Age and hypoalbuminemia independently predict pulmonary consolidation in children with 23S rRNA A2063G-mutant

Background: Methods: A retrospective, single-center analysis was conducted on the clinical data of children with MPP admitted to a Grade A tertiary general hospital between January 2023 and December 2024. Based on targeted next-generation sequencing (tNGS), children were divided into A2063G mutation-positive and -negative groups. Mutation-positive children were further classified into pulmonary consolidation and non-consolidation subgroups. Multivariate logistic regression was used to identify independent risk factors for pulmonary consolidation in A2063G mutation-positive MPP children. Results: A total of 347 children were included in the study. Compared with children without the A2063G mutation, children with the mutation presented older age, higher rates of pre-admission cough and pulmonary consolidation, as well as elevated globulin (GLB), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), pan-immune-inflammation value (PIV) and systemic immune-inflammation index (SII) levels; meanwhile, their lymphocytes (LYM) and albumin (ALB) levels were significantly lower (all Conclusion: Older age and lower ALB levels are associated with a higher risk of pulmonary consolidation in children with A2063G-mutant MPP, suggesting that an enhanced host inflammatory immune response contributes to the development of pulmonary consolidation.