OBJECTIVES@#To study the clinical and microbiological characteristics of
children with
drowning-associated
aspiration pneumonia, so as to provide a reference for empirical selection of
antibacterial agents.@*
METHODS@#A retrospective
analysis was performed on the medical data of 185
children with
drowning-associated
aspiration pneumonia who were admitted to
Children's
Hospital of Chongqing Medical
University from January 2010 to October 2020. According to the
drowning environment, these
children were divided into four groups fecal group (n=44),
freshwater group (n=69),
swimming pool group (n=41), and contaminant
water group (n=31). The clinical characteristics and pathogen
detection results were reviewed and compared among the four groups.@*RESULTS@#The 185
children had an age of 4 months to 17 years (median 34 months).
Sputum cultures were performed on 157
children, and 103 were tested positive (65.6%), with 87
strains of
Gram-negative bacteria (68.5%), 37
strains of
Gram-positive bacteria (29.1%), and 3
strains of
fungi (2.4%).
Gram-negative bacteria were the main pathogen in the fecal group and the contaminant
water group,
accounting for 88.2% (30/34) and 78.3% (18/23), respectively. The
freshwater group had a significantly higher
detection rate of
Gram-positive bacteria than the fecal group (P<0.008), and the
swimming pool group had an equal
detection rate of
Gram-negative bacteria and
Gram-positive bacteria.@*CONCLUSIONS@#For pulmonary
bacterial infection in
children with
drowning in
feces or contaminant
water,
antibiotics against
Gram-negative bacteria may be applied empirically, while for
children with
drowning in a
swimming pool or
freshwater, broad-spectrum
antibiotics may be used as initial
treatment, and subsequently the application of
antibiotics may be adjusted according to the results of the
drug sensitivity test.