Pathogen Distribution Of Children With Acute Lower Respiratory Tract Infection And Its Relationship With Age Climate And Other Factors

Objective:To understand the distribution of bacteria and atypical respiratory pathogens,epidemic trends and their relationship with age of onset and seasonal climatic factors in children with acute lower respiratory tract infection in recent three years in Luzhou,so as to provide reference for clinical prevention and reasonablediagnosis treatment?Methods:use the 19467children with the lower respiratory tract infection in hospitalized for pediatric respiratory medicine in the Department of Respiratory Medicine,Southwest Medical University Affiliated Hospital From July 2013 to December 2016 As research target?retrospectively analyzed of which 10,350 were After admission for Sputum culture,6623 cases children After admissionnine were sent Nine respiratory tract etiology IgM antibody test results.Nine Atypical respiratory tract pathogens included Legionella pneumophila(LP),Mycoplasma pneumoniae(MP),Q fever(QFR),Chlamydia pneumoniae(CP),adenovirus(ADV),respiratory syncytial virus(RSV)Influenza virus(IFA),influenza B(IFB)and parainfluenza viruses 1,2 and 3(PIVS).Results:(1)There were 10,305 sputum cultures of 19467 children hospitalized with lower respiratory tract infection,the Submit rate was 52.9%.Among them,there were1992 cases no bacterial growth,4953 respiratory tract normal bacteria,3360 pathogenic bacteria and Bacteria detection rate was 80.7%,sputum culture pathogenic bacteria detection rate was 32.6%.(2)The top four Pathogenic bacteria was followed by golden sputum,Staphylococcus aureus,Klebsiella pneumoniae,Streptococcus pneumoniae.Among the Gram-positive bacteria,Staphylococcus aureus(629 cases)and Streptococcus pneumoniae(437 cases)are More distribution.Among the gram-negative bacteria,Escherichia coli(519 cases),Klebsiella pneumoniae(478 cases),Haemophilus influenzae(182 cases),Enterobacter cloacae(149 cases),Pseudomonas aeruginosa(99 cases),Acinetobacter baumannii(58 cases),Enterobacter aerogenes(54 cases),Klebsiella oxytoca Cases);Candida albicans(49 cases),Candida glabrata(23 cases)are More distribution.(3)Staphylococcus aureus,Klebsiella pneumoniae,Streptococcus pneumoniae,Escherichia coli in all age distribution was statistically significant,the positive rate of these four bacterial infections with the increase of children's age decreased,Susceptible age group<1 year old group.(4)Escherichia coli,Streptococcus pneumoniae Staphylococcus aureus and temperature were statistically negatively correlated,The correlation coefficients were-0.813,-0.68,-0.757respectively.Regression analysis shows,For every 0.021 degrees of temperature drop,a pneumococcal infection may be added;for every 0.021 degrees of temperature drop,a pneumococcal infection may be added;0.035 degrees per temperature drop may increase the risk of a Staphylococcus aureus infection in patients.Correlation analysis shows that under the influence of seasonal climate factors,Klebsiella pneumoniae infection may increase the susceptibility of Streptococcus pneumoniae,Klebsiella pneumoniae infection may increase the susceptibility to Staphylococcus aureus.2.(1)19467 cases of lower respiratory tract infection in hospital children nine etiology 6623 cases,the delivery rate of34.02%.Respiratory pathogen IgM antibody positive for 5784 cases,the positive rate was 87.33%.The two pathogens with the highest positive rates were Mycoplasma pneumoniae(MP,44.05%)and Influenzavirus B(IFB,27.77%).The positive rates of IgM antibodies of these two pathogens were higher than those of the other seven pathogens.(2)The distribution of various pathogens in all age groups were statistically significant(?~2=455.039,P<0.05):Influenza A(IFA)and respiratory syncytial virus(RSV)attacks peak at<1 year old infants;the adenovirus(ADV)susceptibility age group was 1-2years old;Parainfluenza viruses 1,2 and 3(PIVS)peaked at<1 year and 2-5years;Legionella pneumophila(LP),Influenzavirus(IFB),Chlamydia pneumoniae(CP)and Q fever(QFR)were all 2-5 years old.Mycoplasma pneumoniae(MP)Groups showed particularly susceptible.(3)There are seasonal differences in susceptibility to eight respiratory pathogens except C.pneumoniae.Mycoplasma pneumoniae?influenza B?Legionella pneumophila?and respiratory syncytial virus peak incidence in winter is more common,influenza A?adenovirus?parainfluenza and Q fever rickettsial disease peak is more common in autumn and winter.(4)Related analysis shows that,under the influence of seasonal climate factors,respiratory syncytial virus,adenovirus,Legionella pneumophila,influenza A virus susceptibility increased during Mycoplasma pneumoniae infection,the of adenovirus,influenza A virus susceptibility increase during Influenza B virus infection.(5)There is a correlation between air temperature and the positive rate of IgM antibody of Mycoplasma pneumoniae,the lower the temperature,the higher the positive detection rate of Mycoplasma pneumoniae Ig-M antibody,regression analysis prompt,when the cumulative minimum temperature decreased by 1?,the number of positive MP Ig-M antibodies was rise 0.103.Conclusions:1.In the past 3 years,Luzhou area bacterial lower respiratory tract infections children Staphylococcus aureus,Klebsiella pneumoniae,Streptococcus pneumoniae,Escherichia coli most susceptible.Mycoplasma pneumoniae and influenza B virus were the most susceptible from lower respiratory tract infection caused by atypical respiratory tract infection.2.The susceptible age of the pathogens were statistically different.ALRTI caused by Bacterial strains are more common in children_?1 age group.The positive rate of sputum culture decreased with the age of the children.ALRTI caused by Atypical pathogens 2-5 age group susceptible Mycoplasma pneumoniae(MP)?Legionella pneumophila(LP)?Influenza B(IFB)?Chlamydia pneumoniae(CP);the influenza A(IFA)and respiratory syncytial virus(RSV)attacks peaked at<1 year old infants;the adenovirus(ADV)susceptibility age group was 1-2 years old;Parainfluenza viruses 1,2 and 3(PIVS)peaked at<1 year and 2-5 years.3.The detection rate of sputum culture pathogens is related to temperature,Escherichia coli,Streptococcus pneumoniae,Staphylococcus aureus and the temperature in the climate was statistically negatively correlated,every temperature drop of0.021?,one S.pneumoniae and one strain of Escherichia coli may be added.Each temperature drop of 0.035?may increase one case S.aureus infection.The positive rate of antibody detection for atypical respiratory pathogens in children with ALRTI was associated with seasonal climate factors.In this study,especially the temperature has an important influence on the pathogenesis of Mycoplasma pneumoniae pneumonia.The lower the temperature,the higher the positive rate of MP Ig-M antibody positive.The cumulative lowest temperature decreased by 1 degrees centigrade,and the number of positive MP Ig-M antibodies increased by 0.103 man-time.Winter is the Peak incidence of atypical pathogens in children in this region.Local pediatricians should respond to seasonal changes in children of different ages to make the appropriate respiratory tract infection prevention and treatment work.