| Objective:To explore the clinical features of children’s CAP in our hosptial,accumulate data for the prevention,diagnosis and treatment of CAP in children,in order to improve the treatment of children’s CAP ability in our hosptial.Methods: Mechanical sampling was used to select 1775 children’s CAP who were hospitalized in the pediatric department from January 2016 to December 2020 and aged29 days to 14 years old in the electronic medical record management system of Yan’an University Affiliated Hospital according to the order of hospitalization time for the research object.The age,gender,and clinical symptoms of the children after the hospital admission were collected and sorted;the blood routine,c-reactive protein,procalcitonin,joint examination of respiratory pathogens,liver function,myocardial enzyme spectrum,chest X-ray or chest CT,antibiotic use was recorded etc.After grouping by age,season and year,the etiology,clinical characteristics and antibiotic use of children in each group was statistically analyzed.Result:1.Epidemiological characteristics: The sex ratio of male to female in hospitalized children’s CAP was about 1.58:1.The proportion of each age group was:infant group 32.45%,toddler group 28.11%,preschool group 26.54%,school age group12.79%;the proportion of each season group was: spring group 21.86%,summer group18.14%,autumn group30.20%,winter group 29.80%;the proportion of each year group is: 26.08% in 2016,23.32% in 2017,22.48% in 2018,19.89% in 2019,and 8.23% in2020.2.The pathogenic bacteria characteristics of CAP: the detection rates of pathogenic bacteria were: MP 25.70%,bacteria 21.69%,RSV 13.71%,ADV 11.73%,IFV 1.86%,CP0.62%.The detection rate of MP was relatively high throughout the year,but the detection rate was higher in July,August and September,the detection rate of RSV and ADV in May,June and July was low,and the detection rate of IFV in November,December,January and February was higher.The positive detection rate of MP-Ig M in infant group was lower than that in toddler group,preschool group and school age group(P all =0.000).The bacterial infection rate in the infant group was lower than that in the toddler group and preschool group(P=0.000,0.002),and the school-age group was lower than that in the toddler group and preschool group(P=0.002,0.006).Pairwise comparison of pathogenic bacteria detection rates from high to low are: MP,bacteria,RSV=ADV,IFV,CP(P all are less than the adjusted test level of 0.003).There was no significant annual difference in the detection rate of several common pathogens(P>0.05).3.The clinical characteristics of CAP: The occurrence of various manifestations:cough 91.10%,fever 59.89%,wheezing 21.80%,pulmonary rales 73.07%.The incidence of fever in the infant group was lower than that in the toddler group,preschool group,and school-age group(P all=0.000),and was higher in MP and ADV infection than in RSV infection(P all=0.000).Pairwise comparison,the incidence of cough was the higher in ADV infection,followed by MP infection,and lower in RSA infection(P all less than the adjusted test level of 0.017).The incidence of wheezing in the infant group and the toddler group was higher than that in the school-age group and the school-age group,and the infant group was higher than the toddler group(P all=0.000),and was higher in RSV and ADV than MP infection(P=0.005,0.000);The incidence of pulmonary moist rales in infant group and toddler group was higher than that in preschool group and school-age group respectively(P all=0.000),the higher in RSA infection,the second in ADV infection,and lower in MP infection(P all less than the adjusted test level of 0.017).The incidence rates of liver function injury and myocardial injury in infant group were higher than those in toddler group,preschool group and school age group(P all =0.000).4.The usage of antibiotics in CAP: The usage rate of antibiotics was 94.82%,90.93% used one antibiotic,and 3.89% used antibiotics in combination.The usage rate of various antibiotics: oxycephems 59.77%,cephalosporins 23.44%,macrolides 6.93%,lincomycins 6.54% and other types of antibiotics 2.03%.The usage rate of cephalosporins in the infant group was higher than that in the preschool group and the school age group(P=0.003,0.000);the usage rate of lincomycin antibiotics in the infant group and the toddler group was lower than that in the preschool group and the school age group,respectively.group(P=0.000).Conclusion:1.From 2016 to 2020,there were more boys than girls in hospitalized children with CAP,the proportion of each age group gradually decreased with increasing age,and the proportion of patient seasons from high to low were: autumn,winter,spring,and summer.2.There were great differences in the pathogenic types of CAP in different ages and seasons.MP was an important pathogen of CAP in children,with a high infection rate all year round,and it was not uncommon in infant pneumonia;RSV and ADV were also common pathogens of CAP,but the infection rate was lower in May,June and July.3.Although fever,cough,wheezing,and pulmonary rales are common clinical manifestations of CAP,their manifestations are quite different at different ages and after infection with different pathogens.4.The infancy with CAP is easy to combine with liver function damage and myocardial damage.5.The use rate of antibiotics was high,and there was an unreasonable phenomenon of antibiotic use. |
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