5岁以下儿童重症肺炎的临床微生物学研究

Madhuvan Gupta, Mohit Gupta, G. Singh
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摘要

背景:肺炎是全球5岁以下儿童发病和死亡的主要原因。世卫组织制定并传播了一种用于识别和治疗肺炎的简单病例定义,可供资源贫乏环境中的现场工作人员使用。材料与方法:本前瞻性横断面研究于2018年5月至2019年4月在印度帕尼帕特Israna N.C.医学院和医院儿科和微生物学系进行,为期一年。共有150名5岁以下的儿童被纳入研究。结果:本研究共检查150例,其中0 ~ 1岁占46%,1 ~ 2岁占32.67%,2 ~ 5岁占21.33%。男性占66%,女性占34%。147例(98%)患儿有发热史,150例(100%)患儿以咳嗽、呼吸急促、胸闷为最常见症状,61例(40.67%)患儿出现不能进食或拒绝进食,33例(22%)患儿出现肝脾肿大。按WHO分级记录病情严重程度,94例(62.67%)出现重症肺炎,56例(37.33%)出现极重症肺炎。血培养阳性患儿占22.67%(22.67%),鼻咽吸痰阳性患儿占36.67%。从血液和鼻咽培养中分离到的最常见的细菌是金黄色葡萄球菌(10.67%),其次是肺炎链球菌(4.67%)。结论:血培养中以肺炎链球菌为主,鼻咽吸入物以金黄色葡萄球菌为主。我们的研究强调使用血液培养和鼻咽吸气培养来确认肺炎的细菌性病原体。
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Clinico-microbiological study of severe pneumonia in below five years age of children
Background: Pneumonia is the leading cause of childhood morbidity and mortality under five-yearold children globally. WHO developed and disseminated a simple case definition for identification and treatment of pneumonia, which could be used by field-workers in resource poor settings. Materials and Methods: This prospective and cross sectional study was conducted at Department of Pediatrics and Department of Microbiology, N.C. Medical College and Hospital, Israna, Panipat, India, over a period of one year from May 2018 to April 2019. Total 150 children below 5 years of age were included in the study. Results: Total 150 cases examined in the study out of which 46% children belonged to 0-1 year of age, 32.67% 1-2 years and 21.33% children from 2-5 years. Males were 66% and females 34%. 147 (98%) children had fever history, 150 (100%) children had cough, tachypnea and chest in drawing which were the most common symptom observed in the study, followed by inability to take food or refusal was observed in 61 (40.67%) children, hepato splenomegaly was observed in 33 (22%). Severity of the disease was recorded according to WHO classification, severe pneumonia was observed in 94 (62.67%) and very severe pneumonia was observed in 56 (37.33%) Blood cultures were positive in 22.67% children (22.67%) and nasopharyngeal aspirates were positive in 36.67% children. The most common organism isolated from blood and nasopharyngeal culture was Staphylococcus aureus (10.67%) followed by Streptococcus pneumoniae (4.67%). Conclusions: Streptococcus pneumoniae and Staphylococcus aureus predominate in blood culture and nasopharyngeal aspirates respectively. Our study highlights the use of blood culture and nasopharyngeal aspirates culture to confirm the bacterial pathogens of pneumonia.
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