Clinical correlation of A2063G gene mutation in mycoplasma pneumoniae pneumonia in children: a retrospective analysis.

OBJECTIVE: To investigate the correlation between the A2063G point mutation in the 23S rRNA resistance gene and the clinical features of Mycoplasma pneumoniae pneumonia (MPP) in children. METHODS: A retrospective analysis was conducted on 279 children diagnosed with MPP and hospitalized at Xiamen Hospital of Traditional Chinese Medicine from 2023. Based on the results of drug resistance gene sequencing, the patients were divided into a non-mutation group and a mutation group, and their clinical data were compared. RESULTS: No significant differences were observed between the two groups regarding symptoms of productive cough and wheezing, or in laboratory indicators including white blood cell count (WBC), creatine kinase (CK), creatine kinase-MB (CK-MB), alanine transaminase (ALT), aspartate transaminase (AST), blood urea nitrogen (BUN), and serum creatinine (Scr) (P > 0.05). The total fever duration and hospital stay were significantly longer in the mutation group than in the non-mutation group (P < 0.05). Levels of C-reactive protein (CRP), D-dimer (D-D), and lactate dehydrogenase (LDH) were significantly higher in the mutation group (P < 0.05). No significant differences between the two groups of children regarding antibiotic regimen selection and the use of fiberoptic bronchoscopy (P > 0.05). The usage rate of glucocorticoids in the mutation group was significantly higher than that in the non-mutation group, and the difference was statistically significant (P < 0.05). Multivariate analysis indicated that elevated levels of CRP, D-D, LDH and Glucocorticoid Therapy were independently associated with the A2063G mutation. CONCLUSION: The A2063G mutation may be associated with prolonged hospital stay, total fever duration, glucocorticoid use, and elevated serum CRP, D-D, and LDH levels. Furthermore, certain independent correlations are present between these clinical parameters. Early identification of this mutation during the initial stages of the disease could provide crucial guidance for adjusting clinical management strategies.