ABSTRACT
Objective:To discuss the changes and clinical significance of CD4 -CD8 -double negative T lymphocytes (DNT), T lymphocyte subsets, natural killer (NK) cells and CD 19+ B lymphocytes in peripheral blood of children with confirmed Mycoplasma pneumoniae pneumonia(MPP). Methods:A retrospective analysis was conducted on children with pneumonia admitted to the Children′s Hospital of Shanghai Jiaotong University from January 2019 to February 2020.The patients were stratified into 3 age groups: 0-3 years old, 4-7 years old and ≥8 years old, and they received detection of peripheral blood T lymphocyte subsets in acute stage.As observation group, 185 MPP children were further divided into MPP common group (117 cases) and MPP severe group (68 cases) based on their state of pneumonia.In addition, 69 cases with non-MPP were selected as control group.The absolute counts of DNT, T lymphocyte subsets, NK cells and CD 19+ B lymphocytes in peripheral blood were tested by flow cytometry.DNT levels in diffe-rent age groups were analyzed. Results:(1) The number of CD3 + [1.527(1.059, 2.348)×10 9/L], CD4 + [0.771(0.559, 1.206)×10 9/L], CD8 + [0.528(0.343, 0.773)×10 9/L], CD4 + /CD8 + [1.570(1.130, 1.945)], CD 19+ [0.455(0.285, 0.771)×10 9/L] and DNT[0.168(0.095, 0.294)×10 9/L] lymphocytes in peripheral blood in the observation group were lower than those in the control group[2.116(1.506, 3.728)×10 9/L, 1.170(0.685, 2.114)×10 9/L, 0.696(0.414, 1.226)×10 9/L, 1.780(1.230, 2.210), 0.694(0.483, 1.343)×10 9/L, 0.235(0.134, 0.391)×10 9/L], and the differences were statistically significant (all P<0.05). (2) In addition, the number of CD3 + [1.704(1.215, 2.566)×10 9/L], CD4 + [0.855(0.628, 1.267)×10 9/L], CD8 + [0.582(0.378, 0.843)×10 9/L], NK[0.269(0.176, 0.417)×10 9/L], CD 19+ [0.461(0.317, 0.808)×10 9/L] and DNT[0.180(0.117, 0.306)×10 9/L]lymphocytes in peripheral blood in MPP common group were significantly higher than those in MPP severe group [1.369(0.831, 1.760)×10 9/L, 0.676(0.433, 0.924)×10 9/L, 0.495(0.292, 0.699)×10 9/L, 0.196(0.112, 0.380)×10 9/L, 0.391(0.181, 0.730)×10 9/L, 0.143(0.071, 0.265)×10 9/L], and the differences were statistically significant (all P<0.05). (3) Moreover, in acute phase, the number of DNT in observation group had no significant differences with that in control group of the same age ( P>0.05). In the observation group, the number of DNT[0.230(0.125, 0.364)×10 9/L] in 0-3 years old group was higher than that in 4-7 years old group[0.143(0.085, 0.233)×10 9/L] and ≥ 8 years old group[0.144(0.078, 0.271)×10 9/L]. In 0-3 years old group, the more serious the disease, the lower the indicators, and the differences were statistically significant (all P<0.05). Conclusions:In acute phase, the changes of lymphocyte subsets in peripheral blood of MPP children are remarkable, and the absolute count of DNT lymphocytes in peripheral blood decreased.The decreasing level of DNT has negative association with the severity of pneumonia.The absolute count of DNT was higher in young children.So monitoring peripheral blood DNT may be of some value to the assessment of immune function or pneumonia state in children with MPP.
ABSTRACT
In recent years, the incidence of mycoplasma pneumoniae pneumonia (MPP) has gradually increased, and in infant population, it has an increasing trend.The proportion of severe mycoplasma pneumoniae pneumonia (SMPP) has also increased relatively.In addition to causing respiratory symptoms, SMPP is also prone to complicating extrapulmonary complications, accumulating serious diseases such as the circulatory system, nervous system, blood system, and digestive system, which seriously affect children′s health.Researchers at home and abroad have done a lot of research on its pathogenesis, and found that its pathogenesis is not completely clear, but it is closely related to immune disorders, mainly including immunoglobulin, T lymphocyte subsets, complement, cytokines, affecting the occurrence, development and prognosis of SMPP.Pediatricians should be familiar with changes it′s immune function and then combine clinical manifestations, to make early diagnosis and treatment to improve the prognosis of children.This article reviews the changes of immune function in SMPP.
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Objective To describe the profile of probiotics utilization in hospitalized pneumonia children and evaluate the ef -fectiveness of probiotics in the treatment of pneumonia in hospitalized children combined with antibiotics. Methods Descriptive data a-nalysis was obtained from the medical records in one children′s hospital in one year period. The clinical data including patient charac-teristics, drug prescribed time, drug use duration, and length of stay was reviewed. Ridit analysis was used to compare the data. Re-sults Data of 2 974 children hospitalized for pneumonia was accessed. Antibiotics were prescribed to 99.1 % ( n=2 948) of pa-tients, probiotics were prescribed to 42.1%(n=1 252) of patients, and both antibiotics and probiotics were prescribed to 41.9%(n=1 246 ). The median of the time to start administration of probiotics was the second day of hospitalization and the mode was the first day of hospitalization. For those patients who were prescribed antibiotics combined with probiotics, the median of the duration of ad-ministration of antibiotics before accepting probiotics was 3 days and the mode was 1 day.After administrating probiotics, the median of the duration of accepting of antibiotics was 5 days, the mode was 4 days, and the median and the mode of the duration of administration of probiotics were 4 days.21%(n=626) of all hospitalized patients were administrated anti-diarrheals.The most common age group of them were neonates and infants (82.3%, n=515).The patients with anti-diarrheal who was administrated antibiotics with or with-out probiotics were 585(47.0%), 34(2.0%), respectively (P<0.05).The median of duration of anti-diarrheals in those adminis-trated antibiotics with probiotics was 4 days, the mode was 3 days and the interquartile range was 2-6 days.For those administrated an-tibiotics without probiotics, the median of duration of anti-diarrheals was 3 days, the mode was 1 day and the interquartile range was 1-6 days (P>0.05).The median of the length of stay in those administrated antibiotics with probiotics was 7 days, the mode was 6 days and the interquartile range was 6-9 days.For those administrated antibiotics without probiotics, the median and the mode of the length of stay were 7 days and the interquartile range was 6-9 days(P>0.05).Conclusion The time of starting to administrate probiotics was mainly within 2 days combined with antibiotics. The aim of prescribed probiotics was prevention of antibiotic-associated diarrhea. There was no significant difference in the duration of the following antibiotic therapy, the duration of anti-diarrhea therapy, the length of stay between those administrated antibiotics combination with or without probiotics.
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Moraxella Catarrhalis emerged as the third cause of respiratory tract infection in children.Over 90% of the Moraxella Catarrhalis strains isolated currently produced by β-lactamases positive.Moraxella Catarrhalis resist to Ampicillin because of the β-lactamases,such as the BRO-1 type,BRO-2 type and BRO-3 type.The BRO genes appeared to be located on the chromosome and be coded.Twenty-one new mutations were found in the putative promoter region of the BRO genes.