Study On The Etiology Of Children's Community Acquired Pneumonia (CAP)

Objective : To investigate the etiology of children's community acquired pneumonia (CAP) and the bacterial resistance in patients of dalian city during the last year,and provide evidences to clinical empirical therapy and the pathogenic detection.Thus we could prevent irrational using of antiviral drugs and antibioticsMethods: The patients in dalian children's hospital department of respiratory was devided into four groups from May of 2007 to 2008.Before the treatment ,pharyngeal swabs was taken for culture to find bacteries. The cases which bacterial culture were positive would be done drug sensitivity quantitative test and examed the extended spectrumβlactamases. Serum virus antibody and mycoplasma antibodies were detected after 1 week.Positive was defined as IgM≥1:80.Results:1.In 433 cases ,there are 44.8 % of them were detected positive. The first common is bacteria agent (31%), the second is myoplasma(29%) , the third is virus(23%), and the forth is mix infection(17%).2.In 280 cases which are detected for IgM antibodies, the positive rate is 28.2%.It is mainly consist with respiratory syncytial virus, adenovirus, and parainfluenza virus.The ratio of virus infection in school age group (54%)is higher than other groups,the second is in toddler age . 3.The ratio of myoplasma infection is increase by the age. there was significant difference among the four groups(5.5%,13%,40%,58.7%).4. In 359 cases which are detected for bacteria, the positive rate is 22%. It is mainly consist with gram negative bacteria. Streptococcus pneumoniae(18%) is the most common in gram positive bacteria. It is relative sensitive to amoxicillin-clavulanic acid and there is no drug-resistant strains for panipenam. Drug resistance of ESBLs producing strains to cefepime and cefotaxime is increase. Klebsiella pneumoniae (30%)is most common in gram negative bacteria. And it is highly resistant to erythromycin, clindamycin,and tetracycline. The ratio of bacteria infection in infancy age group (34.6%)is higher than other groups.5.17% of all cases is mixed infection,among which virus mixed with other pathogens are the most important,and the next one is myoplasma.There is no significant difference among the groups.Conclusion:Bacterial pneumonia are the most common one in infant pneumonia. The most common bacterial agents are gram negative bacteria,such as Klebsiella pneumoniae.The next one are gram positive bacteria ,suah as S. pneumoniae .And myoplasma was the second most common cause of CAP. In the elderly children the myoplasma infectious ratio is increased by the children's age . The last common one are viral pneumonia.Viral agents are mainly consist with respiratory syncytial virus (RSV)and adenovirus(ADV).