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Update on protracted bacterial bronchitis in children

儿童迁延性细菌性支气管炎的最新进展

  • 影响因子:1.68
  • DOI:10.1186/s13052-020-0802-z
  • 作者列表:"Xiao-bo Zhang","Xiao Wu","Guang-min Nong
  • 发表时间:2020-04-03
Abstract

Abstract Background Chronic cough is a common symptom in children and protracted bacterial bronchitis (PBB) is one of the causes of chronic cough. However, the understanding of this disease remains limited. The present study aims to update PBB in children. Methods The clinical data of children with PBB from 2014 to 2018 were retrospectively analyzed, and PBB clinical features of published studies were summarized. Electronic databases were searched in May 2019. Clinical studies were included in the present study. Reviews were undertaken in duplicate. Results Totally 712 cases were analyzed in this study, including 52 cases in our center and 660 cases from 14 studies. In the 52 cases, 88.5% of patients with PBB were less than 6 years old and all of them complained of wet cough. Three cases were confirmed with laryngomalacia, and microbiologically-based-PBB were identified in 13 cases (9 Streptococcus pneumonia, 3 Staphylococcus aureus, and 1 Pseudomonas aeruginosa). Twenty cases were completely remitted after treatment. In the 14 studies, the patients with PBB were typically younger than 3 years old, accompanying wheezing and airway malacia. Co-infection was common in most western cases, Streptococcus pneumonia, Haemophilus influenza and Moraxella catarrhalis were the top three pathogens. Symptoms were improved in most patients, whereas some cases with comorbidities required prolonged antibiotics treatment. Conclusions PBB is common in male infants with chronic wet cough and accompanied by wheezing and airway deformities. Most cases are clinically diagnosed PBB in China and microbiologically-based-PBB is common in western countries. Co-infection could be found, Streptococcus pneumoniae and Haemophilus influenza were the most frequent etiology in China and western countries, respectively. Patients with comorbidities may need extended antibiotics treatment for more than 2 weeks.

摘要

文摘背景慢性咳嗽是儿童常见的症状,迁延性细菌性支气管炎 (PBB) 是慢性咳嗽的原因之一。然而,对这种疾病的认识仍然有限。本研究旨在更新儿童 PBB。方法回顾性分析 2014年 ~ 2018年 PBB 患儿的临床资料,总结已发表研究的 PBB 临床特征。2019年5月检索了电子数据库。本研究纳入临床研究。审查一式两份。结果本研究共分析 712 例病例,其中本中心 52 例,14 项研究 660 例。52 例患者中,88.5% 的 PBB 患者年龄小于 6 岁,均以咳嗽为主诉。3 例确诊为喉软化,13 例 (肺炎链球菌 9 例,金黄色葡萄球菌 3 例,铜绿假单胞菌 1 例) 确定为基于微生物的 PBB。20 例经治疗后完全缓解。在 14 项研究中,PBB 患者典型为年轻至 3 岁,伴有喘息和气道软化。多数西方病例合并感染常见,肺炎链球菌、流感嗜血杆菌和卡他莫拉菌为前 3 位病原体。大多数患者症状得到改善,而一些有合并症的病例需要长期抗生素治疗。结论 PBB 常见于慢性湿性咳嗽伴喘息和气道畸形的男婴。在中国,大多数病例是临床诊断的 PBB,基于微生物的 PBB 在西方国家很常见。发现混合感染,肺炎链球菌和流感嗜血杆菌分别是中国和西方国家最常见的病原学。有合并症的患者可能需要延长抗生素治疗 2 周以上。

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发表时间:2020-01-29
DOI:10.1080/02770903.2020.1723622
作者列表:["Parlar-Chun R","Arnold K"]

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影响因子:2.40
发表时间:2020-02-02
来源期刊:BMC Pulmonary Medicine
DOI:10.1186/s12890-020-1056-7
作者列表:["Joon Young Choi","Jeong Uk Lim","Ho Jung Jeong","Ji Eun Lee","Chin Kook Rhee"]

METHODS:Abstract Background We investigated the association between a combination of two markers, peripheral (PEC) and bronchoalveolar lavage (BAL) eosinophil percentage (BEP), and oxygen requirements in patients with acute eosinophilic pneumonia (AEP). Methods We retrospectively reviewed the medical records of patients with AEP treated at the Armed Forces Capital Hospital between May 2012 and May 2017. We used correlation analyses to assess the association between PEC/BEP and clinical outcomes in AEP patients. Receiver operating characteristic (ROC) curve analyses were used to calculate the cut-off value for BEP that categorised patients requiring a significant oxygen supply. The BAL/blood eosinophil (BBE) score was introduced to stratify patients with peripheral eosinophilia and elevated BEP. Clinical characteristics and outcomes were compared between the different groups. Multiple logistic regression was performed for significant oxygen requirements using two different models using age, C-reactive protein (CRP), smoking duration, and BBE score (model 1) and age, CRP, BEP, and PEC (model 2). Results Among the 338 patients, 99.7% were male, and their mean age was 20.4 ± 1.4 years. Only 0.6% of patients were never smokers and the mean number of smoking days was 26.2 ± 25.4. Correlation analyses revealed that both the PaO2/FiO2 ratio and duration of oxygen supply were associated with BEP. ROC curve analyses indicated a cut-off level of 41.5%. Patients with a high BBE score had favourable outcomes in terms of hypoxemia, hospital days, intensive care unit admission, oxygen supply days, and steroid treatment days. Multiple logistic regression revealed that BEP and BBE score tended to be associated with significant oxygen requirements. Conclusions In this study, we revealed that both peripheral and BAL eosinophilia is associated with favourable outcomes in AEP patients.

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影响因子:2.41
发表时间:2020-01-22
DOI:10.1155/2020/9814916
作者列表:["Fei Zhao","Xuemei Guan","Jing Li","Liyong Liu","Jie Gong","Lihua He","Fanliang Meng","Jianzhong Zhang"]

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