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Objective:To understand the epidemiology, clinical characteristics and associated risk factors of severe adenovirus(ADV)pneumonia in children, providing the basis for targeted prevention and treatment.Methods:Clinical features of children with ADV pneumonia at Children′s Hospital of Soochow University from January 2011 to December 2020 were retrospectively analyzed.According to the severity of the disease, cases were divided into severe ADV pneumonia group and common ADV pneumonia group.The epidemiological and clinical characteristics of two groups were compared, and risk factors for the occurrence of severe ADV pneumonia were analyzed.Results:A total of 1 158 patients with ADV pneumonia were enrolled, including severe ADV pneumonia 104 cases(8.98%) and ordinary ADV pneumonia 1 054 cases(91.02%).The median age of severe ADV pneumonia group was 1.17 (0.83, 2.73) years, which was significantly younger than that of common ADV pneumonia group 3.16 (1.50, 4.50) years( P<0.05), and 77.89% (81/104) of them were younger than 3 years old.The occurrence of severe ADV pneumonia was predominant in winter and spring, accounting for 71.15% (74/104).Cough was present in 89.42% (93/104) and fever in 99.01% (103/104) of the severe ADV pneumonia group.Compared with the common ADV pneumonia group, the severe ADV pneumonia group had a significantly longer febrile time[10(6, 14)d vs. 5(4, 7)d, P<0.05], significantly higher incidence of shortness of breath, wheezing, convulsions/coma[100% vs. 2.09%, 45.19% vs. 13.57%, 10.57% vs. 1.99%, P<0.05], and significantly higher incidences of emphysema, pleural effusion, bronchial signs, pulmonary solids, and atelectasis [21.15% vs. 2.09%, 5.77% vs. 0.19%, 4.81% vs. 0, 3.85% vs. 0.09%, P<0.05].Multivariable Logistic regression showed that age younger than 1.71 years old, wheezing, and the presence of underlying diseases (moderate to severe anaemia, congenital heart disease, neurological disease) were risk factors for the development of severe ADV pneumonia ( P<0.05).Receiver operating characteristic curve analysis showed that the sensitivity and specificity of age<1.71 years old(20 months old) for predicting the occurrence of severe ADV pneumonia were 65.4% and 71.5%, respectively. Conclusion:The age of most severe ADV pneumonia is less 3 years in Suzhou.It usually occurres in winter and spring, with fever, cough, shortness of breath, and wheezing as the main symptoms.Pulmonary manifestations such as pleural effusion, emphysema, pulmonary consolidation, and atelectasis may occur.The underlying disease, wheezing, and age of onset less than 1.71 years (20 months) old are independent risk factors for severe ADV pneumonia.
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Objective:To explore the clinical features of Mycoplasma pneumoniae(MP)infection in children, and provide data support for the prevention and control of MP.Methods:In this study , a retrospective analysis was used to collect clinical data with respiratory tract infection from January 2018 to February 2022 in the Shenyang Children′s Hospital, and analyze the distribution characteristics of MP positive rate, season, age, sex.Results:In this study, the positive rate of MP was 17.12% (20 299/118 598), in 2018, 2019, 2020 and 2021 were 22.92% (7 732/33 738), 15.76% (5 736/36 388), 9.81% (1 313/13 379) and 16.60% (4 954/29 849) respectively.The highest positive rates of MP in 2018 and 2019 were 27.72% (1 809/6 527) and 23.45% (1 519/6 478) in summer, respectively, 2020 was spring (19.13%, 216/1 129) and 2021 was autumn (20.09%, 1 665/8 287).The MP positive rates of infancy, early childhood, preschool age and school age were 5.89% (605/10 265), 14.35% (4 639/32 333), 18.51% (10 961/59 203) and 24.37% (4 094/16 798), and MP positive rate increased with age, the difference was statistically significant ( χ2=1 790.971, P<0.05).The positive rate of boys was 14.70% (9 586/65 206), while that of girls was 20.06% (10 713/53 392), the difference was statistically significant ( χ2=594.937, P<0.05). Conclusion:MP can occur all years round, mainly in summer and autumn.Girls are susceptible, especially common in school-age and pre-school children.Prevention and control measures should be taken as soon as possible for susceptible individuals to reduce the infection rate of MP.
