The clinical characteristics of corticosteroid-resistant refractory Mycoplasma Pneumoniae pneumonia in children

To analyze the clinical characteristics of corticosteroid-resistant refractory Mycoplasma pneumoniae pneumonia (RMPP) and explore the related factors that predict corticosteroid-resistant RMPP. Retrospective analysis of 183 children with RMPP in our hospital admitted between January 1, 2012, and December 31, 2014 was performed. Of the 183 RMPP cases, 36 (19.7%) were corticosteroid-resistant RMPP cases. Corticosteroid-resistant RMPP cases had a longer duration of fever and hospitalization compared with corticosteroid-sensitive RMPP cases (P < 0.05). The radiographic findings of 123 (83.7%) cases of corticosteroid-sensitive RMPP apparently resolved after one week of corticosteroid treatment compared with 4 (11.1%) corticosteroid-resistant RMPP cases that had apparently resolution (P < 0.01). Twenty-four (75%) corticosteroid-resistant RMPP patients who received bronchoscopy had mucus plug formation while none of the corticosteroid-sensitive RMPP patients had mucus plug formation (P < 0.05). Multiple logistic regression analysis showed that duration of fever ≥11 days, percentage of lymphocytes ≤32%, CRP ≥48.73 mg/L and LDH ≥ 545.7 U/L were significant predictors of corticosteroid-resistant RMPP. Patients with corticosteroid-resistant RMPP had more severe presentations and more serious radiological findings. Clinicians might use the parameters of duration of fever, CRP, LDH and proportion of lymphocytes to identify children at higher risk of corticosteroid-resistant RMPP.