Comparative analysis of clinical characteristics of drug-resistant Mycoplasma pneumoniae pneumonia and viral pneumonia in children under 6 years of age

Purpose Comparative analysis of differences in clinical features and laboratory findings between macrolide-resistant Mycoplasma pneumoniae pneumoniae (MRMPP) and viral pneumonia in children under 6 years of age. Methods In this study, 213 children with community-acquired pneumonia (CAP) admitted to the pediatrics department of Gansu Provincial Maternal and Child Health Hospital from March 2023 to August 2024 were selected and divided into the MRMPP group and the viral pneumonia group according to the results of Targeted next-generation sequencing (tNGS), and the general data, clinical characteristics, laboratory examinations, chest CT and fiberoptic bronchoscopic manifestations of the two groups were compared and analyzed. Results There were 145 cases (68.1%) in the MRMPP group and 68 cases (31.9%) in the viral pneumonia group. The incidence of severe illness was 59.3% and 29.4% in the MRMPP and viral pneumonia groups, respectively. The MRMPP group showed a higher proportion of fever, longer total duration of fever, more likely to hear moist rales and diminished breath sounds, and more likely to have wheezing and sputum sounds in the viral pneumonia group. The MRMPP group was dominated by increased levels of N%, CRP, D-D, and ESR, and the viral pneumonia group was dominated by increased levels of WBC, L%, Alb, ALT, and AST, and chest CT was more likely to show lobar pneumonia and lung consolidation, and the rates of fiberoptic bronchoscopy, bronchial inflammatory stenosis, and plasmacytoid bronchitis were higher. Conclusions Despite the differences in clinical features and laboratory tests between MRMPP and viral pneumonia in children under 6 years of age, it is difficult to differentiate them in clinical practice, and the use of tNGS may help to clarify the etiology of the infection when it is difficult to do so.