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1.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 29(6): 1957-1962, 2021 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-34893141

RESUMO

OBJECTIVE: To analyze the risk factors affecting prognosis of children with hemophagocytic lymphohistiocytosis (HLH). METHODS: The clinical manifestations and laboratory data of 143 HLH children who met the HLH-2004 diagnostic criteria in Shenzhen Children's Hospital from January 2009 to May 2017 were retrospectively analyzed, and the independent factors affecting prognosis were also analyzed. RESULTS: The median age of 143 HLH children was 1.9 (0.1-14.3) years old, and the median follow-up time was 6.7 years (1 day - 11.9 years). The overall survival rate of 1 month, 1 year, and 10 years was (87.4±5.5)%, (81.1±6.5)%, and (81.1±6.5)%, respectively. The deaths occurred within 1 year after onset. Multivariate analysis showed that central nervous system (CNS) involvement (P=0.047), low hemoglobin (P=0.002), prolonged activated partial thromboplastin time (APTT) (P<0.001), high triglyceride (P=0.005) were all the independent risk factors affecting survival of the children. Receiver operating characteristic curve indicated that APTT (AUC=0.753, P<0.001) was more valuable than other risk factors in predicting death of the children. The cut-off value of APTT was 56.6 s, and the sensitivity and specificity of which was 55.6% and 89.7%, respectively. CONCLUSION: Hypohemoglobinemia, prolonged APTT, hypertriglyceridemia, and CNS involvement the risk factors affecting prognosis of HLH, and prolonged APTT shows a strong predictive value for death.

4.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(9): 933-937, 2021.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34535209

RESUMO

OBJECTIVES: To study the clinical features of obstructive sleep apnea (OSA) in children with obesity. METHODS: A retrospective analysis was performed on the medical data of 33 obese children aged 7-15 years, who were diagnosed with OSA and received polysomnography (PSG) in the Department of Respiratory Medicine in Shenzhen Children's Hospital. Fifty OSA children with normal body weight, matched for sex and age, were enrolled as the control group. RESULTS: Among the 33 obese children with OSA, the three most common daytime symptoms were inattention in 30 children (91%), somnolence in 22 children (67%), and morning fatigue in 21 children (64%), and the three most common nocturnal symptoms were snoring in 27 children (82%), mouth breathing in 20 children (61%), and sweating in 16 children (49%). Compared with the reference values of normal children, both the OSA + obesity group and the control group had prolonged light sleep, shortened deep sleep, and a significantly shortened rapid eye movement (REM) period, while there was no significant difference in these indices between the two groups (P>0.05). The apnea-hypopnea index, obstructive apnea/hypopnea index, and oxygen desaturation index in both REM and non-REM periods in the OSA +obesity group were significantly higher than those in the control group (P<0.05), while the lowest blood oxygen saturation during sleep was significantly lower in the OSA + obesity group (P<0.05). CONCLUSIONS: The children with obesity and OSA have the main daytime symptoms of inattention, somnolence, and morning fatigue and the main nocturnal symptoms of snoring, mouth breathing, and sweating. There is no significant difference in sleep structure between OSA children with obesity and those with normal body weight; however, respiratory events and blood oxygen saturation decline are more severe in OSA children with obesity. Citation.


Assuntos
Obesidade Pediátrica , Apneia Obstrutiva do Sono , Criança , Humanos , Obesidade Pediátrica/complicações , Polissonografia , Estudos Retrospectivos , Apneia Obstrutiva do Sono/complicações , Ronco
5.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(2): 158-163, 2021 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-33627211

RESUMO

OBJECTIVE: To study the clinical features of sleep-disordered breathing (SDB) in children with neuromuscular disease (NMD). METHODS: A retrospective analysis was performed on the medical data of 18 children who were diagnosed with NMD and underwent polysomnography (PSG) (NMD group). Eleven children without NMD who had abnormal sleeping habit and normal sleep structure on PSG were enrolled as the control group. The two groups were compared in terms of the daily and nocturnal symptoms of SDB, incidence rate of obstructive sleep apnea (OSA), pulmonary function, end-tidal partial pressure of carbon dioxide (PetCO2), features of sleep structure, and sleep respiratory events. RESULTS: In the NMD group, 16 children (89%) had related daily and nocturnal symptoms of SDB, and the youngest age was 1 year at the onset of such symptoms. Compared with the control group, the NMD group had significant reductions in total sleep time and sleep efficiency (P < 0.05), a significant reduction in the proportion of rapid eye movement (REM) sleep (P < 0.05), significant increases in obstructive apnea and hypopnea events (P < 0.05) and oxygen reduction events during REM sleep (P < 0.05), and a significant reduction in blood oxygen saturation during REM sleep (P < 0.05). In the NMD group, 17 children (94%) were diagnosed with OSA, and all children had normal lung function and PetCO2. CONCLUSIONS: There is a high proportion of children with SDB among the children with NMD, and SDB can be observed in the early stage of NMD, which results in the damage of sleep structure and the reduction in sleep efficiency. Respiratory events are mainly obstructive events, and oxygen reduction events are mainly observed during REM sleep.


