MICROBIOLOGICAL CHARACTERISTICS OF SEVERE PNEUMONIA IN CHILDREN FROM 2 MONTH TO 24 MONTH HOSPITALIZED AT THE RESPIRATORY DEPARTMENT OF CHILDREN’S HOSPITAL 1

Tóm tắt

Objective: To compare some of clinical features, laboratory fnding and treament of severe pneumonia caused by bacteria, virus and bacteria-virus coinfections based on PCR (Polymerase Chain Reaction) results NTA (Naso tracheal aspiration), and rapid test to fnding RSV, AdV results in children from 2 months to 24 months hospitalized at the Respiratory Department of Children’s Hospital 1.

Materials and method: A prospective, cross-sectional study with analysis of 138 severe cases of pneumonia requiring oxygen when patients were treated at Respiratory Department Children’s Hospital 1 from 11/2021-8/2022, nasopharyngeal swab was tested for RSV, AdV with rapid test, collecting NTA multi-agent PCR of lower respiratory tract infections and culture as an antibiotic map for microbial pathogens,

Results: During the period from 11/2021 to 8/2022, 138 cases that met the criteria were included in the study. the rate of bacteria infection (+): 21%, virus (+): 6,5%, bacteria-virus coinfections: 68,8%, culture NTA (+): 24,6%, RSV (+) 31,8% and AdV (+) 5,1% were detected in nasopharyngeal swab by on rapid test. Bacteria and virus were detected in PCR NTA: S.pneumoniae 49,8%, MRSA 13,1%, H. influenza non-B 9%, M. cataharrlis 4,9%, M. pneumoniae 5,7%, C. trachomatis 13,1%, CMV 25,3%, RSV 31,8%, Parainfluenzavirus 15,2%, Adenovirus 5,1%, Influenzavirus A 0,7%, Rhinovirus 8,7%, Epstein Barr virus 3,6%, Bocavirus 20,2%. Bacterial infection mainly had fever ≥ 390 C (p=0,000204), SpO2 level < 85% mainly in virus and bacteria-virus coinfections group, severe chest constriction mainly in virus and bacteria-virus coinfections group (p=0,001), main wheeze mainly in the viral group (p=0,00125), the number > 15000TB/mm3 (p=0,047), the number of N ≥ 8000TB/mm3 and the CRP > 35 mg/L mainly in the bacteria group (p=0,021), and the group bacteria-virus coinfections. Chest X-ray focus on one side was mainly in the bacteria group, bilateral infltrative lesions were mainly in the virus group, The virus group was treated mainly for less than 7 days and did not need to change antibiotics, respiratory support was needed NCPAP levels were higher. the bacteria-virus co-infected had more poor initial antibiotic response and longer treatment time.

Conclusions: Bacteria-virus coinfections accounted for a high proportion in pneumonia of children under 2 years of age in S.pneumoniae and RSV infection accounted for the highest rate, pneumonia caused by clinical virus wheezing and respiratory failure more than pneumonia caused by bacteria, bacteria-virus coinfections makes pneumonia less responsive to initial antibiotics and prolonged treatment time. The rapid test for detecting RSV and AdV in thí study has results within 15 minutes and the value is similar to PCR, support the treatment plan after admission, prevent the spread.