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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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Objective To analyze the epidemiological characteristics and risk factors of antibiotic-associated diarrhea (AAD) in children with pneumonia in Chongzhou, Sichuan Province, and to provide a theoretical basis for the diagnosis and treatment of AAD in children with pneumonia. Methods A total of 394 children with pneumonia admitted to our hospital from June 2018 to June 2021 were selected and divided into control group and AAD group according to whether the children had AAD. Univariate analysis and logistic regression were used to analyze the risk factors of pediatric pneumonia complicated with AAD. Results There were 79 cases of children with pneumonia complicated with AAD (20.05%). The average age of the ADD group was significantly lower than that of the control group (P<0.05). There were significant differences between the two groups in age of onset, length of hospital stay, type of antibiotics combined use, duration of antibiotics application, proportion of bacterial use of probiotics, and type of antibiotics (P<0.05). The age of onset <3 years old, duration of antibiotics application ≥5 days, combined use of three kinds of antibiotics, use of cephalosporin antibiotics, and no use of probiotics are independent risk factors for AAD in children with pneumonia. Conclusion The risk of AAD in children with pneumonia in Chongzhou is high, and the main pathogens are Candida and Escherichia coli. For children with cephalosporin antibiotics use, long application time of antibiotics, and onset age <3 years old, early application of probiotics should be done to reduce the risk of pediatric pneumonia complicated with AAD.
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Objective To study the clinical application effect of risk preventive nursing on children with pneumonia and their rehabilitation. Methods One hundred children with pneumonia admitted to Xiaoyi People's Hospital from March 2016 to March 2017 for treatment were enrolled. Among them, 45 cases from March the 1st to August the 1st in 2016 were treated with conventional nursing (conventional nursing group), while 55 cases from August the 2nd, 2016 to March the 1st, 2017 were taken cared by the risk prevention nursing (risk prevention group). The levels of tumor necrosis factor-α (TNF-α), interleukins (IL-6, IL-8) were examined on admission and discharge in the two groups by enzyme-linked immunosorbent assay (ELISA); the time length for clinical symptoms to disappear, rehabilitation effect, hospitalization time, family members' satisfaction and incidence of complications were observed in the two groups. Results No statistically significant differences were detected in serum TNF-α, IL-6 and IL-8 levels between the two groups before nursing (all P > 0.05).The levels of inflammatory factors at discharge in both groups were lower than those at admission, the levels of TNF-α, IL-6 and IL-8 in the children of risk prevention group were significantly lower than those in the conventional nursing group discharge [TNF-α (μg/L): 16.54±7.13 vs. 22.78±9.12, IL-6 (ng/L): 9.25±5.48 vs. 15.11±7.01, IL-8 (μg/L): 4.08±2.16 vs. 7.69±3.56, all P < 0.05]. The duration for clinical symptoms to disappear and duration of hospital stay in the risk prevention group were significantly shorter than those in the conventional nursing group [cough stopping time (days): 6.87±2.54 vs. 10.35±3.08, duration of rale disappearance (days): 7.01±2.13 vs. 10.87±3.25, fever recovery time (days): 6.25±2.64 vs. 8.76±3.58, duration of asthma relief (days): 7.59±3.17 vs. 10.26±3.26, duration of hospital stay (days): 8.16±1.86 vs. 13.25±3.64, all P < 0.05]. The total effective rate and family members' satisfaction in the risk prevention group were significantly higher than those in the conventional nursing group [total effective rate: 94.54% (52/55) vs. 77.78% (35/45), family members' satisfaction: 96.36% (53/55) vs. 84.44% (38/45), both P < 0.05]. The incidence of complications in the risk prevention group was obviously lower than that in the conventional nursing group [5.45% (3/55) vs. 46.67% (21/45), P < 0.05]. Conclusion Risk prevention nursing can reduce the incidence of inflammatory reaction, improve the family members' satisfaction with nursing, and promote the children recovery process.
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Objective@#To investigate the association of D-dimer (DD) level on admission with the hospital length of stay (LOS) for the children with community-acquired pneumonia (CAP). @*Methods@#The children diagnosed as CAP hospitalized in the Second Hospital of Tianjin Medical University from December 2016 to December 2017 were studied. The clinical and biological variables were retrieved via electronic medical record system. Binary logistic regression model and Cox proportional risk model were constructed to estimate the assosiation of DD level with hospital length of stay(LOS). @*Results@#A total of 413 children met the inclusion criteria. Their median of LOS was 7 days (range from 3 to 21 days). The median of DD level on admission was 510.87 ng/mL and tertiles were 400 ng/mL and 712.23 ng/mL. In logistic regression model, both the high (＞712.23 ng/mL) and middle (400-712.23 ng/mL) DD level groups were in more risk for hospital stay of more than 7 days in comparison with the low DD level group (＜400). The OR values were 3.335 (95%CI:1.973-5.637, P＜0.001) and 2.015 (95%CI:1.195-3.398, P=0.009) respectively. Consistently, in Cox model high level of DD was associated with low probability of discharge (HR=0.652, 95%CI: 0.486-0.874, P=0.004 ), suggesting more risk of prolonged LOS in contrast to the low DD level group. @*Conclusion@#The DD level on admission should be independently associated with the hospital length of stay, suggesting the consideration of DD levels may be helpful for clinical management of the hospitalized children with CAP.