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ObjectiveTo understand the epidemiological characteristics of an outbreak of respiratory tract infections caused by Mycoplasma pneumoniae （MP） in a primary school in Huzhou City， Zhejiang Province， and to provide scientific reference for future prevention and control of school outbreaks of upper respiratory tract infections caused by M. pneumoniae. MethodsAccording to the requirements for investigating respiratory infectious disease outbreaks， basic information， clinical history and epidemiological information were collected from the cases. Throat swab samples of cases for COVID-19 nucleic acid testing， influenza A and B virus antigen testing， and serum samples for detecting total antibody of mycoplasma were also collected. ResultsA total of 47 cases related to M. pneumoniae infection were identified. The first case occurred on May 4， 2022， and the cases were concentrated between May 22 and May 31， 2022. The last case occurred on June 21， marking a duration of 48 days for the outbreak. All cases were second-grade students， with an incidence rate of 35.07% （47/134） in the affected classes， with Class 206 at 53.330% （24/45）， Class 207 at 38.64% （17/44）， and Class 211 at 13.33% （6/45）. There was a statistically significant difference in the incidence rates among the classes （χ2=16.57，P<0.05）. The incidence rate was 32.39% （23/71） for boys and 38.10% （24/63） for girls， with no statistically significant difference by gender （χ2=0.48，P>0.05）. The main clinical manifestations included cough， fever， and sore throat， and some cases exhibited signs of pneumonia. Pharyngeal swabs and serum samples were collected from 27 patients. The results were negative for pharynx swab samples， and positive for total mycoplasma antibody in 12 serum samples， with a positive rate of 44.44%. ConclusionSymptoms caused by M. pneumoniae are diverse in clinical manifestations， with atypical signs and a slow progression. Early cases tend to exhibit mild symptoms. The onset of the disease is not detected in time when students are attending classes. The school morning health checks fail to promptly detect it and trigger home isolation control measures， which all contribute to the outbreak of the epidemic. Schools should conduct relevant prevention and control campaigns， improve morning and afternoon health checks， and prevent students from attending classes while sick.
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Objective To investigate and study epidemiological characteristics and risk factors of rotavirus lower respiratory tract infection in preschool children. Methods The preschool children with rotavirus enteritis and lower respiratory tract infection admitted to the hospital were retrospectively analyzed January 2021 and June 2022. The situations and risk factors of lower respiratory tract infection were evaluated by chest X-ray, serological examination and throat swab culture. Results In the 155 preschool children with rotavirus enteritis, there were 59 (38.06%) cases with lower respiratory tract infection. The results of pathogens culture showed that proportion of Haemophilus influenzae was the highest (28.81%), followed by Streptococcus pneumoniae and Klebsiella pneumoniae (18.64%, 15.25%). There were significant differences between infection group and non-infection group in age, histories of family members smoking, children's aggregated activities and family members' respiratory diseases, family members' and children' attention to hand hygiene, pregnancy outcomes, age at the first usage of antibiotics and onset seasons (P0.05). Logistic regression analysis showed that age <3 years (OR=2.962, P=0.031), history of family members' smoking (OR=2.869, P=0.035), history of family members' respiratory diseases (OR=2.354, P=0.039) and the age at the first usage of antibiotics <1 year (OR=2.622, P=0.033) were all independent risk factors of rotavirus lower respiratory tract infection in preschool children. Conclusion The preschool children with rotavirus are prone to lower respiratory tract infection. Clinically, more attentions should be payed to children with age <3 years, history of family members' smoking, history of family members' respiratory diseases and the age at the first usage of antibiotics <1 year. The targeted measures should be actively taken to prevent the risk of lower respiratory tract infection.
