Readmission Of Children With Bronchopulmonary Dysplasia For Respiratory Tract Infection:Clinical Analysis Of 156 Cases

Objective : To summarize the clinical features of children with bronchialpulmonary dysplasia(BPD)who rehospitalize due to respiratory tract infection.method:The clinical data of 361 readmissions of children with BPD for respiratory tract infection were retrospectively analyzed.Results:Among the 156 cases of BPD,46 cases were rehospitalized for over 3 times,a total of 220 readmissions,103 cases were positive for sputum culture alone(47.5%),35 cases were positive for sputum culture and virus detection(16.1%);110 cases were rehospitalized less than 3times,a total of 141 readmissions,47 cases were positive for sputum culture alone(34.6%),31 cases were positive for sputum culture and virus detection(22.8%).Sputum cultures were positive for gram-negative bacilli mainly,and there was no statistically significant difference in gram-negative bacilli positive in sputum culture between the group with over 3 times of rehospitalization and the group with less than 3 times ofrehospitalization.In cases which were positive for Sputum culture,the most commom bacteria was klebsiella pneumoniae,e.coli and haemophilus influenzae were the second;Respiratory syncytial virus and parainfluenza virus 3 were the most common viruses in cases which were positive for virus detection.The mean length of hospital stay in the group which was positive for sputum culture and virus detection was12.4 ? 7.5 days,higher than the other 3 groups,and the difference was statistically significant.265 cases received chest imaging examination,among whom 139(52.5%)had consolidation and atelectasis,54(20.4%)had cystic lucent shadow,3(1.1%)had bronchiectasis,2(0.8%)had thickening of bronchial wall,and 10(3.8%)had fibrosis.conclusion:Gram-negative bacilli infection is common in children with BPD rehospitalized due to respiratory tract infection,suggesting that antibiotics such as third generation of cephalosporin should be selected firstly;Both sputum culture and virus detection positive group had a longer hospital stay,which may be related to the synergistic effect of mixed infection of bacteria and virus on lung injury,including impaired epithelial barrier and immune dysfunction;The interval between two consecutive readmissions was short,and sputum culture were often the same kind of bacteria,suggesting that the clinical treatment course of antibiotics for those children may need to be extended appropriately;The incidence of recurrent respiratory infection is high in children with BPD,and thepositive rate of gram-negative bacilli in sputum culture is high.Therefore,it is necessary to be vigilant that the inflammatory reaction caused by repeated gram-negative bacilli infection or colonization will further damage the lung structure and affect the prognosis of children with BPD.Long-term follow-up should be further conducted for these children.