The risk factors of children acquiring refractory mycoplasma pneumoniae pneumonia: A meta-analysis

OBJECTIVES: Refractory mycoplasma pneumoniae pneumonia (RMPP) in children has been increasing worldwide. In this study, we conducted a meta-analysis to generate large-scale evidence on the risk factors of RMPP to provide suggestions on prevention and controlling for children. METHODS: Web of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang (Chinese) were searched to identify relevant articles. All analyses were performed using Stata 14.0. RESULTS: We conducted a meta-analysis of 15 separate studies. Fever for more than 10 days (odds ratio [OR] 3.965, 95% confidence interval [CI] 2.109–7.456), pleural effusion (OR 6.922, 95% CI 2.058–23.282), extra-pulmonary complications (OR 17.762, 95% CI 11.146–28.305), pulmonary X-ray consolidation ≥2/3 (OR 8.245, 95% CI 1.990–34.153), CRP >40 mg/L (OR 4.975, 95% CI 2.116–11.697) were significantly related to the risk of RMPP. We did not find an association between male sex (OR 0.808, 95% CI 0.548–1.189), LDH >410IU/L (OR 1.033, 95% CI 0.979–1.091) and the risk of RMPP. CONCLUSIONS: Fever for more than 10 days, pleural effusion, extra-pulmonary complications, pulmonary X-ray consolidation≥ 2/3 and CRP >40 mg/L are risk factors for early evaluation of RMPP.