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Objective To explore the effect of overweight / obesity on the levels of serum immunoglobulin and IGF-1 in children with recurrent respiratory tract infection and its clinical preventive value. Methods In the study, 126 children with recurrent respiratory tract infection admitted to our hospital from January 2019 to June 2021 were included in the analysis, and the BMI standard levels of different age groups were compared to distinguish the children's body types, and then compared with the overweight/obese patients. The information of serum IGF-1 and immunoglobulin levels in infants, obese patients and normal children were analyzed and discussed, and the factors of body type, the expression of serum IGF-1 and immunoglobulin (IgG, IgA, IgM) and the relationship between repeated respiratory tract infection in children were analyzed and discussed. The association between occurrence and disease in order to guide prevention and clinical work. Statistical analysis was performed using SPSS 19.0. Results The average age of 126 children with recurrent respiratory tract infection was (5.24±2.09) years old, including 71 male children and 55 female children, 79 mild children and 47 severe children. According to the BMI standard level of age group, 39 overweight and obese children were detected in this study, 16 were thin children, and the remaining 71 children were normal. The expression levels of IGF-1 and IgG, IgA, and IgM were the lowest among the children with different disease states (P<0.05). The expression of -1, IgG, IgA, and IgM was positively correlated with the children's height, weight and BMI (all P<0.05). Conclusion The decreased expression of IGF-1, IgG, IgA and IgM was associated with the aggravation of recurrent respiratory tract infection, especially in emaciated children. It may be associated with low expression of IGF-1 and poor growth and development, low expression of IgG, IgA and IgM and poor immune level. It can actively prevent recurrent respiratory tract infection, especially severe syndrome recurrent respiratory tract infection, in children with high-risk body type, low growth and development level and immune status.
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Objective To analyze the epidemiological characteristics of pathogenic bacteria for respiratory tract infection in children with asthma to facilitate the prevention, diagnosis, and treatment. Methods Among 206 hospitalized children with asthma and respiratory tract infection from January 2019 to December 2021 were selected for analysis in this study, including 131 cases with upper respiratory tract infection and 75 cases with lower respiratory tract infection. The potential correlation between the distribution of pathogenic bacteria and drug resistance was analyzed and compared between the two groups. Results A total of 167 strains of pathogenic bacteria were detected in 131 children with upper respiratory tract infection, and 262 strains were detected in 75 children with lower respiratory tract infection. The distribution characteristics of pathogenic bacteria in children with asthma and acute upper respiratory tract infection were consistent with the total distribution characteristics. Among children with asthma and acute lower respiratory tract infection, the infection of Gram-positive bacteria was higher than that of Gram-negative bacteria in female children younger than 5 years old, and the proportion of staphylococcus epidermidis was the highest (P<0.05), The distribution characteristics of pathogenic bacteria in children of other ages and sexes were consistent with the total distribution characteristics. The resistance rate of Gram-positive bacteria to penicillin, erythromycin and clarithromycin was high, while the resistance rate of Gram-negative bacteria to ampicillin, cefazolin and cefuroxime was high. The distribution characteristics of pathogenic bacteria in children with upper respiratory tract infection and lower respiratory tract infection were consistent. Conclusion In children with pediatric asthma and respiratory tract infection, the main pathogens are Gram-negative bacteria, and the drug resistance rate is high. However, the infection of Gram-positive bacteria (mainly Staphylococcus epidermidis) in young female children under 5 years old is higher than that of Gram-negative bacteria in other children, which deserves special attention.
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Objective To analyze Pseudomonas aeruginosa (PA) infection and drug resistance in the elderly with respiratory tract infection, so as to provide a basis for the control of nosocomial infection and rational use of antibiotics. Methods The samples from elderly inpatients with respiratory tract infection were collected between March 2020 and March 2022. PA infection/colonization were investigated, and the drug resistance of pathogens was determined according to CLSI criteria (2019 version). Results There were 123 strains of PA isolated from the sputum and bronchoscopy lavage fluid of elderly patients with respiratory tract infection. The main departments with positive PA detection were respiratory department, ICU ward and neurology department. The difference of PA detection in different years was not statistically significant (P>0.05). The proportion of nosocomial infection in 2021 was lower than that in 2020 (44.44% vs 63.33%, c2=4.410, P=0.036). The resistance rate of 123 isolated PA strains to piperacillin was >90.00%, and they were resistant to ceftazidime, cefotaxime, cefepime, aztreonam and gentamicin to varying degrees. There was no significant difference in resistance rate of PA to antibiotics in different years (P>0.05). In the 123 strains of pathogens, there were 17 strains (13.82%) of carbapenem-resistant PA, and their resistance to common antibiotics was significantly higher than that of carbapenem-sensitive PA (P<0.05). Conclusion The main pathogen of nosocomial infection is PA, and the proportion of nosocomial infection shows a downward trend. The detection rate of carbapenem-resistant PA is high. In clinical treatment, targeted antibiotics can be applied.
