| Objective: The present study was designed to investigate the clinical characteristics,bacteria cultivation and antibiotic susceptibility analysis of bronchoalveolar lavage fluid of chronic suppurative lung disease.Methods: A retrospective chart review was undertaken in 46 CSLD patients admitted to Children's Hospital of Chongqing Medical University from January 2013 to December 2016.Results:(1)The mean age of CSLD patients was 10(3-109)months,the cough duration was 14.7(4.7-157)weeks,34 cases(73.9%)accompanied with wheezing.31cases(67.4%)were clinically diagnosed as protracted pneumonia,27 cases(58.7%)were diagnosed as airway abnormalities,and 21 cases(45.7%)were diagnosed as asthma.(2)All the patients showed purulent inflammation under bronchoscopy,22 cases(47.8%)had airway abnormalities and were more common in younger patients(P=0.035),the mean percentage of neutrophils in BALF was47.3%(14% to 76%),and macrophages was 9.4%(1%-28%).(3)The distribution of detected pathogens showed a predominance ofStreptococcus pneumoniae 7 cases(26.9%),followed by Escherichia coli 6cases(23.1%)and Haemophilus influenzae 5 cases(19.2%).(4)The resistance rate of Streptococcus pneumoniae to amoxicillin was relatively low(28.6%),and was totally sensitive to vancomycin,linezolid and evofloxacin.Escherichia coli and Haemophilus influenzae were completely resistant to ampicillin,and also serious to piperacillin,while had a higher sensitivity to imipenem,meropenem,piperacillin tazobactam and amikacin.(5)Patients got symptoms free after receiving intravenous antibiotics with average course of 14.45±4.89 days.Conclusion: CSLD is more common in infants,has similar clinical characters with PBB while presents with purulent bronchitis under bronchoscopy,and BALF reveals neutrophilia.Streptococcus pneumoniae is the most common pathogen,amoxicillin potassium clavulanate could be used as the first choice.While oral antibacterial drugs are less effective,intravenous antibiotics are recommended with the course of 14 days.The prognosis of CSLD is generally well,but a few children may relapse and even develop bronchiectasis. |
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