Analysis Of Clinical Characteristics Of Community-acquired Pneumonia In Children

BackgroundCommunity-acquired pneumonia in children(community acquired pneumonia,CAP)is the most common pediatric disease.The disease causes great threat to lots of children’s health,which can occur in all ages.Especially,it is more prominent for children under five years old to be attacked by CAP,which is the leading cause of death.CAP can be caused by a variety of pathogenic microorganisms.Numerous studies both at home and abroad reported that in different countries,different regions,different eras,the distribution of bacteria that lead to CAP is different due to the influence of many factors(such as temperature,humidity,economy,etc.).Because of the high morbidity rate of CAP,it is very important to timely diagnosis and targeted treat CAP according to the typical clinical features,laboratory examination,bacterial pathogen distribution characteristics.This region is lack of analysis about the clinical features of CAP currently.The objectives of this study is to provide the theory basis for the region’s CAP empirical diagnosis and treatment through the analysis of regional CAP clinical features,laboratory examination and bacterial etiology characteristic.ObjectiveThe specific objective of this paper is to provide a reference for the region’s CAP empirical diagnosis and treatment,by retrospectively analysising the pneumonia clinical features of hospitalized children and data of laboratory examination,sputum bacterial culture in The First Affiliated Hospital of Xinxiang Medical University from Jan.2014 to Jan.2015.MethodsThe 1702 cases of children with CAP treated in The First Affiliated Hospital of Xinxiang Medical University from Jan.2014 to Jan.2015 were took as the research object.The all CAP children were examined by sputum bacterial culture,white blood cell(WBC)and hypersensitivity C-reactive protein(hs-CRP)tests.We collected clinical data,such as age,sex,clinical characteristics,WBC,hs-CRP,sputum culture results,etc.According to the result of sputum culture in back,the research object was divided into the bacterial positive group and the bacterial negative group.And the research object was divided into four groups according to age: the group of age of 28d~1 year,1~3 years old group,3~6 years old group and 6~14 years old group.According to the characteristics of climate in the region(not including the January 2015 cases)the research object was divided into four groups,namely: the spring cases in March~May,the summer cases in June~August,the autumn cases in September~November,the winter cases in December~February.The data analyze was conducted using SPSS17.0 statistical software.Results1.Clinical features: There was no difference(P>0.05)between the heating rate of the bacterial positive group and that of the bacterial negative group.The incidence of lung wet rale of the bacterial positive group is higher than that of the bacterial negative group(P<0.05).The incidence of lung wheezing of the bacterial positive group is higher than that of the bacterial negative group(P<0.05).2.Characteristics of laboratory examination: hs-CRP,WBC of the bacterial positive group were higher than those of the bacterial negative group(P<0.05).3.Etiology characteristics: Bacteria detection rate in this region was 41.2%,gram-negative bacteria detection rate was 27.8%,and gram-positive bacteria detection rate was 72.2%.Streptococcus pneumoniae(SP),Haemophilus influenzae(HI),Staphylococcus aureus(SA)and Escherichia coli(E.coli)were the top four members of CAP bacterial infections in this region.4.There was no difference for bacterial infection rate between the different gender (P>0.05).5.Bacteria detection features of different season groups and distribution characteristics of common bacteria: the bacteria detection rates in different season groups had difference(P<0.05),and the maximum detection rate located in spring group,the minimum in summer group.SP was generally highly occur in different seasons,and the highest detection rate was located in spring(P<0.05).The highest detection rate of HI was in winter(P<0.05).The infection rate of SA in spring and winter was higher than that in summer and autumn(P<0.05).However,the infection rates of E.coli,Klebsiella pneumonia(KPN)and Bowman’s acinetobacter(AB)in different seasons were not difference(P>0.05).6.Detection characteristics of different age groups of bacteria and distribution characteristics of common bacteria: The bacteria detection rate between different age groups were significantly different(P<0.05).Bacteria detection rate of 1~3 years old cases was the highest(P<0.05).SP infection rate in 1~3 years old group(P<0.05)was the highest,and the infection rates of SA and E.coli.at the age of 28d~1 year group were higher.While infection rates of HI,KPN and AB in all age groups are undifferentiated(P>0.05).Conclusions1.It is easier to smell pulmonary moist rale and wheezing for the children who were detected bacteria in sputum.2.WBC and hs-CRP are sensitive diagnostic indexes in bacterial infection of children with CAP.3.In the region,the main pathogenic bacteria leading to community-acquired pneumonia in children were as following: SP,HI,SA,E.coli.The distribution of bacterial pathogens was closely related to age and seasons,but it was not related to sex.4.SP,HI,SA were the main pathogenic bacteria leading to pneumonia for 28d~1 year age group in children.The top three pathogenic bacteria leading to pneumonia for 1~3 years old group and 3~6 years old group are : SP,HI,AB;and that for 6~14 years old of group are: HI,SP,SA.