A2063G macrolide-resistant Mycoplasma pneumoniae: epidemic dominance without more frequent pulmonary consolidation or worse short-term in-hospital outcomes in hospitalized children.
Pulmonary consolidation was associated with lower odds of A2063G-resistant Mycoplasma pneumoniae
A2063G macrolide-resistant Mycoplasma pneumoniae: epidemic dominance without more frequent pulmonary consolidation or worse short-term in-hospital outcomes in hospitalized children.
Macrolide resistance is common in pediatric Mycoplasma pneumoniae pneumonia (mycoplasma pneumoniae pneumonia), but its relationship with clinical phenotype, short-term in-hospital course, and radiographic severity remains uncertain.
We aimed to characterize macrolide resistance-associated sites and their clinical correlates in hospitalized children with mycoplasma pneumoniae pneumonia, focusing on A2063G and pulmonary consolidation.
This retrospective study included children aged < 14 years hospitalized with mycoplasma pneumoniae pneumonia at Shantou Central Hospital, China, from January 1 to December 31, 2024.
consolidation was less common with the resistant strain than wild-type
Among 402 hospitalized children with mycoplasma pneumoniae pneumonia, A2063G was detected in 362 (90.0%), whereas A2064G, A2067G, and C2617G were not detected.
Monthly case counts peaked during June-August, while the proportion of A2063G remained consistently high throughout the year.
For pulmonary consolidation, A2063G positivity remained independently associated with lower odds after adjustment for age, Tmax_24h, and CRP (OR 0.378, 95% CI 0.190-0.752; P = 0.006).
No clear differences were observed by resistance-site status in systemic inflammatory profile, overall clinical course, or in-hospital resource use.
In hospitalized children with mycoplasma pneumoniae pneumonia from the Chaoshan region of southern China in 2024, A2063G was the dominant macrolide resistance-associated site.
In this cohort, A2063G positivity was not accompanied by more frequent pulmonary consolidation, a more severe clinical phenotype based on the available indicators, or worse short-term in-hospital outcomes.
These findings suggest that, in pediatric mycoplasma pneumoniae pneumonia, predominance of a resistance-associated site, radiographic severity, and short-term clinical course may not necessarily vary in parallel.