The Clinical Study Of The Relationship Of Mycoplasma Pneumoniae Infections With Bronchiolitis In Children

ObjectivesBronchiolitis is a common disease in children.Virus are the most common cause detected in acute bronchiolitis cases in infants;however the importance of other pathogens such as Mycoplasma pneumonia(MP)in the etiology and clinical manifestation of bronchiolitis may not be completely understood.This study aims at identifying the prevalence,seasonal distribution and clinical characteristics of bronchiolitis caused by MP in hospitalized children.MethodsA retrospective study approach was used and analysis was done on the clinical data within 2 years,from January 2013 to January 2015.168 children aged between 2 months and 36 months old,hospitalized with diagnosis of bronchiolitis were included in this study as study population.On the second day of admission the patients' serum were tested for the respiratory tract profile and through ELISA and Immunofluorescent procedures,the RSV antibody(Ig M)was detected and when the titer ? 1:80 was considered positive.The MP antibody(Ig M)was determined through Passive agglutination kit and when the titer ? 1:80 was considered positive.Patients who had MP Ig M antibody identified in their serum are considered as MP infection group as the first group.Second group was RSV group these are the children patients with RSV antibody detected.Third group are children whose serum detected positive for both pathogens and are considered as co-infection MP + RSV group.Forth group are children whose serum were not detected by neither MP nor RSV antibodies Ig M as NON group.Comparison was achieved through age,sex,laboratory investigations which are WBC count,CRP,ESR,neutrophils and radiologic findings that is chest X-ray result.1.MP group compared to RSV group.2.MP group compared to MP+ RSV group and 3.MP group compared to NON group.4.After a course of treatment of anti-MP drugs,the groups were furthermore compared.Finally the groups' prevalence,clinical features and seasonality of the pathogens were compared within and across the groups.Seasons of Dalian annually are considered as follows: December to February as winter,March to May as spring,June to August as summer,and September to November as autumn.All statistical analyses were performed by using SPSS version 19.0.The Independentsamples t-test was used for normally distributed independent variables.To compare mean differences in 2 or more groups,One-Way ANOVA was used.Data is presented as mean and standard deviation(SD)in()differences were considered to be statistically significant when P was 0.05 or less(P?0.05).Results1.Demographic findings;168 children who were diagnosed with acute bronchiolitis were included in this study.Out of the total number of patients,111 were boys and 57 girls(female/male ratio was 1:1.9).2.Etiologic results;overall,a respiratory virus or atypical bacterial pathogen was identified in 56.55% of children(95/168).The pathogen most commonly identified was RSV in 47.62%(80/168),followed by MP in 25%(42/168)and co-infection of the two was 16.1%(27/168).The prevalence of single infection cases was RSV 31.5%(53/168)and MP was 8.9%(15/168).3.Clinical features: the mean age of children at diagnosis was(16.61±10.07)months.The age of the patients was older in MP and RSV+MP groups with mean value(12.94±8.00)months and(20.70±9.46)months respectively than that RSV single infection group with mean age value of(12.84±8.00)months.The difference was significant at P<0.05 in RSV group compared to RSV+MP group as well as compared to MP group.Hospitalization days with mean of(10.63±2.02)days were longer in RSV+MP than any other group.There was significant difference between MP group with hospitalization days mean value of(8.33±1.68)days,RSV mean hospitalization days of value of(8.30±3.13)days and when compared to RSV+MP there was statistical difference at P<0.05,however when the rest of groups compared to each other,there was no significant different in days of hospitalization observed.Temperature was significant different at P<0.05 between RSV group with mean temperature of(37.39±0.92)0C and MP group with mean temperature of(38.01±1.06)0C.RSV group with mean temperature of(37.39±0.92)0C when compared with RSV+MP group with mean temperature of(38.29±0.96)0C had significant difference at P<0.05.The CRP test values were higher in MP group with mean value of(14.07±7.69)mg/L and least RSV group mean value of(7.26±7.09)mg/L.Statistical difference was observed at P<0.05 between MP group with mean CRP of(14.07±7.69)mg/L and RSV group with CRP mean of(7.26±7.09)mg/L.4.Patients' radiologic findings;Overall,normal X-rays were observed in 24.4%(41/168)of the patients in which RSV group had the highest prevalence 49.2%(21/41).Atelectasis had high prevalence in overall cases prevalence was 54.8%(56/92).RSV group had a prevalence of 27.2%(26/92)Patchy infiltrates had high prevalence of 34.2%(14/38)followed by RSV+MP group which had a prevalence of 28.9%(11/38).5.The incidence of RSV infection peaked in winter(November-February)and spring(MarchMay).MP group and MP+RSV group prevailed throughout the year with a slight peak in summer for MP group was observed.Conclusion1.MP infections play an important role in bronchiolitis.2.Severity of the disease is related to co-infection of other etiology with MP.3.Bronchiolitis exhibit a seasonal pattern and observed MP infection in bronchiolitis was identified throughout the year with peaks in summer and early autumn...