迁延性细菌性支气管炎的病例对照分析

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Abstract Objective: To analyze the clinical characteristics and etiology in children with protracted bacterial bronchitis (PBB) confirmed by bronchoscopy. Methods: The hospitalized children who had over 4 weeks cough from June 2014 to December 2016 were investigated retrospectively. The children were defined as PBB (n=50) who had a chronic wet cough without signs of an alternative specific cause and responding to 2 weeks of appropriate antibiotics, had positive bacterial culture and/or increased of neutrophils in bronchoalveolar lavage fluid (BALF). Those did not fulfill the above criteria were divided into the ‘no PBB group’ (n=48). Results: In the PBB group, there were 36 boys and 14 girls. The median (IQR) age was 3.2 (2.0~4.0) years and 58.0% cases were under 3 years. Thirty children were accompanied by wheezing. Airway malacia were found in five cases. The average of neutrophils in BALF was 0.63 (0.50, 0.82), which was significantly higher than that in the control group (P<0.01). 36 isolates were identified from BALF in children with PBB, the common pathogens were Streptococcus pneumoniae (n=19), Haemophilus influenzae (n=5) and Moraxella catarrhalis (n=4). All children received a 2~4 weeks course of antibiotics. The majority (n=48) received oral amoxicillin/clavulanic acid. Twenty-three cases (47.9%) had a recurrent PBB by 1 year follow-up. Conclusion: PBB occurs mainly in younger children and often co-exist with wheezing. Streptococcus pneumoniae is the leading pathogen in children with PBB. Amoxicillin/clavulanic acid is the major treatment for PBB.

Key words： cough bronchitis bronchoalveolar lavage fluid child

Received: 05 January 2018

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	LI Changchang
	DONG Lin
	XIA Yongqiang
	ZHANG Hailin
	HU Xiaoguang
	ZHENG Yangming.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2018/V48/I11/837

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