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Objective To investigate the effect of high altitude on peak expiratory flow (PEF) in elderly patients with heart failure and respiratory tract infection and its relationship with inflammatory response. Methods A total of 380 elderly patients over 60 years old with heart failure and respiratory tract infection admitted to our hospital from January 2020 to September 2022 were selected by cluster sampling method as research objects, including 190 long-term residents in high-altitude areas and 190 long-term residents in non-high-altitude areas.Information on current diseases, peak expiratory flow (PEF) levels, and inflammatory status (serum TNF) were collected- α， CRP, PCT and IL-6 levels) and other potential influencing factors; The relevant test indexes were collected at the time of enrollment (baseline) and at the time of discharge after treatment (the shortest hospital stay of 6 days and the longest hospital stay of 21 days); To compare the effects of long-term living at high altitude on PEF level and inflammatory state. The study used spss19 0 statistical software package for analysis. Results In this study, 380 elderly patients over 60 years old with heart failure and respiratory tract infection were enrolled, including 190 long-term residents in high-altitude areas (high-altitude group) and 190 long-term residents in non-high-altitude areas (control group). The mean age of patients in the high altitude group was (66.20±6.56) years old, the proportion of male patients was 53.16%, and the proportion of patients with heart failure duration less than 5 years was 70.00%. The average age of the control group was (66.93±6.77) years old, the proportion of male patients was 53.85%, and the proportion of patients with heart failure duration less than 5 years was 71.79%. The levels of PEF, FEV1 and FVC in 2 groups were higher than the baseline level at discharge (t=2.095, 7.139, 11.047, 14.594, 14.104, 12.250, all P<0.05). And the high altitude group was significantly lower than the control group (t=5.260, 6.912, 6.262, P<0.05). The baseline levels of TNF-α, CRP, PCT and IL-6 in the high altitude group were higher than those in the control group. After treatment, the levels of several inflammation-related factors decreased in both groups, but the high altitude group was still higher than the control group. The expression levels of inflammation-related factors (TNF-α, CRP, IL-6, PCT) in subjects at high altitude were negatively correlated with the levels of lung function related indicators (PEF, FEV1, FVC) (r=-0.453, -0.496, -0.379, -0.563, -0.467, -0.522, -0.497, -0.518, -0.419, -0.416, -0.438, -0.480), and the correlation coefficients were statistically significant (P<0.05). Conclusion High altitude living factors are associated with the decrease of PEF. At the same time, it indirectly aggravates the inflammatory state of patients, and it is more difficult for therapeutic intervention to control the inflammation to the ideal level within the same time, which is worthy of clinical attention.
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Objective To analyze the epidemiological characteristics and drug resistance of pathogenic bacteria in 276 hospitalized children with lower respiratory tract infection to facilitate prevention and treatment. Methods Among of 276 hospitalized children with lower respiratory tract infection from January 2019 to December 2021 were analyzed. Data on the distribution of pathogenic bacteria were collected and analyzed. At the same time, the information on drug resistance was collected, and the potential relationship between pathogen distribution and drug resistance was briefly analyzed and discussed. Results A total of 532 strains of pathogenic bacteria were detected in the blood samples from 276 patients in this study. There were 207 strains of Gram-positive bacteria, including 104 strains of Staphylococcus aureus, 96 strains of Staphylococcus epidermidis and 7 strains of others. Gram negative bacteria (325 strains) were 172 strains of Klebsiella and 153 strains of Escherichia coli. The distribution of pathogenic bacteria in different gender and age groups (under 5 years old, 5-10 years old, and over 10 -14 years old) was calculated separately. The results showed that the distribution of pathogenic bacteria in female children under 5 years old (n=49 cases) was different from the total population: the infection of Gram-positive bacteria was higher than that of Gram-negative bacteria, and the proportion of Staphylococcus epidermidis was the highest (P<0.05). The distribution characteristics of children of other ages and sexes were consistent with the total distribution characteristics. The resistance rate of Gram-positive bacteria to penicillin, erythromycin and clarithromycin was high, while the resistance rate of Gram-negative bacteria to ampicillin, cefazolin and cefuroxime was high. The distribution characteristics were the same in children of different sex and age. Conclusion The pathogenic bacteria in children with lower respiratory tract infection in pediatric ward are mainly Gram-negative bacteria, and the main pathogenic bacteria have a high resistance rate to common drugs. The distribution of pathogenic bacteria in female children under 5 years old is unique: the infection of Gram-positive bacteria is higher than that of Gram-negative bacteria, and the proportion of Staphylococcus epidermidis is the highest, which deserves attention. The clinical drug sensitivity test can be used as an important reference for the treatment of drugs to guide the rational selection of antibiotics.