Assuntos
Doenças Neuromusculares , Síndromes da Apneia do Sono , Criança , Humanos , Doenças Neuromusculares/complicações , Polissonografia , Estudos Retrospectivos , Sono , Síndromes da Apneia do Sono/etiologia
6.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(10): 1105-1108, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-33059808

RESUMO

OBJECTIVE: To study the clinical features of children with influenza and plastic bronchitis (PB). METHODS: A retrospective analysis was performed on the medical data of 63 children with influenza and PB, including clinical manifestations, laboratory examination results, imaging findings, treatment, and outcome. RESULTS: Among the 63 children, there were 52 boys (83%) and 11 girls (17%), and 42 children had influenza A and 21 had influenza B. Among these children, 38 (60%) aged 3-6 years, and 15 (24%) had underlying diseases. The main clinical manifestations were high fever (90%), cough (95%), and shortness of breath (73%). Twenty-four children (38%) were found to have atelectasis by imaging examination. Auscultation showed that 16 children (25%) had no rales in the lungs. Of all children, 41 were admitted to the intensive care unit, and 32 required mechanical ventilation. All children underwent fiberoptic bronchoscopy and alveolar lavage. Among the 63 children, 60 recovered and 3 died. CONCLUSIONS: Influenza with PB is often observed in boys and preschool children. For influenza children with shortness of breath, even if there is no atelectasis on chest X-ray or no rales are found by auscultation, the possibility of PB still needs to be considered.


Assuntos
Bronquite , Influenza Humana , Bronquite/diagnóstico , Broncoscopia , Criança , Pré-Escolar , Feminino , Humanos , Influenza Humana/diagnóstico , Masculino , Atelectasia Pulmonar , Estudos Retrospectivos
8.
World J Pediatr ; 16(3): 232-239, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32333248

RESUMO

In the early February, 2020, we called up an experts' committee with more than 30 Chinese experts from 11 national medical academic organizations to formulate the first edition of consensus statement on diagnosis, treatment and prevention of coronavirus disease 2019 (COVID-19) in children, which has been published in this journal. With accumulated experiences in the diagnosis and treatment of COVID-19 in children, we have updated the consensus statement and released the second edition recently. The current version in English is a condensed version of the second edition of consensus statement on diagnosis, treatment and prevention of COVID-19 in children. In the current version, diagnosis and treatement criteria have been optimized, and early identification of severe and critical cases is highlighted. The early warning indicators for severe pediatric cases have been summarized which is utmost important for clinical practice. This version of experts consensus will be valuable for better prevention, diagnosis and treatment of COVID-19 in children worldwide.


Assuntos
Infecções por Coronavirus , Coronavirus , Pandemias , Pneumonia Viral/epidemiologia , Betacoronavirus , COVID-19 , Criança , Consenso , Humanos , SARS-CoV-2
9.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(2): 106-111, 2020 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-32051075

RESUMO

OBJECTIVE: To study the clinical features of influenza with plastic bronchitis (PB) in children, and to improve the awareness of the diagnosis and treatment of PB caused by influenza virus. METHODS: A retrospective analysis was performed for the clinical data of 70 children with lower respiratory influenza virus infection from October 2018 to October 2019. According to the presence or absence of PB, they were divided into an influenza+PB group with 12 children and a non-PB influenza group with 58 children. Related clinical data were collected for the retrospective analysis, including general information, clinical manifestations, laboratory examination, imaging findings, treatment, and prognosis. RESULTS: In the influenza+PB group, most children experienced disease onset at the age of 1-5 years, with the peak months of January, February, July, and September. Major clinical manifestations in the influenza+PB group included fever, cough, and shortness of breath. The influenza+PB group had significantly higher incidence rates of shortness of breath and allergic diseases such as asthma than the non-PB influenza group (P<0.05). Of the 12 children in the influenza+PB group, 7(58%) had influenza A virus infection and 5 (42%) had influenza B virus infection, among whom 1 had nephrotic syndrome. For the children in the influenza+PB group, major imaging findings included pulmonary consolidation with atelectasis, high-density infiltration, pleural effusion, and mediastinal emphysema. Compared with the non-PB influenza group, the influenza+PB group had a significantly higher proportion of children who were admitted to the pediatric intensive care unit (P<0.05). Bronchoscopic lavage was performed within 1 week after admission, and all children were improved and discharged after anti-infective therapy and symptomatic/supportive treatment. CONCLUSIONS: Influenza with PB tends to have acute onset and rapid progression, and it is important to perform bronchoscopy as early as possible. The possibility of PB should be considered when the presence of shortness of breath, allergic diseases such as asthma or nephrotic syndrome in children with influenza.


