Bernstein T, Brilli R, Jacobs B
Division of Critical Care Medicine, Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
Clin Infect Dis. 1998 Sep;27(3):458-62. doi: 10.1086/514681.
Bacterial tracheitis is characterized by acute upper-airway obstruction and purulent secretions within the trachea. Historically, affected children were young, stridorous, and toxic-appearing and required tracheal intubation, and morbidity and mortality were significant. Staphylococcus aureus was the most common organism involved. During the 14 months of this retrospective study, 46 children were admitted to the pediatric intensive care unit because of this diagnosis, and their medical records were reviewed. Compared with those in previous reports, children in this study were older (mean +/- standard error of the mean [SEM], 69.3 +/- 6.8 months) and less toxic. Only 26 (57%) of 46 patients required tracheal intubation. Intubated patients were significantly younger than nonintubated patients (mean +/- SEM, 46.9 +/- 6.5 vs. 98.9 +/- 9.9 months). Moraxella catarrhalis was identified in 12 (27%) of 45 bacterial respiratory cultures, while influenza A virus was recovered from 18 (72%) of 25 viral respiratory cultures. There were no major complications. This series represents the largest reported cohort of patients with this condition and suggests an epidemiological change toward a less morbid condition.
细菌性气管支气管炎的特征为急性上呼吸道梗阻及气管内脓性分泌物。从历史来看，患病儿童年幼，有喘鸣音，且呈现中毒症状，需要气管插管，发病率和死亡率都很高。金黄色葡萄球菌是最常见的相关病原体。在这项回顾性研究的14个月期间，有46名儿童因该诊断入住儿科重症监护病房，并对他们的病历进行了审查。与之前报告中的儿童相比，本研究中的儿童年龄更大（平均±平均标准误差[SEM]，69.3±6.8个月），中毒症状较轻。46例患者中只有26例（57%）需要气管插管。插管患者明显比未插管患者年龄小（平均±SEM，46.9±6.5岁 vs. 98.9±9.9岁）。在45份细菌呼吸道培养物中有12份（27%）检测出卡他莫拉菌，而在25份病毒呼吸道培养物中有18份（72%）检测出甲型流感病毒。无重大并发症。该系列代表了已报道的患有这种疾病的最大患者队列，并表明了一种朝着病情较轻状态发展的流行病学变化。