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Objective:To analyze the clinical and epidemiological features of human rhinovirus (HRV) infection in adult patients with upper respiratory tract infection (URTI) in Nanjing.Methods:Epidemiological data of adult patients with URTI in Nanjing from October 2021 to September 2022 were collected. Clinical specimens were collected and subjected to quantitative reverse transcription polymerase chain reaction (qRT-PCR) for the detection of 14 common respiratory viruses. The VP4/VP2 genes in HRV-positive samples were amplified and sequenced. Then a phylogenetic tree was constructed.Results:A total of 399 pharyngeal swabs were collected from patients with URTI. The overall positive rate of respiratory viruses was 28.07% (112/399) with HRV accounting for most at 9.52% (38/399). Thirty-seven VP4/VP2 sequences were successfully obtained from the 38 HRV-positive specimens. Three genotypes involving 25 serotypes were identified with 13 strains belonging to HRV-A, 14 belonging to HRV-B, and 10 belonging to HRV-C. The three genotypes of HRV showed alternate prevalence or co-prevalence.Conclusions:HRV was the main pathogen causing URTI in adult patients in Nanjing from October 2021 to September 2022, and three genotypes of HRV-A, B and C were prevalent alternatively or together.
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Objective:To analyze the molecular characteristics of hemagglutinin-neuraminidase (HN) gene of human parainfluenza virus type 3 (HPIV3) among the cases with acute respiratory tract infection (ARI) in Henan Province.Methods:Nasal/throat swab samples collected from patients with severe acute respiratory tract infection (SARI) in Luohe and patients with influenza-like illness (ILI) in Zhengzhou were used in this study. HPIV nucleic acids in the samples were detected using real-time fluorescent PCR. HPIV3-positive samples were subjected to RT-PCR for the amplification of HN genes and the sequences were analyzed with Sanger method. CExpress and MEGA7.0 software were used for sequences editing, evolution tree construction and gene sequence analysis.Results:A total of 374 throat swab samples collected form ARI cases in Luohe and Zhengzhou were tested and 20 (5.3%) of them were positive for HPIV3. Eighteen HPIV3 HN gene sequences were successfully amplified and all belonged to C3 subgroups, including 16 sequences of C3f genotype and two sequences of C3a genotype. The 18 HN gene sequences shared the homology of 97.6%-100.0% in nucleotide and 99.3%-100.0% in amino acid, but the differences between them and the prototype strain Wash/47885/57 were significant. There were 12 amino acid mutations shared by them, including four function-related mutations (H295Y, I391V, D556N and I53T). There were no significant differences in the nucleotide or amino acid sequences as compared with the epidemic strain of China/BCH4210A/2014.Conclusions:The C3f and C3a branches of HPIV3 were the epidemic genotypes in Henan Province in recent years and a local circulating prevalence might be established. Continuous and in-depth monitoring of HPIV3 C3 subtype would be of great significance for the prevention and control of HPIV3-associated diseases.
