{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:33:31Z","timestamp":1792100011252,"version":"4.4.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      We aimed to investigate prognostic indicators for pediatric macrolides-unresponsive\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      pneumonia (MUMPP) cases with A2063\/2064G mutations with azithromycin therapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a retrospective observational cohort study conducted at the Children\u2019s Hospital of Chongqing Medical University. Children with macrolide-resistant mutations (A2063\/2064G) diagnosed as MUMPP who received only anti-\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      (MP) treatment with azithromycin were retrospectively enrolled. Logistic regression analysis was used to identify potential risk factors for predicting short-term (refractory\n                      <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                      pneumonia [RMPP]) and long-term (bronchiolitis obliterans [BO] or bronchiectasis) adverse prognosis. The results were visualized using forest plots.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study retrospectively included 82 children with MUMPP, and all received only azithromycin for anti-MP treatment. The incidence of pulmonary consolidation, pleural effusion, and atelectasis was 80.49% (66\/82), 34.15% (28\/82), and 24.39% (20\/82), respectively. 29.27% (24\/82) of patients diagnosed with RMPP, and 14.63% (12\/82) of patients diagnosed with bronchiolitis obliterans (BO) or bronchiectasis diagnosed within one year after discharge. Logistic analysis showed that atelectasis was independently associated with short-term (RMPP) and long-term (BO or bronchiectasis) adverse prognosis (odds ratio [OR] 4.02, 95% confidence interval [CI] 1.03-16.00, P = 0.043; OR 5.62, 95% CI 1.04-32.80, P = 0.045; respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Atelectasis predicts a poor prognosis for children with A2063\/2064G MUMPP. The occurrence of atelectasis may indicate an increased risk of failure of current azithromycin treatment. Combined with the results of drug-resistant mutations, it is recommended to strengthen disease monitoring and individualized intervention evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2025.1604102","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T01:32:38Z","timestamp":1750987958000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Atelectasis predicts poor prognosis in pediatric macrolides-unresponsive Mycoplasma pneumoniae pneumonia with A2063\/2064G mutations treated with azithromycin"],"prefix":"10.3389","volume":"15","author":[{"given":"Jie","family":"Cheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangli","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyin","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengxiu","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"8315","DOI":"10.3390\/ijms23158315","article-title":"Hypoxia aggravates inhibition of alveolar epithelial na-transport by lipopolysaccharide-stimulation of alveolar macrophages","volume":"23","author":"Baloglu","year":"2022","journal-title":"Int. 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