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Additionally, the research sought to identify laboratory markers for rapidly distinguishing refractory <jats:italic>Mycoplasma pneumoniae<\/jats:italic> pneumonia (RMPP) from ordinary <jats:italic>Mycoplasma pneumoniae<\/jats:italic> pneumonia (OMPP). In total, 265 <jats:italic>Mycoplasma pneumoniae<\/jats:italic> (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 (<jats:italic>P<\/jats:italic>\u2009=\u20090.004), elevated CRP levels (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), and higher MP DNA loads than MSMP patients (<jats:italic>P<\/jats:italic>\u2009=\u20090.037). Based on clinical symptoms, MRMP was divided into RMPP (n\u2009=\u200956) and OMPP (n\u2009=\u200970), with RMPP demonstrating significantly increased IL-18, community-acquired respiratory distress syndrome (CARDS) toxins in nasopharyngeal aspirate, and serum CRP levels (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001; <jats:italic>P<\/jats:italic>\u2009=\u20090.006; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). 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.<\/jats:p>","DOI":"10.1038\/s41598-024-55311-2","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T15:03:22Z","timestamp":1709823802000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Observational retrospective clinical study on clinical features of macrolide-resistant Mycoplasma pneumoniae pneumonia in Chinese pediatric cases"],"prefix":"10.1038","volume":"14","author":[{"given":"Peng","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianhui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,7]]},"reference":[{"key":"55311_CR1","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1186\/s12879-021-05830-4","volume":"21","author":"Z Zhu","year":"2021","unstructured":"Zhu, Z. et al. 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