Macrolide-resistant Mycoplasma pneumoniae is an independent risk factor for bronchial mucus plug formation in children.

: This study aimed to explore the characteristics of bronchial mucus plug formation and its risk factors. A total of 578 children who underwent bronchoalveolar lavage treatment between January 2022 and June 2024 at the Department of Pediatric, Women and Children's Hospital of Ganzhou were assessed in this study.The bronchoalveolar lavage fluid was tested by next-generation sequencing. The resistance genes of macrolides in Mycoplasma pneumoniae (MP) were detected by polymerase chain reaction. Data related to the basic information, clinical characteristics, and etiology were statistically analyzed. Logistic regression analysis was performed to identify the independent risk factors for bronchial mucus plug formation. There were 312 cases in the mucus plug group and 266 in the non-mucus plug group. The mucus plug group children were older, had longer hospital stays, exhibited a higher incidence of fever, experienced more complications, and had higher rates of hormone use when compared to those in the non-mucus plug group (P < 0.05). The detection rate of MP and macrolide resistance was significantly higher in the mucus plug group than in the non-mucus plug group (P < 0.05). According to the logistic regression analysis, macrolide-resistant MP (MRMP) acted as an independent risk factor for the formation of bronchial mucus plugs in children. Conclusions: Bronchial mucus plugs were common in children with MP infection, often accompanied by fever and prolonged hospitalization. MRMP was thus identified as an independent risk factor for bronchial mucus plug formation.

Background: • MP can lead to bronchial mucus plugs. Background: • MRMP is an independent risk factor for the formation of bronchial mucus plugs.