Assuntos
Bronquite , Influenza Humana , Criança , Humanos , Vírus da Influenza B , Atelectasia Pulmonar , Estudos Retrospectivos
10.
World J Pediatr ; 14(4): 335-343, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30062648

RESUMO

BACKGROUND: Children as a population have high antimicrobial prescribing rates which may lead to high resistance of bacteria according to data from some single-center surveys of antibiotic prescribing rates in China. The acquirement of baseline data of antibiotic prescribing is the basis of developing intervention strategies on inappropriate antimicrobial prescriptions. Few studies show clearly the pattern and detailed information on classes of antibiotics and distribution of indications of antibiotic prescriptions in children in China. This study aims to assess the antibiotic prescribing patterns among children and neonates hospitalized in 18 hospitals in China. METHODS: A 24-hour point prevalence survey on antimicrobial prescribing was conducted in hospitalized neonates and children in China from December 1st, 2016 to February 28th, 2017. Information on the antibiotic use of patients under 18 years of age who were administered one or more on-going antibiotics in the selected wards over a 24-hour period was collected. These data were submitted to the GARPEC (Global Antimicrobial Resistance, Prescribing and Efficacy in Children and Neonates) web-based application ( https://pidrg-database.sgul.ac.uk/redcap/ ). For statistical analysis, Microsoft Excel 2007 and SPSS 22.0 were used. RESULTS: The antibiotic data were collected in 35 wards in 18 hospitals from 9 provinces. In total, 67.76% (975/1439) of the patients (n = 1439) were given at least one antibiotic, including 58.1% (173/298) of neonates (n = 298) and 70.3% (802/1141) of children (n = 1141). In neonates, the three most frequently prescribed antibiotics were third-generation cephalosporins (41.7%), penicillins plus enzyme inhibitor (23.8%), and carbapenems (11.2%). In children, the three most frequently prescribed antibiotics were third-generation cephalosporins (35.5%), macrolides (23.2%), and penicillins plus enzyme inhibitors (15.9%). The most common indication for antibiotics was proven or probable bacterial lower respiratory tract infection (30.9% in neonates and 66.6% in children). CONCLUSIONS: Antibiotics are commonly prescribed in the Chinese children population. It is likely that the third-generation cephalosporins and macrolides are currently overused in Chinese children. Efforts must be made to ensure safe and appropriate antibiotic prescribing to reduce and prevent the future development of antibiotic resistance.


Assuntos
Antibacterianos/uso terapêutico , Resistência Microbiana a Medicamentos , Uso de Medicamentos/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Prescrição Inadequada/estatística & dados numéricos , Criança , Pré-Escolar , China , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Prevalência , Medição de Risco
11.
World J Pediatr ; 14(5): 482-491, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30047047

RESUMO

BACKGROUND: Asthma is a significant chronic health problem worldwide. Management aims at disease control by reducing functional impairment and exacerbations and improving quality of life (QoL). We report a multi-center study to survey asthma control and QoL in four cities in the Pearl River Delta. METHODS: The conjoint survey involved ten Hong Kong pediatric hospitals/units, two Shenzhen hospitals, two Macau hospitals, and two Guangzhou hospitals on asthma control (using Asthma Control Test) and QoL (Pediatric Allergic Disease Quality of Life Questionnaire, PADQLQ). Acceptability of a treatment is graded as very good/good/fair/poor. RESULTS: Good asthma control was only reported in 80% subjects in Hong Kong, but higher in sister cities (85-94%, P < 0.001). Allergic rhinitis, "incense burning", and "smoker in family" were prevalent among the four cities. Logistic regression showed better control of asthma was associated with better PADQLQ (B = - 0.029, P < 0.001), better acceptability of bronchodilator (B = - 1.488, P = 0.025), negatively with "smoker in family" (B = - 0.83, P = 0.015) and various PADQLQ domains. Conversely, worse PADQLQ was associated with allergic rhinitis severity (B = 4.77, P < 0.001), poor control of asthma (B = 7.56, P < 0.001), increased frequency of traditional Chinese medicine use (B = 1.7, P < 0.05), increased frequency of bronchodilator usage (B = 1.05, P < 0.05), "smoker in family" (B = 4.05, P < 0.05), and incense burning at home (B = 3.9, P < 0.05). CONCLUSIONS: There are some clinical and cultural differences among the four southern Chinese cities within the Guangdong province. This study identifies potentially modifiable environmental and treatment factors associated with poor asthma control and QoL for health-care interventions. Having a smoker in the family is independently associated with poor asthma control and QoL.


