Clinical Analysis Of Acute Lower Respiratory Tract Infection With Wheezing In Hospitalized Children Under 6 Years Of Age Under The Epidemic Situation Of Novel Coronavirus Infection

Objective:To study the incidence and severity of acute lower respiratory tract infection with wheezing in hospitalized children under 6 years old before and after the COVID-19 pandemic,as well as the changes in the distribution of sputum culture bacteria and drug resistance.Materials and methods:The data is sourced from the Pediatric Inpatient Electronic Medical Record System of the First Affiliated Hospital of Nanchang University.The study subjects were children under 6 years old who were hospitalized from January 1,2017 to December 31,2022 due to acute lower respiratory tract infection accompanied by wheezing.The study subjects from 2017 to 2019 were set as the control group,and the study subjects from 2020 to 2022 were set as the observation group.Clinical data such as age,gender,admission time,onset to admission time,hospitalization time,wheezing relief time,systemic hormone use,sputum culture results,and drug sensitivity results were collected.Using SPSS 26.0 to analyze data,chi square test was used for comparison of count data,and non parametric rank sum test was used for comparison of measurement data.All test levels were specified as α=0.05.Results:A total of 809 children under 6 years of age were hospitalized due to acute lower respiratory tract infection with wheezing from the observation group,and a total of 536 children were hospitalized from the control group.The proportion of hospitalized children under 6 years of age with acute lower respiratory tract infection with wheezing in the observation group was significantly higher than that in the control group(r<0.05).Male children accounted for 73.3% in the observation group,significantly higher than 67.2% in the control group(r<0.05).In the observation group,77.6% of children aged ≤ 3 years were significantly lower than83.2% in the control group(r<0.05).The hospitalization season from the observation group was mainly distributed in autumn and winter,while from the control group,it was mainly distributed in winter and spring,with a statistically significant difference(r<0.05).The median number of days from onset to admission in the observation group was 4(2-7)days,which was significantly different from the median number of days in the control group of 5(3-9.75)days(r<0.05).There was no significant difference between the two groups in the proportion of allergic history and wheezing history(r>0.05).There was no significant difference in the duration of wheezing relief,length of stay,and systemic hormone use among hospitalized children with acute lower respiratory tract infection and wheezing under the age of 6years from the observation group compared to the control group(r>0.05).There was no difference in the sputum culture detection rate between the observation group and the control group(r>0.05),but the overall positive rate of sputum culture in the observation group was significantly lower than that in the control group(r<0.05).Among them,there was no statistically significant difference in the positive rates of Staphylococcus aureus,Streptococcus pneumoniae,Moraxella catarrhalis,and Pseudomonas aeruginosa(r>0.05).The positive rates of Escherichia coli,Klebsiella pneumoniae,and Baumannia/Acinetobacter hemolyticus significantly decreased,while the positive rates of Haemophilus influenzae significantly increased(r<0.05).Before and after the epidemic,Gram negative bacteria were mainly distributed.There was no statistically significant difference in the proportion of Gram negative bacteria between the observation group and the control group(r>0.05).The proportion of Escherichia coli,Klebsiella pneumoniae,and Baumannia/ Acinetobacter hemolyticus significantly decreased,while the proportion of Haemophilus influenzae significantly increased(r<0.05).There was no significant difference in the resistance rate of commonly used antibiotics among Haemophilus influenzae,Staphylococcus aureus,Streptococcus pneumoniae,Moraxella catarrhalis,and Escherichia coli before and after the epidemic(r>0.05).Conclusions:1.The proportion of hospitalized children under 6 years old and those in the age group over 3 years old who were hospitalized due to acute lower respiratory tract infections with wheezing from 2020 to 2022 has significantly increased compared to 2017 to 2019,and the seasonal distribution has undergone significant changes.These changes maybe related to the prevention and control measures taken during the epidemic.2.Compared with 2017-2019,the severity of acute lower respiratory tract infections with wheezing in hospitalized children under the age of 6 did not significantly worsen or decrease from 2020 to 2022.3.Compared with 2017-2019,the positive rate of sputum culture in hospitalized children with acute lower respiratory tract infection and wheezing under the age of 6 significantly decreased from 2020 to 2022,but the positive rate of Haemophilus influenzae significantly increased.Attention should be paid to the role of Haemophilus influenzae in pediatric respiratory tract infections.