ABSTRACT
Objective To explore the expression of cytokine and Toll- like receptors(TLRs) in children′s bacterial infection and its clinical significance. Methods Sixty children patients with systemic inflammatory response syndrome(SIRS)were enrolled in this study from December 2014 to June 2016.They were infected by Gram-positive bacteria(G+), Gram-negative bacteria(G+), and regarded as G+group (30 cases) and G- group (30 cases). In addition, 20 healthy subjects were selected as control group.The levels of tumor necrosis factor(TNF)-α, interferon(IFN)-γ, interleukin(IL)-2, IL-4, IL-6, IL-10 and TLR2, TLR4 in peripheral blood were compared.Results The levels of TNF-α,IFN-γ,IL-2, IL-6 and IL-10 in G+group and G-group were significantly higher than those in the control group, and the levels of IFN-γ,IL-6,IL-10 in G+group were significantly lower than those in G+group(P<0.05). The level of TLR2 in G+group was significantly higher than that in G+group and control group(P<0.05).The level of TLR4 in G+group was significantly higher than that in G+group and control group(P<0.05). After treatment, the levels of TNF-α, IFN-γ, IL-2,IL-4, IL-6,IL-10,TLR2 and TLR4 in SIRS were significantly lower than those before treatment: (5.42 ± 1.34) ng/L vs. (9.13 ± 2.91) ng/L, (3.91 ± 1.26)ng/L vs.(6.69 ± 2.13)ng/L,(2.42 ± 0.34)ng/L vs.(3.28 ± 0.62)ng/L,(3.57 ± 0.69)ng/L vs.(4.55 ±1.17) ng/L, (18.82 ± 3.32) ng/L vs. (253.32 ± 38.21) ng/L, (14.32 ± 2.57) ng/L vs. (45.27 ± 8.24) ng/L, 0.366 ± 0.015 vs.1.084 ± 0.053, 0.424 ± 0.029 vs.0.824 ± 0.068,P<0.01.Conclusions Cytokine spectroscopy and TLRs is involved in the process of bacterial infection. Combined detection has great significance in the diagnosis of bacterial infection and identification of infection in children and can provide reference for clinic.
ABSTRACT
Objective To study the etiology of comumunity acquired pneumonia (CAP) in children of Jiaxing city and provide the basis for the clinical diagnosis and treatment.Methods An etiological study was performed on 800 young children with CAP in Jinxing First Hospital from Jan 2008 to Dec 2010.Sputum samples were collected for isolating bacteria and checking the antigen of respiratory syncytial virus ( RSV),adenovirus ( ADV),influenza virus (IV) and parainfluenza virus ( PIV ).IgM antibodies of mycoplasma pneumoniae (MP),ADV,W and PIV paired serum samples were detected.The 202 cases with positive etiology were divided into three groups:bacteria group ( 109 cases),virus group (54 cases) and MP group (39 cases).The leukocyte,C-reactive protein (CRP) and procalcitonin (PCT) were detected.Results The etiology of CAP was identified in 202 (25.25％) children of all the 800 cases,the distribution of causal agents was as follows:Streptococcus pneumoniae in 46 cases (22.77％,46/202 ),Haemophilus influenzae in 32 cases (15.84％,32/202),Staphylococcus in 5 cases (2.48％,5/202),Klebsiella pneumoniae in 8 cases (3.96％,8/202),Escherichia coli in 12 cases (5.94％,12/202),MP in 39 cases ( 19.31％,39/202),RSV in 48 cases (23.76％,48/202),ADV in 1 case (0.50％,1/202),IV in 3 cases ( 1.49％,3/202),and PIV in 2 cases ( 0.99％,2/202 ),Streptococcus pneumoniae and RSV mixed infection in 3 cases ( 1.49％,.3/202),Streptococcus pneumoniae and MP mixed infection in 3 cases ( 1.49％,3/202).RSV infection occured mainly in infants less than 1-year-old,Streptococcus pneumoniae oceured in all ages but was mostly in 1 ～ 3years,Haemophilus influenzae infection occured mainly in infants less than 3-year-old,MP infection occured mainly in infants more than six years.The PCT levels of the three groups were (7.78 ±6.14) ng/ml,(0.39 ±0.56) ng/ml,and (0.20 ±0.34) ng/ml,respectively.There were significant differences among the three groups ( P ＜ 0.05 ).Conclusion RSV infection occurs mainly in infants of age less than 1 year,Streptococcus pneumoniae and Haemophilus influenzae infection occur mainly in infants of age 1 ～3 years,while MP is the leading cause of pneumonia in children of age more than 6 years in Jiaxing city.We can decide pathogen on ages,clinical manifestation and PCT level to guide the rational use of drugs.