Etiology Analysis Of Severe Pneumonia In Children With Nasal Continuious Positive Airway Pressure In A Hospital

objective: To investigate the etiology of hospitalized children with severe pneumonia treated by nasal continuous positive airway pressure(n-CPAP)in our hospital.Methods: Retrospectively analyze the etiology of 354 hospitalized children diagnosed with severe pneumonia and treated by n-CPAP in the respiratory department of Chongqing children’s hospital from March 2015 to April 2019.Results: The average use time of n-CPAP in 354 children was(72.45± 43.04)hours.The pathogen positive rate of 354 sputum specimens was81.36%(288/354),virus 57.06%(202/354),bacteria 47.18%(167/354),and mycoplasma pneumoniae(MP)6.78%(24/354).A total of 435 pathogenic strains were detected in 354 sputum specimens,the virus strain detection rate was 50.57%(220/435),the respiratory syncytial virus(RSV)strain detection rate was the highest 26.44%(115/435),the bacterial strain detection rate was 41.61%(181/154),and the gram-negative bacilli were dominant 63.42%(66/181).The pathogen positive rate of 354 bronchoalveolar lavage fluid(BALF)specimens was 44.63%(158/354)and the positive rate of bacteria was 25.99%(158/354).A total of 180 pathogenic strains were detected in 354 BALF specimens,the virus strain detection rate was 38.89%(70/180),the RSV strain detection rate was thehighest 18.33%(33/180),the bacterial strain detection rate was 53.33%(96/180),and gram-negative bacilli were dominant 60.42%(58/96).The bacterial detection rate of sputum samples(47.18%)was higher than that of the BALF samples(25.99%),and the difference was statistically significant(P<0.05).The highest detection rate of virus in sputum samples was69.23%(72/104)in winter and 68.18%(45/66)at the age of 1 to 3 months,and the highest bacterial detection rate was 61.17%(63/103)at the age of 6to 12 months.The detection rate of sputum pathogens in different seasons and age groups was statistically significant(P<0.05).The antibiotic utilization rate was 94.92%(336/354),and the antibiotic utilization rate in different pathogens detection was statistically significant(P<0.05).Conclusion: The sputum pathogens of children with severe pneumonia treated with n-CPAP were mainly viruses,followed by bacteria,and RSV was the most in both sputum and BALF.Gram-negative bacteria were the main bacteria detected in sputum and BALF,and the bacteria detection rate of sputum was higher than that of BALF.Sputum pathogens were detected differently in different seasons and age groups.The detection of pathogens can guide the use of antibiotics.