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Objective:To investigate the impact of SARS-CoV-2 pandemic on the prevalence of viral pathogens in hospitalized children with acute respiratory tract infections (ARTIs) in Shanghai.Methods:A total of 6 020 throat swab specimens were collected from hospitalized children with ARTIs in Shanghai Children′s Hospital from August 1, 2019 to February 28, 2022. Eleven common respiratory pathogens were detected using multiplex PCR and capillary electrophoresis. Pre-epidemic data referred to the data from August to December, 2019, and the data from August to December, 2020 and August to December, 2021 were used as the post-epidemic data for comparison. Based on the data from March 2020 to February 2022 (the epidemic period), the epidemiology of respiratory pathogens in children with ARTIs in different seasons were compared (spring: March to May, summer: June to August, autumn: September to November, winter: December to February of the next year).Results:Of the 6 020 specimens obtained from the patients, 3 753 (62.34%) were positive for at least one pathogen. Human rhinovirus (HRV) was the most commonly detected pathogen (22.76%, 1 442/6 020), followed by human respiratory syncytial virus (HRSV) (16.05%, 966/6 020). From August to December, the detection rate of single respiratory pathogen was 87.94% (569/647) in 2019, 66.21% (480/725) in 2020 and 60.33% (1 075/1 782) in 2021, and the co-infection rate was 25.66% (166/647) in 2019, 9.93% (72/725) in 2020 and 8.87% (158/1 782) in 2021, showing a decreasing trend (χ 2=165.19 and 127.79, P<0.01). Compared with the pre-epidemic period, human metapneumovirus (HMPV), HRV and human parainfluenza virus (HPIV) were the most prevalent pathogens in 2020 [4.97%(36/725), 34.21%(248/725) and 14.48%(105/725); χ 2=26.16, 42.04 and 60.52; P<0.01] and HRSV was the predominant pathogen in 2021 [21.27%(387/1 782), χ 2=44.26, P<0.01]. During the epidemic period, the detection rate of pathogens was 64.49%(1 340/2 078) in 2020, which was significantly higher than that in 2021 [57.48%(1 771/3 081), χ 2=25.43, P<0.01]. Only two respiratory pathogens, Mycoplasma pneumonia and human coronavirus, were detected in the spring of 2020; HRV, human adenovirus and HPIV were detected since the summer of 2020; influenza virus B was detected since the spring of 2021; influenza virus A was detected in only one case in 2020 and other respiratory pathogens were detected since the autumn of 2020. HRV+ HRSV were the main pathogens of co-infections. Conclusions:A series of prevention and control measures taken after the SARS-CoV-2 epidemic caused major changes in the prevalence and the epidemiology of respiratory pathogens in hospitalized children in Shanghai. With the normalization of epidemic prevention and control, the cancellation of strict epidemic prevention policy might lead to the outbreak of some pathogens (HMPV, HRV, HPIV and HRSV) and much attention should be paid to the outbreaks of other respiratory pathogen infections in children.
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Objective:To investigate the epidemiology of pathogens of acute respiratory tract infection (ARTI) in children in Guangzhou area.Methods:A total of 13 610 hospitalized children with ARTI in Guangzhou Women and Children′s Medical Center from January 2018 to December 2021 were enrolled. Throat swab specimens were collected, and fluorescent quantitative polymerase chain reaction (PCR) was performed to detect 11 respiratory pathogens, including respiratory syncytial virus (RSV), adenovirus (ADV), parainfluenza virus (PIV), human rhinovirus (HRV), human bocavirus (HBoV), human metapneumovirus (HMPV), enterovirus (EV), influenza A virus (IFA), influenza B virus (IFB), Mycoplasma pneumoniae (MP) and Chlamydia pneumoniae (CP). Grouping according to age (< one year group, one to < three years group, three to < six years group, six to 14 years group) and season. Chi-square test was used for statistical analysis. Results:At least one pathogen was detected in 6 331 cases among 13 610 patients, and the overall positive rate was 46.52%. The detection rates from high to low were as follows: RSV (13.75%(1 872/13 610)), ADV (4.82%(656/13 610)), PIV (4.82%(656/13 610)), MP (4.54%(618/13 610)), HRV (3.39%(462/13 610)), HBoV (2.64%(359/13 610)), HMPV (2.59%(352/13 610)), EV (1.76%(239/13 610)), IFA (1.29%(176/13 610)), IFB (0.90%(122/13 610)) and CP (0.30%(41/13 610)). The positive rate of viral detection showed significant differences among different age groups ( χ2=49.91, P<0.001), and the highest positive rate was in the age group of one to <three years (50.83%(2 196/4 320)). The positive rate of viral detection showed a significant difference in terms of seasonal distribution ( χ2=13.90, P=0.003), with a peak prevalence in summer (48.76%(1 498/3 072)). Conclusions:RSV, ADV, PIV, MP and HRV are important pathogens causing ARTI in children in Guangzhou area. The distribution of pathogens in children with ARTI is associated with age and season.
