Retrospective Analysis Of 970 Children With Community-acquired Lobar Pneumonia In Eastern Heilongjiang

Objective:Conduct an cross sectional study to find out and discuss the changes of lobar pneumonia with respect to sex,age,pathogen and season of diseases in children admitted in the first affiliated hospital of Jiamusi university,providing a reference for clinicians,in order for better clinical diagnosis and treatment.Methods: A total number of 970 children were diagnosed with lobar pneumonia in our hospital from September 2016 to August 2018.Having proper counseling to guardian and signed informed consent,fasting blood samples were taken for serum examination.The sputum samples and blood samples were cultured,drug sensitivity was identified,and Mycoplasma pneumoniae(MP)was detected by fluorescence quantitative PCR(FQ-PCR).Venous blood: ELISA method was used to detect IgM antibodies: adenovirus(ADV),respiratory syncytial virus(RSV),influenza virus(FIU),and indirect immunofluorescence assay was used to detect Epstein-Barr virus(EBV)antibody.The Excel software was used to input and arrange the relevant data.The data after processing were carried out for statistical analysis using SPSS25.0.The difference was compared with the chi-square test.The exact probability method of Fisher was used for those which did not meet the chi-square test conditions.The significance level of the test was set to 0.05.The pairwise comparison between groups was performed by Bonferroni method to find the changes of sex,age,pathogen and season in children with lobar pneumonia.Results: Among 970 children with lobar pneumonia,499 were male(51.44%)and 471 were female(48.56%).There was no significant difference in morbidity of male and female.The age of susceptibility for male and female was highest in school age,followed by pre-school age and infantile age.The incidence according to season was 347(35.77%)in autumn,301(31.03%)in summer,231(23.81%)in winter and 91(9.38%)in spring.There was no difference between male and female gender.There were significant differences in EB infection among different age groups,and the positive rate of EB infection in preschool children was higher than in infants and school-age children,but there was no significant difference in respiratory tract infection among different age groups.The positive rate of mycoplasma pneumoniae infection in infants was lower than that in preschool children and school-age children.The number of influenza virus infection was the most common among respiratory tract virus,the age distribution of influenza virus had no significant difference,the age distribution of adenovirus was statistically significant,the positive rate of preschool children was higher than that of school age children.The age distribution of syncytial virus in infants was higher than that in school age,and preschool children was higher than that in school age.There was no significant difference in EB infection in different seasons,but there was significant difference in respiratory tract infection in different seasons.The results showed that the infection in winter was higher than that in summer,and the infection in winter was higher than that in autumn.There were only 26 cases(2.68%)culture positive bacteria in different age groups.There were 9 different micro organisms found in sputum,including Staphylococcus aureus,Pseudomonas aeruginosa,Myxobacterium Shareh,yeast like fungus,Streptococcus pneumoniae.Haemophilus influenzae,Klebsiella influenzae,Acinetobacter baumannii,Radiorhizobia.Among them,Staphylococcus aureus infection was the highest,followed by Pseudomonas aeruginosa infection.The number of gram-negative bacteria was higher than that of Grampositive bacteria.The detection rate of sputum bacteria in preschool and school age was higher than that of infants.The lung rales were not obvious at the time of treatment,the number of diagnosed lobar pneumonia was 12.78%(124 cases).The first symptom of infantile lobar pneumonia was fever where as fever and cough were first symptoms of older children.Conclusion: The susceptible age of lobar pneumonia was mainly in school age and preschool age.The incidence of large leaf pneumonia was the highest in autumn and summer;the respiratory tract virus infection in winter was higher than that in summer and autumn;the infection rate of adenovirus in preschool children was higher than that in school age children.The infection rate of syncytial virus was mainly in infantile and preschool children,the positive rate of EB infection in preschool children was higher than that in infants and school-age children,mycoplasma pneumoniae infection was mainly in preschool children and school-age children.The first symptom of infantile lobar pneumonia was fever where as fever and cough were first symptoms of older children.