Risk factors for bronchiolitis obliterans development in children after Mycoplasma pneumoniae pneumonia: a retrospective study of 981 patients.

BACKGROUND

Bronchiolitis obliterans (BO) is a rare and severe chronic pulmonary condition in children following an injury to lower respiratory tract lesion. Mycoplasma pneumoniae (M. pneumoniae) is the second etiology of post-infectious bronchiolitis obliterans (PIBO). The aim of this study was to determine risk factors for PIBO development in children after M. pneumoniae pneumonia.

METHODS

This retrospective study enrolled 981 children admitted to Beijing children's hospital due to M. pneumoniae pneumonia between January 2016 and December 2022. The medical records of the PIBO and non-PIBO groups, including demographic, clinical, radiologic, and laboratory data were analyzed by multivariate logistic regression to reveal PIBO development-associated risk factors.

RESULTS

Seventy-two of the study patients developed PIBO after M. pneumoniae pneumonia. Multivariate analysis showed that large lobar consolidation (OR 4.06, 95% CI 1.18-14.03), diffuse bronchiolitis (OR 11.78, 95% CI 3.28-42.22), co-infection (OR 3.65, 95% CI 1.60-8.33), atopic conditions (OR 12.32, 95% CI 5.2-29.11), bronchial mucus plug (OR 2.48, 95% CI 1.10-5.58), CPR (OR 1.01, 95% CI 1.00-1.02), mechanical ventilation (OR 2.95, 95% CI 1.00-8.67), and duration of fever (OR 1.19, 95% CI 1.05-1.37) were significantly associated with development of PIBO after M. pneumoniae pneumonia.

CONCLUSIONS

In children with M. pneumoniae pneumonia, large lobar consolidation, diffuse bronchiolitis, co-infections, atopic conditions, bronchial mucus plug, CRP, mechanical ventilation, and duration of fever appeared as prominent independent risk factors for PIBO. Timely application of HRCT could provide a basis for the early prediction of PIBO development in children.