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迁延性细菌性支气管炎患儿的临床特征:一项观察性队列研究

Clinical characteristics of infants with protracted bacterial bronchitis: an observational cohort study.

作者信息

Xie Yaping, Chen Chen, Yang Diyuan, Xu Xuehua, Lu Gen, Fan Huifeng

机构信息

Department of Respiration, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.

出版信息

Transl Pediatr. 2025 Mar 31;14(3):400-408. doi: 10.21037/tp-2024-509. Epub 2025 Mar 26.

Abstract

BACKGROUND

Infants with protracted bacterial bronchitis (PBB) have been reported in case reports and limited small case series, which is not commonly recognized. The aim of the study is to determine the clinical features and image findings of infants with PBB for early detection and diagnosis.

METHODS

Infants with PBB were prospectively enrolled during January 2021 to January 2024 in Guangzhou Women and Children's Medical Center. Clinical data were collected, including clinical manifestations, laboratory parameters, radiological findings, management, and follow-up.

RESULTS

There were 37 patients included (30 boys, 81.08%; 7 girls, 18.92%) with a median onset age of 6 months [interquartile range (IQR), 4-7.5 months]. All patients presented with wet cough (100.00%), 34 presented with persistent wheezing (91.89%). bacteria (12/37, 32.43%) and (11/37, 29.73%) were the most often diagnosed pathogens. There were nine patients detected with multiple drug-resistant strains by bronchoalveolar lavage (BAL) cultures (9/32, 28.13%). Uneven inflation was the most common form of chest computed tomography (CT) manifestation (27/37, 72.97%). Under bronchoscopy, thick pale yellow or yellow mucus was attached to the airway in all patients. The use of antibiotics was permitted for all infants with PBB after a definite diagnosis (37/37, 100.00%). The condition can be completely mitigated (34/37, 91.89%), only three patients developed recurrent PBB.

CONCLUSIONS

Wheezing was a very common clinical performance in infants with PBB, and the most common pathogens were bacteria and Streptococcus pneumoniae. The CT performance of PBB mainly is uneven inflation in infants.

摘要

背景

迁延性细菌性支气管炎(PBB)患儿已在病例报告和有限的小病例系列中有所报道,但尚未得到普遍认识。本研究的目的是确定PBB患儿的临床特征和影像学表现,以便早期发现和诊断。

方法

2021年1月至2024年1月期间,前瞻性纳入广州妇女儿童医疗中心的PBB患儿。收集临床资料,包括临床表现、实验室参数、影像学检查结果、治疗及随访情况。

结果

共纳入37例患者(男30例,占81.08%;女7例,占18.92%),发病年龄中位数为6个月[四分位间距(IQR),4 - 7.5个月]。所有患者均有湿性咳嗽(100.00%),34例有持续性喘息(91.89%)。 细菌(12/37,32.43%)和 (11/37,29.73%)是最常被诊断出的病原体。通过支气管肺泡灌洗(BAL)培养,有9例患者检测出多重耐药菌株(9/32,28.13%)。胸部计算机断层扫描(CT)表现最常见的形式是充气不均匀(27/37,72.97%)。在支气管镜检查下,所有患者气道内均附着有浓稠的淡黄色或黄色黏液。确诊后,所有PBB患儿均使用了抗生素(37/37,100.00%)。病情可完全缓解(34/37,91.89%),只有3例患者出现复发性PBB。

结论

喘息是PBB患儿非常常见的临床表现,最常见的病原体是 细菌和肺炎链球菌。PBB在婴幼儿中的CT表现主要为充气不均匀。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c91/11983007/e065fca21207/tp-14-03-400-f1.jpg

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