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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
[Clinical analysis of 309 hospitalized children with pertussis-associated pneumonia]
Insights
Pertussis-associated pneumonia is common in hospitalized children, particularly males and younger children with underlying conditions. Early recognition and management are crucial for better outcomes.
Area of Science:
- Pediatrics
- Infectious Diseases
- Respiratory Medicine
Background:
- Pertussis, or whooping cough, remains a significant public health concern globally.
- Pneumonia is a common and serious complication of pertussis, especially in infants and young children.
- Understanding the risk factors and clinical characteristics of pertussis-associated pneumonia is essential for timely diagnosis and treatment.
Purpose of the Study:
- To investigate the clinical features of pertussis-associated pneumonia in hospitalized children.
- To identify risk factors associated with the development of pneumonia in children with Bordetella pertussis infection.
Main Methods:
- Retrospective analysis of clinical data from 501 children hospitalized with Bordetella pertussis infection between October 2013 and December 2015.
- Patients were categorized into groups with and without radiologically confirmed pneumonia.
- Statistical analysis, including t-tests, rank sum tests, chi-square tests, and unconditional logistic regression, was used to compare groups and identify risk factors.
Main Results:
- Of 501 children, 309 (61.7%) developed pneumonia. The median age was 3 months.
- Common symptoms included paroxysmal cough (81.6%), cyanosis (34.0%), and tachypnea (22.3%).
- Male sex, younger age (median 3 vs. 4 months), and presence of comorbidities were significantly associated with pneumonia. Male sex (OR=1.648), younger age (OR=1.486), and comorbidities (OR=2.695) were independent risk factors.
Conclusions:
- Pneumonia is a frequent complication of pertussis in hospitalized children, often requiring extensive hospitalization.
- Younger male children with underlying comorbidities are at higher risk for developing pertussis-associated pneumonia.
- Pneumonia commonly develops within the first two weeks of the disease course.
Abstract:
Objective: To investigate the clinical characteristics of pertussis-associated pneumonia and analyze it's risk factors. Methods: Clinical data were taken from Shenzhen Children's Hospital with Bordetella pertussis infection and confirmed by culture or real-time polymerase chain reaction (PCR) of nasopharyngeal secretion from October 2013 to December 2015. Patients were divided into two groups, those with radiologically confirmed pneumonia in the course of their disease and those with not. Clinical data were retrospectively analyzed and compared. T test, Rank sum test or chi square test were used for comparison between groups. Risk factors were analyzed by unconditional Logistic regression analysis. Results: A total of 501 children hospitalized with Bordetella pertussis infection were included. Among them, 309 patients were diagnosed with pneumonia. The median age was 3 (2, 6) months. Symptoms were paroxysmal cough (n=252, 81.6%), tachypnea (n=69, 22.3%), and cyanosis (n=105, 34.0%). The time from onset of cough to radiologically confirmed pneumonia was between 1 and 66 days with a median of 9 (5.5, 15.0) days. The most common pathogen of coinfection was respiratory syncytial virus (RSV)(20 cases). Macrolides were used in 306 cases for (8.2±3.6) days. All cases showed significant improvement. There were more male children (62.1% (192/309) vs. 50.3% (95/189) , χ(2)=6.768, P=0.009), and more instances of comorbidities (13.3% (41/309) vs.5.8% (11/189) , χ(2)=6.957, P=0.008) in the pneumonia group than in the other. The age was younger (3 (2,6) vs.4 (2,6) months, Z=32.91, P=0.000) in pneumonia group than in the other. Male sex, younger age, and underlying disease were independent risk factors for pertussis-associated pneumonia (OR=1.648, 1.486, 2.695, P=0.008, 0.036, 0.005). Conclusions: Pneumonia, as a complication of pertussis, is very easy to see in hospitalized children. The duration of hospitalization is extensive. It is more likely to happen in children who are male, young, and having underlying diseases. Pneumonia is easy to occur in the first 2 weeks of the course of disease.
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