Assuntos
Asma/diagnóstico , Asma/terapia , Terapias Complementares/métodos , Qualidade de Vida , Inquéritos e Questionários , Adolescente , Asma/psicologia , Criança , Cidades , Estudos Transversais , Feminino , Hong Kong , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Pediatria , Medição de Risco , Índice de Gravidade de Doença , Resultado do Tratamento , População Urbana
12.
World J Gastroenterol ; 23(12): 2149-2158, 2017 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-28405142

RESUMO

AIM: To determine whether oral administration of Bifidobacterium infantis CGMCC313-2 (B. infantis CGMCC313-2) inhibits allergen-induced airway inflammation and food allergies in a mouse model. METHODS: Ovalbumin (OVA)-induced allergic asthma and ß-lactoglobulin-induced food allergy mouse models were used in this study. Following oral administration of B. infantis CGMCC313-2 during or after allergen sensitization, histopathologic changes in the lung and intestine were evaluated by hematoxylin and eosin (HE) staining. In the allergic asthma mouse model, we evaluated the proportion of lung-infiltrating inflammatory cells. OVA-specific IgE and IgG1 levels in serum and cytokine levels in bronchoalveolar lavage fluid (BALF) were also assessed. In the food allergy mouse model, the levels of total IgE and cytokines in serum were measured. RESULTS: Oral administration of B. infantis CGMCC313-2 during or after allergen sensitization suppressed allergic inflammation in lung and intestinal tissues, while the proportion of infiltrating inflammatory cells was significantly decreased in the BALF of allergic asthma mice. Moreover, B. infantis CGMCC313-2 decreased the serum levels of total IgE in food allergy mice, and reductions in IgE and IgG1 were also observed in OVA-induced allergic asthma mice. The expression of interleukin-4 (IL-4) and IL-13 in both serum and BALF was suppressed following the administration of B. infantis CGMCC313-2, while an effect on serum IL-10 levels was not observed. CONCLUSION: B. infantis CGMCC313-2 inhibits the secretion of allergen-induced IgE, IL-4 and IL-13, and attenuates allergic inflammation.


Assuntos
Asma/induzido quimicamente , Bifidobacterium longum subspecies infantis , Hipersensibilidade Alimentar/prevenção & controle , Intestinos/imunologia , Probióticos , Alérgenos/química , Animais , Líquido da Lavagem Broncoalveolar , Citocinas/sangue , Modelos Animais de Doenças , Hipersensibilidade Alimentar/terapia , Imunoglobulina E/sangue , Imunoglobulina G/sangue , Inflamação , Interleucina-13/sangue , Interleucina-4/sangue , Lactoglobulinas/química , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Ovalbumina/química
13.
Chin Med J (Engl) ; 126(8): 1522-7, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23595388

RESUMO

BACKGROUND: Erythromycin-resistant Streptococcus pneumoniae isolates that causing invasive pneumococcal diseases (IPD) in Chinese children remain uncharacterized. This study aims to identify the resistance genes associated with erythromycin resistance and to determine the genetic relationships of IPD isolates in Chinese children. METHODS: A total of 171 S. pneumoniae strains were isolated from 11 medical centers in China from 2006 to 2008. All the isolates were characterized via serotyping and antibiotic susceptibility determination. The erythromycin-resistant isolates were further characterized via ermB and mefA gene detection, multi-locus sequence typing analysis, and pulsed-field gel electrophoresis. RESULTS: A total of 164 (95.9%) isolates showed resistance to erythromycin, of which 162 strains with high high-level resistance (MIC ≥ 256 µg/ml). A total of 104 (63.4%) isolates carry the ermB gene alone, whereas 59 (36.0%) harbor both ermB and mefA genes. Of the 59 strains, 54 were of serotypes 19A and 19F and were identified as highly clonal and related to the Taiwan(19F)-14 clone. CONCLUSIONS: The erythromycin resistance rate in IPD isolates is significantly high and is predominantly mediated by the ermB gene. Isolates that carry both ermB and mefA genes are predominantly of serotypes 19A and 19F.


