Xiamen Children's Hospital, Xiamen Branch of children's Hospital of Fudan University, 361006, Xia Men, China.
Infectious Disease Department, Children's Hospital of Fudan University, National Children's Medical Center, 201102, Shanghai, China.
BMC Infect Dis. 2022 Nov 1;22(1):814. doi: 10.1186/s12879-022-07749-w.
There is little evidence about consistency between nasopharyngeal and pulmonary pathogens in children with severe pneumonia. This study aims to compare the difference of pathogens between nasopharyngeal aspirates (NPAs) collected before bronchoscopy and bronchoalveolar lavage fluids (BALFs) in children with severe community-acquired pneumonia (SCAP).
NPAs and BALFs were collected form pediatric SCAP cases hospitalized from January 2018 to March 2019. NPAs were colleced within 3 days before bronchoscopy. Samples were detected by direct immunofluorescence assay (DFA) for seven respiratory viruses and by routine bacterial culture in the clinical microbiology laboratory. Respiratory syncytial virus (RSV), Adenovirus (ADV), Influenza virus types A, B (IV-A and IV-B), Parainfluenza virus 1-3 (PIV1-3) were detected with a commercial assay. The virological and bacteriological detention results of NPAs were compared with the results of BALFs.
In total 204 cases with mean age of 3.4 ± 2.8 years (IQR, 1 month-14 years) were included in the study. Both NPA and BALF were collected from those cases. The positive rates of pathogen in NPAs and BALFs were 25.0% (51/204) and 36.7% (75/204), respectively (x = 6.614, P = 0.010). Respiratory viruses were found in 16.1% (33/204) from NPAs and 32.3% (66/204) from BALFs (x = 14.524, P < 0.001). RSV and ADV were the two most frequent detected viruses in NPAs and BALFs. High consistentcy of pathogens between NPAs and BALFs was observed, and 96.9% (32/33) viruses detected in NPAs were also found in BALFs. While bacteria were isolated from 12.7% (26/204) and 10.7% (22/204) of the two kinds of samples, respectively (x = 0.378, P = 0.539). In addition, Haemophilus influenzae (HI) was the dominant germ in both samples.
The DFA method used to detect seven respiratory viruses from NPAs collected within 3 days before bronchoscopy can partially reflect the pathogens in the lungs in children with SCAP.
儿童重症社区获得性肺炎（SCAP）患者鼻咽部和肺部病原体之间的一致性证据较少。本研究旨在比较支气管镜检查前采集的鼻咽抽吸物（NPA）和支气管肺泡灌洗液（BALF）中儿童重症 SCAP 患者病原体的差异。
2018 年 1 月至 2019 年 3 月，从住院的儿童 SCAP 病例中采集 NPA 和 BALF。NPA 在支气管镜检查前 3 天内采集。使用直接免疫荧光法（DFA）检测七种呼吸道病毒，并在临床微生物学实验室进行常规细菌培养。采用商业检测法检测呼吸道合胞病毒（RSV）、腺病毒（ADV）、甲型流感病毒、乙型流感病毒（IV-A 和 IV-B）、副流感病毒 1-3（PIV1-3）。将 NPA 的病毒学和细菌学检测结果与 BALF 的检测结果进行比较。
本研究共纳入 204 例平均年龄为 3.4±2.8 岁（IQR，1 个月-14 岁）的患者。这些患者均同时采集了 NPA 和 BALF。NPA 和 BALF 的病原体阳性率分别为 25.0%（51/204）和 36.7%（75/204）（x=6.614，P=0.010）。呼吸道病毒在 NPA 中的检出率为 16.1%（33/204），在 BALF 中的检出率为 32.3%（66/204）（x=14.524，P<0.001）。RSV 和 ADV 是 NPA 和 BALF 中最常见的两种检测病毒。NPA 和 BALF 之间病原体高度一致，NPA 中检测到的 96.9%（32/33）病毒也在 BALF 中检出。两种样本中分别分离出细菌 12.7%（26/204）和 10.7%（22/204）（x=0.378，P=0.539）。此外，流感嗜血杆菌（HI）是两种样本中的主要细菌。
支气管镜检查前 3 天内采集的 NPA 采用 DFA 方法检测七种呼吸道病毒，可部分反映儿童 SCAP 肺部病原体情况。