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Cholestatic jaundice is rare in patients with Graves' disease and is generally considered to be a complication of Graves' disease or an adverse reaction to methimazole. We report a case of acute cholestatic jaundice caused by Graves' disease complicated with upper respiratory tract infection in Jinan Central Hospital. After timely treatment with glucocorticoid, the jaundice quickly subsided and the liver function gradually returned to normal. We believe that Graves' disease combined with upper respiratory tract infection can lead to cholestatic jaundice, the pathogenesis of which may be immune dysfunction, and glucocorticoid therapy is beneficial to the regression of jaundice.
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Objective To analyze the risk factors of mycoplasma pneumoniae (MP) infection and recurrent respiratory tract infection (RRTI) in children, and to provide reference for early clinical intervention. Methods A total of 648 RRTI children admitted to our hospital from October 2018 to December 2020 were selected. Serum MP antibody levels were detected by semi-quantitative method. According to whether the children were combined with mycoplasma infection, they were divided into experimental group (MP positive, n=283) and control group (MP negative, n=365). Age, gender, body mass index, nutrient deficiency, preterm birth, anemia, onset season, collective living, antibiotics application were collected from the two groups. Logistic regression was used to analyze the independent risk factors of MP infection in RRTI children. Results Among of 648 RRTI children, 283 (43.67%) had MP infection. There was no statistical significance in MP infection of pneumonia in children of different ages and genders between the two groups (P>0.05).There were statistically significant differences between the two groups in nutrient deficiency, onset season, length of hospital stay, days of fever, group living, application of antibiotics and invasive operation (P<0.05). Logistic regression analysis showed that the onset season, length of hospital stay, group living were independent risk factors for MP infection in RRTI children (P<0.05). Conclusion The risk of MP infection in RRTI children is higher, and the main risk factors are onset season, length of hospital stay, group living and application of antibiotics.
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Background:In summer due to heat there may occur shortage of water so people try to get water from anywhere, even purification system is weak due to water shortage causing chance of water getting infected from various bacilli causing water borne diseases like Diarrhoea, Dysentery, Cholera, Typhoid etc. Some other factors like eating ice-creams, ice-gola, out-side unhygienic food, swimming in unclean swimming pool plays important role in development of acute diarrhoea. This study has been done in order to study role of Zingiber in reducing duration, intensity and frequency of summer diarrhoea. So that morbidity due to summer diarrhoea as well as general condition of the patients can be taken care of effectively, gently in a cost-effective manner. Material and Methods:This study is a prospective, clinical, interventional study .Sample of 30 cases had been selected by simple randomized method from Bhavnagar district from Swami Vivekananda homoeopathic medical college and hospital as well as my private OPD at Vrushti Homoeopathic clinic,Jail Road, Bhavnagar. Result:In this study age group of 0-3 and 3-6 are found more liable to get summer diarrhoea .As far as sex distribution is concern male: female is almost same. Cold food, cold drink, ice gola, out-side food, drinking impure water and swimming are found as major causative factors. As far as miasms are concern more cases (almost 60%) are found to have psora in background.Zingiber was used in various potencies in diarrhoea cases and assessment was done on the basis of improvement in terms of reducing intensity, duration and frequency of cases of acute summer diarrhoea. Purposive Sampling for research purpose has been done. Selection of the medicine is according to totality of symptoms. Selection of the potency and repetition was based on laws of Homeopathic Posology which is described in Organon of medicine. Cases were followed for 6 months. Conclusion:There is a better scope in Homoeopathic for the treatment of summer diarrhoea, since the treatment is based on holistic and individualistic approach. A homoeopathic remedy Zingiber not only annihilates the disease but also prevents the complications associated with it.
