■长期细菌性支气管炎(PBB)通常根据慢性湿咳进行临床诊断,可以通过适当的抗生素解决。虽然很少在PBB诊断中进行,痰或支气管肺泡灌洗(BAL)液的细菌培养可以提供病因学特征,这在西方国家和中国的不同地区可能是不同的。本研究旨在探讨中国东北地区不同年龄多溴联苯患儿的临床和病原学特征及转归。
■我们回顾性分析了2017年至2021年间通过BAL液或痰细菌培养阳性诊断为PBB的儿童。儿童分为三个年龄组:<1岁(婴儿),1-5岁(年龄较小的儿童),和≥6岁(年龄较大的儿童)。临床特征,胸部影像学检查结果,支气管镜检查结果,微生物学发现,治疗策略,对各年龄组的结局进行回顾和比较.随访期间与缓解相关的因素采用logistic回归分析。
■共包括45名PBB儿童,由24名(53.3%)婴儿组成。婴儿通常是男孩,咳嗽持续时间较短,咳痰的比例较低,喘息的比例更高,与年龄较大的儿童相比,高分辨率计算机断层扫描的支气管壁增厚较少(P<0.05)。在宏观发现方面,各年龄组之间没有发现显着差异,婴儿气管支气管软化的比例高于年龄较大的儿童(P=0.013)。最常见的培养细菌是流感嗜血杆菌(42.2%),其次是肺炎链球菌(22.2%)和肺炎克雷伯菌(20.0%)。与年龄较大的孩子相比,婴儿的缓解率较高(P=0.009),复发率相对较低(P=0.059).咳嗽持续时间短(OR=0.58,95%CI:0.34-0.99,P=0.046)和诊断前没有头孢菌素类药物复发(OR=0.05,95%CI:0.00-0.73,P=0.028)与缓解有关。
■婴儿更容易感染多溴联苯,增加喘息。革兰阴性杆菌感染在中国东北地区的婴儿中很常见。应该仔细评估患有多溴联苯的年龄较大的儿童,治疗和随访,特别是那些长时间咳嗽和对抗生素治疗反应不佳的人。
UNASSIGNED: Protracted bacterial bronchitis (PBB) is often diagnosed clinically according to chronic wet cough, which can be resolved by appropriate antibiotics. Though rarely performed in PBB diagnosis, bacterial cultures by sputum or bronchoalveolar lavage (BAL) fluid can provide etiological features, which may be different in western countries and different areas of China. This study aimed to investigate the clinical and etiological features and outcomes in children of different ages with PBB in northeast China.
UNASSIGNED: We retrospectively analyzed children diagnosed with PBB by positive BAL fluid or sputum bacterial cultures between 2017 and 2021. Children were divided into three age groups: <1 year (infants), 1-5 years (younger children), and ≥6 years (older children). Clinical characteristics, chest radiographic findings, bronchoscopy findings, microbiological findings, treatment strategies, and outcomes were reviewed and compared among the age groups. Factors associated with remission during follow-up were examined using logistic regression.
UNASSIGNED: A total of 45 children with PBB were included, consisting of 24 (53.3%) infants. The infants were often boys and had a shorter cough duration, a lower proportion of expectoration, a greater proportion of wheezing, and less bronchial wall thickening on high-resolution computed tomography compared to older children (P < 0.05). No significant differences were found among the age groups regarding macroscopic findings, except for a higher proportion of tracheobronchial malacia in infants than in older children (P = 0.013). The most commonly cultured bacteria were Haemophilus influenzae (42.2%), followed by Streptococcus pneumoniae (22.2%) and Klebsiella pneumoniae (20.0%). Compared to older children, infants had a higher remission (P = 0.009) and relatively lower relapse rates (P = 0.059). Short duration of cough (OR = 0.58, 95% CI: 0.34-0.99, P = 0.046) and absence of recurrent cephalosporins before diagnosis (OR = 0.05, 95% CI: 0.00-0.73, P = 0.028) were associated with remission.
UNASSIGNED: Infants are more prone to PBB, with increased wheezing. Gram-negative bacilli infections are common in infants in northeast China. Older children with PBB should be carefully assessed, treated and followed up, particularly those with long duration of cough and poor response to antibiotic treatments.