Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Eur J Clin Microbiol Infect Dis. 2010 May;29(5):519-25. doi: 10.1007/s10096-010-0889-z. Epub 2010 Feb 24.
The aim of this study is to confirm the usefulness of sputum sampling from the hypopharynx through the nose to identify causative bacteria of pediatric community-acquired lower respiratory tract infection (CA-LRTI) and compare its features between the patients with and without underlying diseases. A retrospective study was performed on 244 pediatric patients hospitalized for CA-LRTI of suspected bacterial etiology. Sputum sample was obtained from these patients by aspirating airway secretion through the nose or the tracheostomy orifice, or coughing up by themselves. Sputum samples were assessed as suitable in 119 (74.4%) of 160 patients with CA-LRTI of suspected pure bacterial etiology. Ninety-six (70.1%) of 137 samples suctioned from the hypopharynx through the nose were suitable for bacterial examination. Seventy-eight (73.6%) of 106 patients identified with causative bacteria had some underlying diseases, and the other 28 patients did not have any underlying diseases. Proportions and antibiotics susceptibility profiles of the identified causative bacteria were almost similar in the patients with and without underlying diseases. Sputum sampling from the hypopharynx through the nose might be significant in pediatric CA-LRTI of suspected bacterial etiology. The initial treatment for patients without underlying diseases would be applicable to those with underlying diseases in the CA-LRTI of children.
本研究旨在确认经鼻抽吸咽部分泌物培养鉴定儿童社区获得性下呼吸道感染（CA-LRTI）病原菌的作用，并比较伴有和不伴有基础疾病患儿的特征。对 244 例因疑似细菌性病因住院的 CA-LRTI 患儿进行回顾性研究。通过经鼻或气管造口抽吸气道分泌物或自行咳痰获得这些患儿的痰标本。160 例疑似单纯细菌性病因的 CA-LRTI 患儿中，119 例（74.4%）的痰标本适合进行细菌学检查。96 例（70.1%）经鼻抽吸咽部分泌物的标本适合进行细菌检查。78 例（73.6%）明确病原菌的 106 例患儿存在某些基础疾病，另外 28 例患儿没有任何基础疾病。有和无基础疾病患儿的病原菌构成及药敏谱几乎相似。经鼻抽吸咽部分泌物培养对疑似细菌性病因的儿童 CA-LRTI 可能具有重要意义。无基础疾病患儿的初始治疗方案适用于伴有基础疾病的患儿。