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Background: Acute respiratory tract infections (ARTIs) are a major burden to child health in developing countries like India. Preschool children have 4–8 episodes of the upper respiratory tract infection (URTI) per year on average, while school-aged children experience 2–6 episodes per year. They are the most prevalent reason for visits to the outpatient section of a hospital and general practice. Aim and Objective: The aim of this study was to evaluate the prescribing patterns in patients aged 1–18 years with URTIs. Materials and Methods: A prospective study conducted in the department of pharmacology at a tertiary health care center. Two hundred and fifty patients with URTI visiting pediatric and ENT department of tertiary health care center during December 2014–June 2015 were studied. Data included detailed history, physical examination, investigations, antimicrobial treatment given, and other treatment given were noted. This data was gathered from the records of Pediatric and ENT department. Statistical tests were used to analyze the data. Results: The most common clinical presentation was fever and cough. The common diagnosis noted in the study were non-specific URTI, tonsillitis, and sinusitis. Antipyretics (99.6%) and antibiotics (52%) were the frequently prescribed drugs among the patients. Amoxicillin-clavulanic acid and cephalosporins were the common antibitoics prescribed. Beta-hemolytic streptococci were the common microbe isolated among the patients tested to know the etiology. Conclusion: Antipyretics (99.6%) and antibiotics (52%) were the frequently prescribed drugs among the patients. Antibiotics were prescribed in most of the non-specific URTI and pharyngitis which is a matter of concern.
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Background: Breast milk contains some proteins whose functions are not nutritive but anti-infective, which prevents infants from infections. Objective: The objective of the present study was to evaluate an association between the occurrence of diarrhea and respiratory tract infection (RTI) and breastfeeding among infants of Muslim mothers in Kolkata. Materials and Methods: An observational cross-sectional community-based study was conducted among mother–infant pairs of a total of 540 numbers in Muslim-dominated urban slums of Kolkata. The study period was from November 1, 2017, to October 31, 2018. Results: The findings indicated that 82.22% of breastfed infants had no diarrhea, and the absence of RTI was observed in 69.81%. It was also noted that both episodes of diarrhea and RTI in infants become less when the duration of breastfeeding increases. The study also significantly (P < 0.001 and P = 0.03) revealed that the occurrence of diarrhea and RTI was found to have lower incidence in colostrum-fed babies. Out of 391 colostrum- fed babies, about 85.42% had no diarrhea, and the absence of RTI was noticed in 72.12%. In conclusion, breast milk gives protection to babies against diarrheal diseases and RTI. It is the most appropriate food for infants. Conclusions: It is concluded that the prevention of RTI and diarrhea in infants, exclusive breastfeeding (EBF), early initiation of breastfeeding, and avoidance of bottle feeding should be the best practice to be recommended. To explore appropriate intervention strategies for reinforcing early initiation and continuation of EBF from birth to 6 months of life.
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Acute respiratory tract infections (ARIs) are a major cause of morbidity and mortality in under?five children worldwide. Assam has around 2500 river islands (locally called Chars/Chaporis) in the Brahmaputra River with socioeconomically deprived inhabitants lacking access to basic health?care facilities. A community?based cross?sectional study was carried out among 380 under?five children living in the Char areas of Tinsukia District to estimate the prevalence of ARI and determine the associated risk factors. The prevalence of ARI among under?five children was found to be 56.32%. Prevalence was significantly higher among children living in Dibru?Saikhowa island, with families having >2 children, belonging to socioeconomic class 5 (modified BG Prasad scale), having a positive history of smoking or ARI in family members, having homes with attached kitchens or using wood for cooking, inadequate ventilation or overcrowding and residences of katcha ghars.
ABSTRACT
Group A Streptococcus (GAS), also known as Streptococcus pyogenes, is one of the key pathogenic bacteria leading to bacterial infection in children.GAS infection can result in both non-invasive and invasive infections.GAS plays a crucial role in contributing to childhood respiratory tract infections, including pharyngitis, tonsillitis and pneumonia.In order to improve clinical understanding of GAS, the relationship between GAS and respiratory tract infections were introduced from the aspects of epidemiology, pathogenesis, clinical characteristics, diagnosis and treatment.