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Objective To explore the effect of stratified chain nursing model on the efficacy, symptom improvement and nursing satisfaction in pediatric pneumonia nursing. Me thods 58 cases of pediatric pneumonia in our hospital from March 2015 to March 2016 were selected as the control group. 58 cases of pediatric pneumonia in our hospital from April to April 2017 were selected as observation group. After 2 weeks of care, the two groups were compared in the curative effect, the symptoms improved and the nursing satisfaction. Re s ults The total effective rate of the two groups was significantly higher than that of the control group (P＜0.05). The disappearance time of fever, the time of disappearance of cough, the time of disappearance of lung rales and the time of hospitalization were shorter than those of the control group, the difference was statistically significant (P ＜0.05). The observation group had higher evaluation scores in ward environment, nursing technology, sense of responsibility, health education, psychological care, and service attitude than the control group, the difference was statistically significant (P ＜0.05). Conclus ion Hierarchical chain nursing model is effective in the treatment of pediatric pneumonia, which can effectively improve the curative effect and nursing satisfaction, which is beneficial to the improvement of symptoms.
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La neumonía adquirida en la comunidad (NAC) es una de las infecciones bacterianas más comunes en la infancia y la causa más frecuentes de derrame pleural en niños. OBJETIVOS: describir las características epidemiológicas y microbiológicas de las neumonías complicadas con derrame pleural en pacientes ingresados en el Hospital de Niños JM de los Ríos (HNJMR). METODOS: estudio descriptivo, transversal, retrospectivo. Población estudiada: pacientes de 1 mes hasta 18 años ingresados con diagnóstico de neumonía complicada con derrame pleural durante el periodo enero 2013 - diciembre 2015 en el HNJMR, Caracas-Venezuela. Datos recolectados a través de revisión de historias médicas y plasmadas en formato preestablecido. Análisis de datos a través de medidas de tendencia central. RESULTADOS: se reportaron 580 neumonías, 28 presentaron derrame pleural (4,8%). La mortalidad general por neumonía fue 4,5% (26/580). De los 28 casos, 82,1% (23/28) eran menores de 5 años. 53,6% (15/28) masculinos. 78,6% (22/28) eran previamente sanos. 89,3% (25/28) había recibido parcial o completamente las dosis contra Haemophilus influenzae tipo B (HiB) y 21,4% (6/28) contra Streptococcus pneumoniae. Se logró identificar etiología bacteriana en 60,7% (17/28): 8 Streptococcus pneumoniae, 4 Staphylococcus aureus, 1 Mycobacterium tuberculosis, 3 diplococos gram positivos (probable Streptococcus pneumoniae), uno fue reportado como bacterias visibles (sin caracterización al gram). Todos los Staphylococcus aureus fueron resistentes a meticilina. Evolución tórpida en 14,3%(4/28) de los casos. CONCLUSIONES: El derrame pleural continúa siendo una complicación importante de las neumonías en niños. Streptococcus pneumoniae sigue siendo el agente más frecuente. Alta resistencia de S. aureus a meticilina.
Community-acquired pneumonia (CAP) is one of the most common childhood bacterial infections and the most frequent cause of children pleural effusion. OBJECTIVES: To describe the epidemiological and microbiological features of complicated pneumonia with pleural effusion in patients admitted to Children's Hospital JM de los Rios (HNJMR). METHODS: Descriptive and transversal, retrospective study. The study population included patients aged 1 month to 18 years, who were admitted with the diagnosis of pneumonia complicated by pleural effusion during the period January 2013 - December 2015 in HNJMR, Caracas-Venezuela. Data was collected by medical records review. Statistical analysis was performed by central tendency measures, Chi square and Fisher test. RESULTS: 580 pneumonias were reported, 28 had pleural effusion (4,8%). Overall mortality from pneumonia was 4, 5% (26/580). 82,1% (23/28) were under 5 years. 53,6% (15/28) were male. 7,6% (22/28) were previously healthy. 89,3% (25/28) had received partial or complete doses against Haemophilus influenzae type B and 21,4% (6/28) against Streptococcus pneumoniae. It was possible to identify bacterial etiology in 60,7% (17/28): eight Streptococcus pneumoniae, Staphylococcus aureus 4 and 1 case of Mycobacterium tuberculosis, 3 gram positive diplococcic (likely Streptococcus pneumoniae); one was reported as visible but without characterization bacteria to gram. All Staphylococcus aureus were methicillin-resistant. 14,3% (4/28) had torpid evolution. CONCLUSIONS: Pleural effusion remains an important complication of pneumonia in children. Streptococcus pneumoniae remains the most common agent. S. aureus was highly resistant to methicilyn.
