The Characteristic Of The Etiology Of Severe Community Acquired Pneumonia In Children

Purpose:Severe pneumonia in children and its complications,especially the systemic inflammatory response and multiple organ failure is the main reason of the threat to chi ldren health and life.Many studies have confirmed that different areas always have so me difference in the pathogenic spectrum,and it always need properly experience admi nistration in the early stages of the disease.In this study we purposed to detect characte ristics of children with community-acquired pneumonia through analysing the data,su ch as serum virus and mycoplasma pneumoniae and chlamydia antibodies,phlegm culti vation alveolar lavage fluid,blood culture information,of the patients in our hospital of severe community-acquired pneumonia at the xx area,in order to guide clinical work.Methods:550 cases of children with severe community-acquired pneumonia pathogen data were retrospectively analyzed,choose between January 2014 and December 2014 in Dalian Children’s hospital.All selected patients were diagnosed with severe commu nity-acquired pneumonia,and 28 days older than,less than 168 month(14 year).Withi n 24 hours after admission complete airway deep phlegm cultivation,different parts of t he blood,serum antibody of respiratory virus IgM,serum antibody of mycoplasma pne umoniae and chlamydia specimen,IgM and inspection as soon as possible were collect ed.We statistic the above test results and part of the children of alveolar lavage fluid pathogen detection results,at the same time record the general information and complic ations.In addition,all children can be divided into four groups according to the ages,fo r 29 days～12 months,～36 months,～72 months and～168 months,and we analyzd the differences between the different age.All children can be divided into four groups acc ording to the season,for spring,summer,autumn and winter,and we analyze the differe nces between the different seasons pathogens.Using statistical analysis software SPSS 20.0.Result:1.Total positive rate was 58.2%,the pathogen of bacterial infection was 35.3%,the vir-us infection 15.6%,atypical pathogens infection 20.0%,fungal infections 8.8%,mixe-d infection 20.3%.2.All children do sputum culture,check out the pathogen of 177 plants,142 strains(80.2%)bacteria,97 strains(54.8%)of gram-negative bacteria,and 45 strains(25.4%)of gram-positive bacteria,including with 32 strains klebsiella pneumoniae strains,25 strai ns of e.Coli and 19 strains of staphylococcus aureus;35 strains(19.8%)Fungi,of whic h 31 strains of the white candida.3.345 cases of children do blood culture,check out the pathogen of 112 plants,102 stra-ins bacteria(91.1%),60(53.6%)strains of gram-negative bacteria and 42 strains(37.5%)of gram positive bacteria strains,including with 21 strains klebsiella pneumoniae,15 strains of acinetobacter baumannii and 16 strains streptococcus pneumoniae;10 strai-ns fungi,including 8 strains white candida among them.4.100 cases of children do fiber bronchoscope examination,take alveolar lavage fluid(BALF)is used to detect the etiology,check out the pathogen of 38 plants,2 5 strains ba-cteria(91.1%),15 strains(39.5%)of gram-negative bacteria,including 9 strains of aci-netobacter baumannii,and 10 strains(26.3%)of gram positive bacteria,including 8 str ains streptococcus pneumoniae,13 strains(34.2%)mycoplasma pneumoniae.5.All children do common respiratory virus serum,serum pneumonia mycoplasma and chlamydia IgM antibody detection,88 strains were detected virus,including 31 strains respiratory syncytial virus,17 strains cytomegalovirus.112 strains were detected with atypical pathogens,including 96 strains mycoplasma pneumoniae.6.In 29 days-12 months,the proportion of bacteria is 68.2%,virus proportion is 22.3%.In-36 months group,the proportion of bacteria is 29.8%,atypical pathogens proportio n is 40.5%.In-72 months group,atypical pathogens proportion is 67.3%.7.Patients affected the severe community-acquired pneumonia pathogen in the summer bacteria accounted for 61.3%.In the autumn atypical pathogens accounted for 42.9%.I n the winter bacteria accounted for 49.7%.Conclusions:1.The cases of pathogen in children with severe community-acquired pneumonia in dali an are in turn bacteria,mycoplasma,viruses and fungi.The bacterium is mainly related to klebsiella pneumoniae and streptococcus pneumoniae,and the virus is mainly of resp iratory syncytial virus.We can choose drugs more appropriately based on the disease s pectrum.2.The origin of the disease varies by age and season.Therefore,the results of the disea se should be obtained as early as possible to better guide the clinic.