| OBJECTIVE: To analyze the clinical features, the chest radiographcharacteristics, the common laboratory indicators, the pathogen distribution anddrug sensitive situation, and prognosis relevant factors in infant with bacterialpneumonia. To explore the clinical characteristic and effect factors of prognosisin of bacterial pneumonia of infant.METHODS: Retrospective analyze60cases of infants with bacterialpneumonia，aging from45days to3years were involved in the study. Theclinical features, the chest radiograph characteristics, the common laboratoryindicators, the pathogen distribution and drug sensitive situation, and prognosisrelevant factors were collected. Incidence of the clinical manifestations, theresults of laboratory markers and the kinds of complications etc werestatistically analyzed by using statistical methods of the constituent ratio, twosample t-test and chi-square test.RESULTS:1. Clinical features: Among of60cases infant with bacterial pneumonia,cough96.7%(58/60), small and medium-sized blisters sound in lung81.7%（49/60）,poor spirit and reaction41.7%(25/60), fever40.0%（24/60）, shortness of breath36.7%(22/60), dyspnea16.7%(10/60)，pale16.7%(10/60)，lipscyanosis15.0%(9/60)，drowsiness11.7%(7/60）.2. Chest radiograph characteristics:45of total60cases were completedchest X-ray examination.Among them, abnormal88.9%(40/45). Show as follow:double-and lower lung fields brought in small spots and flake opacities55.6(25/45), markings increased of double lung texture and hilar shadow increasedthick20.0%(9/45), floe shadow13.3%(5/45), some accompany with localatelectasis or emphysema11.1%(5/45), some accompany with pleuraleffusion4.4%(2/45).3.Commom complication disease: diarrhea21.7%（13/60）,anemia16.7%（10/60）,malnutrition16.7%（10/60）,congenital heart disease10.0%（6/60）,septicaemia8.3%（5/60）.4. Laboratory parameters: The results of laboratory indicators in severepneumonia group and common pneumonia group compared: WBC,PLT,CRP,CK-MB in severe pneumonia group were statistically significantincreased higher than that of common pneumonia group（t=2.153,2.146,4.567,2.461，P<0.05）.The result of NEU%，ALT，AST insevere pneumonia group were also higher than that of common pneumoniagroup, but there were not statistical differences between the two group（t=1.838,1.354,1.397,P>0.05）.5.Pathogen distribution: G—bacteria90.2%(55/61), includingescherichia coli29.5%(18/61), klebsiella pneumonia24.6%(15/61),pseudomonas aeruginosa13.2%(8/61), G+bacteria9.8%(6/61).6. Pathogen drug sensitive situation: The drug resistance rate of thecommon G—bacteria to ampicillin, piperacillin, cephazoline, cefuroxime,cefotaxime was40.0%to100%, to SMZco and aztreonam was12.5%to38.9%,to cefoperazone/sulbactam, piperacillin/tazobactam was0%to13.3%, to imipenem/cilastatin,meroperem was0%to5.6%, to amikacin, ciprofloxacinwas0%to6.7%.7. Prognosis relevant factors: All of60cases of infant bacterialpneumonia, the average length of stay hospital was9.67days. Cured orimproved and discharged90.0%,10.0%of the deaths. To analysis therelationship of complications (including diarrhea, anemia, malnutrition,congenital heart disease, septicemia) and prognosis in the severe pneumoniagroup. Which severe pneumonia with malnutrition is a risk of death in infantswith pneumonia (χ~2=8.553, P=0.003).Conclusion:1.Clinical characteristics of infant bacterial pneumonia: cough, fever,shortness of breath, dyspnea, moist rales are common symptoms and sighs, cheatradiograph showed as inflammatory change.2.The common complication disease are diarrhea, anemia, malnutrition,congenital heart disease, septicemia. Which severe pneumonia with malnutritionis a risk factor of death in infants with pneumonia.3. Bacterial pneumonia in infants，the level of WBC, the PLT, CRP,CK-MB, NEU%, ALT, and AST can be increased, and the PLT, WBC, CRP andCK-MB maybe associated with the severity of the pneumonia disease.4. Bacterial pneumonia pathogen in infants is common mainly in theG-bacteria, Escherichia coli and Klebsiella pneumoniae.5. G—bacteria to penicillins,cephalosporins were high resistance. However,their compound of addingβ-lactamase inhibitors agents was relatively lowresistance. G—bacteria were mostly sensitive to carbapenem and quinolonesantibiotics. |
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