is crucial for enhancing prognosis. The identification of MRMP, coupled with proinflammatory cytokines such as IL-18, CARDS toxins, and CRP, emerges as promising markers with the potential to contribute significantly to diagnostic accuracy and prognosis assessment.
摘要：
本研究旨在探讨大环内酯敏感型肺炎支原体(MSMP)和大环内酯耐药型肺炎支原体(MRMP)感染患儿的临床特征和实验室检查结果的差异。此外,本研究旨在鉴定实验室标志物,以快速区分难治性肺炎支原体肺炎(RMPP)和普通肺炎支原体肺炎(OMPP).总的来说,纳入265例肺炎支原体（MP）患者，通过23SrRNA基因V结构域中的特定点突变鉴定MRMP。回顾性分析比较了临床课程和实验室数据，揭示MRMP患者经历了延长的发热天数（P=0.004），CRP水平升高（P<0.001），MPDNA载量高于MSMP患者(P=0.037)。根据临床症状，MRMP分为RMPP(n=56)和OMPP(n=70),与RMPP显着增加IL-18，社区获得性呼吸窘迫综合征（CARDS）毒素在鼻咽抽吸，和血清CRP水平（P<0.001；P=0.006；P<0.001）。总之,及时识别RMPP对提高预后至关重要.MRMP的鉴定,再加上促炎细胞因子，如IL-18，CARDS毒素，CRP,作为有希望的标志物出现，有可能对诊断准确性和预后评估做出重大贡献。
