ABSTRACT
<p><b>OBJECTIVE</b>To investigate the infection rate and genotypes of Mycoplasma pneumoniae (MP) by examining bronchoalveolar lavage fluid from children with community acquired pneumonia (CAP).</p><p><b>METHODS</b>Polymerase chain reaction (PCR) was used for detecting MP in bronchoalveolar lavage fluid from 220 children hospitalized with CAP, and the accuracy was confirmed by quantitative real-time PCR. Positive samples were digested with HaeⅡ and Hae Ⅲ and compared with standard strain to analyze the genotypes of MP from positive samples. The accuracy of genotyping was confirmed by sequencing the amplified products of some randomly selected positive samples.</p><p><b>RESULTS</b>The positive rate of MP in 220 samples was 55.0% (121/220). MP infection occurred mostly in preschool and school-age children (63.5%, 101/159), and the lowest positive rate was seen in children aged under 6 months (20%, 1/5). The positive rate showed no significant differences between sexes and between seasons. Sixty randomly selected MP-positive samples showed a genotype of P1 type 1 after restriction digestion, which was further confirmed by sequencing of 4 samples.</p><p><b>CONCLUSIONS</b>MP is one of the main pathogens of pneumonia in children, and the MP infection rate is significantly correlated with age. The dominant genotype of MP in children is P1 type 1.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Genotype , Hospitalization , Mycoplasma pneumoniae , Classification , Genetics , Phylogeny , Pneumonia, Mycoplasma , Microbiology , Real-Time Polymerase Chain Reaction , SeasonsABSTRACT
Objective To evaluate the value of bacteria culture and antimicrobial susceptibility test of bronchoalveolar lavage fluid(BALF) in diagnosis and treatment of refractory pneumonia in children.Methods Three hundred and sixty-eight patients who failed to a 2 weeks,routine antibiotic therapy,hospitalized in Department of Respiration,Tianjin Children's Hospital from Aug.2010 to Dec.2011,were diagnosed as refractory pneumonia.They were examined with fiberoptic bronchoscopy,BALF was collected,and bacteria culture and antimicrobial susceptibility test in BALF were performed.Results One hundred and ninety-five stains of bacteria were identified from BALF of 181 cases.There were 10 (5.1％) gram-positive stains (7 Streptococcus pneumonia and 3 Staphylococcus aureus),48 stains (24.6％) were gram-negative bacterial,and the predominant were Pseudomonas aeruginosa (23 stains,11.8 ％),followed by Serratia marcescens and Stenotrophomonas maltophilia (6 stains respectively,3.1％).There were 1 Staphylococcus aureus with positive beta-lactamases and 1 Pseudomonas fluorescens with positive AmpC enzyme.There were 1 fungi (0.5％)and 136 parasitic bacteria stains(69.7％).Gram-positive stains were universally resistant to Erythromycin,Penicillin,Cefuroxime,and susceptible to Chloramphenicol,Levofloxacin,Vancomycin.Gram-negative stains were universally resistant to Ampicillin,Cefazolin,Cefuroxime,Cefotaxime,and susceptible to Amikacin,Cefepime,Cefoperazone sulbactam,Meropenem,Imipenem,Levofloxacin,Ceftazidime,Piperacillin.There were mixed infection in most children and the predominant pathogen was Mycoplasma pneumoniae.Conclusions Bacteria culture of BALF is relatively reliable and instructively recommended for the treatment of refractory pneumonia in children,meanwhile,it can help choose the antibiotics reasonably.
ABSTRACT
<p><b>OBJECTIVE</b>To study the significance and safety of flexible bronchoscopy and balloon dilatation in the diagnosis and treatment of respiratory diseases in children.</p><p><b>METHODS</b>A total of 438 children (236 males and 202 females) with respiratory diseases who were aged from 17 days to 15 years, were examined and/or treated by bronchoscopy (including bronchoscopic intervention) under local anesthesia.</p><p><b>RESULTS</b>Of the 438 children, 311 were diagnosed with pulmonary infection, 68 with atelectasis, 36 with recurrent cough and asthma, 6 with hemoptysis of unknown origin, 6 with bronchial foreign body, 5 with congenital bronchopulmonary dysplasia, 2 with bronchiectasis, 1 with ciliary dyskinesia syndrome, 1 with lung tumor, and 2 with congenital immunodeficiency disease. After bronchoscopic examination, local flushing or bronchoalveolar lavage, and foreign body extraction, marked response was seen in 379 cases and response was seen in 46 cases. High-pressure balloon dilatation under bronchoscopy was performed in 5 cases with inflammatory stricture and achieved satisfying clinical effect. No severe complications were found in bronchoscopy.</p><p><b>CONCLUSIONS</b>Bronchoscopy and balloon dilatation under local anesthesia is safe and effective for the diagnosis and treatment of respiratory diseases in children.</p>