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Objective To study effect of traditional Chinese medicine chrysanthemum decoction on RSV infection after A549 cells chemotactic factor.Methods Subjects from The Second Hospital Affilated To Suzhou University in recent days, 64 cases of patients diagnosed with RSV effected pneumonia by clinical examination, RSV infection A549 cell model was established and the infected cells were cultured, chrysanthemums with TCM decoction and conventional antiviral observed its effect on RSV infection cell survival, compared two groups of cell SAP was determined by ELISA kit and the expression of RANTEs and chemokines MCP-1.Results Chrysanthemum, according to the results of in vitro cell culture studies traditional Chinese medicine decoction had the effect of directly inhibit the growth of virus replication, and there were some positive effects RSV infected A549 cells, MCP-1 and RANTEs expression or release significantly increased ( P<0.05 ) .Chrysanthemum Chinese medicine decoction and antiviral drugs after the intervention, the expression of MCP-1 and RANTES reduced significantly (P<0.05), but overall volume was still significantly higher than the normal. Conclusion Chrysanthemum Chinese medicine decoction can inhibit RSV infected A549 cells release chemokine RANTEs and MCP-1 to some extent, and then reduce the airway inflammation reaction of children.
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<p><b>OBJECTIVE</b>To ascertain the extent of under-utilization and insufficiency or inappropriateness in provision of health services as one of the possible causes of high mortality from pediatric pneumonia in pilot areas in Vietnam.</p><p><b>METHOD</b>The household survey on morbidity and treatment of acute respiratory infections, simple cough, and cold and pneumonia, was conducted in two communities with 10% sampling of the child population.</p><p><b>RESULTS</b>Both under-treatment of "fast breathing", a proxy for pneumonia, and over-treatment of simple cough and cold with antimicrobials by health workers, mothers, and private practitioners were common.</p><p><b>CONCLUSIONS</b>A household survey on morbidity and treatment was found to be useful to clarify actual practices in the treatment of acute respiratory infections in the community, which cannot be obtained by mere interview with health workers or mothers. Since a change of knowledge did not automatically lead to change of practice, the training of health workers, health education of mothers and provision of antimicrobials at village health stations would not guarantee improved practice of health workers and mothers. Therefore, constant supervision for health workers, continued health education of mothers and involvement of private practitioners are needed to improve the situation.</p>
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Objective: To ascertain the extent of under-utilization and insufficiency or inappropriateness in provision of health services as one of the possible causes of high mortality from pediatric pneumonia in pilot areas in Vietnam. Method: The household survey on morbidity and treatment of acute respiratory infections, simple cough, and cold and pneumonia, was conducted in two communities with 10% sampling of the child population. Results: Both under-treatment of “fast breathing”, a proxy for pneumonia, and over-treatment of simple cough and cold with antimicrobials by health workers, mothers, and private practitioners were common. Conclusions: A household survey on morbidity and treatment was found to be useful to clarify actual practices in the treatment of acute respiratory infections in the community, which cannot be obtained by mere interview with health workers or mothers. Since a change of knowledge did not automatically lead to change of practice, the training of health workers, health education of mothers and provision of antimicrobials at village health stations would not guarantee improved practice of health workers and mothers. Therefore, constant supervision for health workers, continued health education of mothers and involvement of private practitioners are needed to improve the situation.
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Health , Workforce , Respiratory Tract InfectionsABSTRACT
The aim of this study was to evaluate the appropriateness of some kinds of surgery and admission, such as cesarean section (C/S), cholecystectomy, and pediatric pneumonia. For appropriateness evaluation, we ourselves developed some criteria, which were included in the category of explicit and linear criteria, with the assistance of specialists of relevant clinical field. The evaluation of appropriateness was performed by two family physicians. The major findings were as follows: 1. For ceserean section, 77.6% of deliveries were determined to be 'appropriate', but the level of appropriateness was not significantly different among hospitals between hospital groups by size. The most frequent indication of C/S was repeated operation, followed by cephalopelvic disproportion(CPD). The labor trials for vaginal delivery among repeated C/S and CPD cases were performed in 24.5% of pertinent deliveries. 2. About 73.8% of cholecystectomy cases was appropriate to one of the surgical indications, without significant differences among hospitals. Of surgical indications, 'sufficiently frequent and intense symptom recurrence' was the most frequent, and 'confirmed acute cholecystitis' was the second. 3. Of children admitted due to pneumonia, only 57.4% of cases satisfied admission criteria, and the level of appropriateness of admission was different among hospitals. The common reasons for admission were 'failure to initial treatment', 'suspected bacterial pnermonia', 'young infant', etc. We could find that there were differences of quality among hospitals in some procedures, especially in the pediatric pneumonia and labor trial before C/S, which suggested that the implementation of quality assurance activities would be necessary in this country. In this study, we used some simple and primitive research tools and the numbers of subjects and tracer procedures were limited. So advanced studies with plentiful subjects and more representative diseases or procedures should be tried.