{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:00:36Z","timestamp":1791910836899,"version":"4.3.4"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Shanghai Municipal Health Commission Research Project","award":["202340070"],"award-info":[{"award-number":["202340070"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Indian Pediatr"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To investigate the impact of macrolide resistance and\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      DNA (MP-DNA) load in bronchoalveolar lavage fluid (BALF) on immune and inflammatory responses in children with\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      pneumonia (MPP).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 190 hospitalized children with MPP who underwent bronchoscopy. Patients were classified as macrolide-resistant or macrolide-sensitive based on 23S rRNA mutation analysis. MP-DNA load and cytokines in BALF and inflammatory markers in blood were measured. MRMP patients were further stratified by MP-DNA load for subgroup analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1029 children screened, 474 had MPP, and 190 who underwent bronchoscopy were analyzed. Macrolide-resistant mycoplasma pneumonia (MRMP) accounted for 73.2% of cases and was associated with longer fever duration and hospital stay, lower lymphocyte counts, higher BALF total cell counts and neutrophil proportions, and increased inflammatory cytokines. Among MRMP patients, those with high MP-DNA loads had greater BALF cytokine levels than those with low loads. MP-DNA load positively correlated with IL\u20111\u03b2 and IL\u20116 levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Macrolide resistance and high pathogen load are associated with enhanced airway inflammation and immune dysregulation in children with MPP. Early detection of resistance and quantification of pathogen load may guide timely antibiotic adjustment and improve clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s13312-025-00190-7","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T06:53:05Z","timestamp":1758696785000},"page":"893-898","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Effect of Macrolide Resistance and Mycoplasma pneumoniae DNA Load in Bronchoalveolar Lavage Fluid on Immune and Inflammatory Responses in Children with Mycoplasma pneumoniae Pneumonia"],"prefix":"10.1007","volume":"62","author":[{"given":"Haiqin","family":"Zhong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeyu","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoxiang","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9656-7129","authenticated-orcid":false,"given":"Xiaoyan","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"190_CR1","doi-asserted-by":"publisher","first-page":"1306234","DOI":"10.3389\/fped.2023.1306234","volume":"11","author":"Z Song","year":"2023","unstructured":"Song Z, Jia G, Luo G, Han C, Zhang B, Wang X. Global research trends of Mycoplasma pneumoniae pneumonia in children: a bibliometric analysis. Front Pediatr. 2023;11:1306234.","journal-title":"Front Pediatr"},{"key":"190_CR2","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1186\/s12879-024-09340-x","volume":"24","author":"S Yang","year":"2024","unstructured":"Yang S, Lu S, Guo Y, Luan W, Liu J, Wang L. A comparative study of general and severe Mycoplasma pneumoniae pneumonia in children. BMC Infect Dis. 2024;24:449.","journal-title":"BMC Infect Dis"},{"key":"190_CR3","first-page":"1","volume":"2022","author":"W Huang","year":"2022","unstructured":"Huang W, Xu X, Zhao W, Cheng Q. Refractory mycoplasma pneumonia in children: a systematic review and meta-analysis of laboratory features and predictors. 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J Clin Med. 2022;11:1782.","journal-title":"J Clin Med"},{"key":"190_CR6","doi-asserted-by":"publisher","first-page":"2353","DOI":"10.1093\/jac\/dkac170","volume":"77","author":"G Wang","year":"2022","unstructured":"Wang G, Wu P, Tang R, Zhang W. Global prevalence of resistance to macrolides in Mycoplasma pneumoniae: a systematic review and meta-analysis. J Antimicrob Chemother. 2022;77:2353\u201363.","journal-title":"J Antimicrob Chemother"},{"key":"190_CR7","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1007\/s12098-025-05603-w","volume":"92","author":"PN Bhaskaran","year":"2025","unstructured":"Bhaskaran PN, Kumar A, Shashindran N, Menon VP. Macrolide resistance due to A2063G mutation in 23S rRNA gene of Mycoplasma pneumoniae, Kerala, India, 2024. Indian J Pediatr. 2025;92:872.","journal-title":"Indian J Pediatr"},{"key":"190_CR8","doi-asserted-by":"publisher","first-page":"1369431","DOI":"10.3389\/fped.2024.1369431","volume":"12","author":"W Wang","year":"2024","unstructured":"Wang W, Wang L, Yin Z, et al. Correlation of DNA load, genotyping, and clinical phenotype of Mycoplasma pneumoniae infection in children. Front Pediatr. 2024;12:1369431.","journal-title":"Front Pediatr"},{"issue":"33","key":"190_CR9","first-page":"983","volume":"2018","author":"Experts Groups of Pediatric Respiratory Endoscopy, Talent Exchange Service Center of National Health Commission, Endoscopy Committee, Pediatric Section of Chinese Medical Doctor Association, Pediatric Respiratory Endoscopy Committee, Endoscopists Section of Chinese Medical Doctor Association, Pediatric Interventional Respirology Group, Maternal and Pediatric Minimally Invasive Section of Chinese Maternal and Child Health Association, Bronchoscopy Collaboration Subgroup of Respirology Group, Pediatric Section of Chinese Medical Association. Guideline of Pediatric Flexible Bronchoscopy in China","year":"2018","unstructured":"Experts Groups of Pediatric Respiratory Endoscopy, Talent Exchange Service Center of National Health Commission, Endoscopy Committee, Pediatric Section of Chinese Medical Doctor Association, Pediatric Respiratory Endoscopy Committee, Endoscopists Section of Chinese Medical Doctor Association, Pediatric Interventional Respirology Group, Maternal and Pediatric Minimally Invasive Section of Chinese Maternal and Child Health Association, Bronchoscopy Collaboration Subgroup of Respirology Group, Pediatric Section of Chinese Medical Association. Guideline of Pediatric Flexible Bronchoscopy in China(2018 version). Chin J Appl Clin Pediatr. 2018;33:983\u20139 ([in Chinese]).","journal-title":"Chin J Appl Clin Pediatr"},{"key":"190_CR10","doi-asserted-by":"publisher","first-page":"1382","DOI":"10.3201\/eid2607.200017","volume":"26","author":"Y Chen","year":"2020","unstructured":"Chen Y, Hsu W, Chang T. 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