Assuntos
Antibacterianos/farmacologia , Eritromicina/farmacologia , Infecções Pneumocócicas/microbiologia , Streptococcus pneumoniae/efeitos dos fármacos , Adolescente , Criança , Pré-Escolar , Farmacorresistência Bacteriana , Eletroforese em Gel de Campo Pulsado , Humanos , Lactente , Tipagem de Sequências Multilocus , Sorotipagem , Streptococcus pneumoniae/classificação , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/isolamento & purificação
14.
Zhongguo Dang Dai Er Ke Za Zhi ; 14(12): 918-23, 2012 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-23234778

RESUMO

OBJECTIVE: To investigate the prevalence rate and risk factors for asthma in children from the Futian District of Shenzhen, China who were aged from 0-14 years between 2010 and 2011, and to provide scientific evidence for the prevention and treatment of childhood asthma. METHODS: A multistage stratified cluster sampling survey of 7168 children aged 0-14 years from the Futian District of Shenzhen was conducted using the Third National Childhood Asthma Epidemiological Questionnaire 2010, to investigate the prevalence rate of childhood asthma. A case-control study (1∶1) and logistic regression analysis were used to investigate the risk factors for childhood asthma. RESULTS: Of the 7168 children surveyed, 169 were diagnosed with asthma, with a total prevalence rate of 2.36%. The prevalence rate was higher in males than in females (3.06% vs 1.55%, P<0.01). Of the 169 cases, 115 (68.1%) had their first asthma attack before the age of 3 years, 95 (56.2%) had moderate attacks, 159 (94.1%) had sudden attacks, 86 (50.9%) suffered from asthma during periods of seasonal change, 97 (57.4%) had attacks before going to bed, 157 (92.9%) suffered from asthma caused by respiratory infection, and 159 (94.1%) had sneezing as the sign of oncoming attack. The case-control study (including the 169 asthma cases and 169 healthy children) and logistic regression analysis both showed that the independent risk factors for asthma in children were a personal history of drug allergy (OR=3.431, 95%CI: 1.240-9.496, P=0.018), a history of food allergy (OR=4.043, 95%CI: 1.669-9.795, P= 0.002), allergic rhinitis (OR=9.686, 95%CI: 5.137-18.263, P<0.001), and a family history of allergy (OR=4.059, 95%CI: 2.054-8.018, P<0.001). CONCLUSIONS: The prevalence rate of asthma was 2.36% in children aged 0-14 years in the Futian District of Shenzhen between 2010 and 2011. The prevalence rate had not increased when compared with the rate in this region 10 years earlier (2.39%). The prevalence rate of childhood asthma is higher in males than in females. Personal history of drug allergy, food allergy, allergic rhinitis and a family history of allergy are the independent risk factors for childhood asthma in this region.


Assuntos
Asma/epidemiologia , Adolescente , Asma/etiologia , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Prevalência , Fatores de Risco , Estações do Ano
15.
Zhongguo Dang Dai Er Ke Za Zhi ; 14(11): 815-8, 2012 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-23146725

RESUMO

OBJECTIVE: To investigate changes in the fraction of exhaled nitric oxide (FeNO) in childhood asthma, and to evaluate the clinical value of continuous monitoring of FeNO. METHODS: Twenty children with mild to moderate asthma were enrolled from the special outpatient clinic for asthma. Follow-up was performed at 8, 16, 24, 32 and 40 weeks after treatment. At each follow-up, asthmatic symptoms were recorded, pulmonary function was evaluated and FeNO was measured. RESULTS: The mean FeNO decreased rapidly 8 weeks after treatment and slowly afterwards. It decreased significantly 8,16,24 and 40 weeks after treatment (P<0.01). It increased significantly during acute attacks of asthma and decreased rapidly during periods of remission. There was significant negative correlation between FeNO and forced expiratory volume in one second (r =-0.193 P<0.05). The receiver operating characteristic curve of FeNO showed that FeNO had a sensitivity of 87.9% and a specificity of 80% for uncontrolled asthma when FeNO was 35.5 ppb, and that it had a sensitivity of 97% and a specificity of 27.1% when FeNO was 20.5 ppb. CONCLUSIONS: monitoring of FeNO can be used to evaluate the control level of airway inflammation in childhood asthma. When FeNO is less than 20.5 ppb, airway inflammation may be well controlled. When FeNO is more than 35.5 ppb, airway inflammation may be out of control. A sharp increase in FeNO suggests the possibility of acute asthma attack in children.


Assuntos
Asma/diagnóstico , Testes Respiratórios , Óxido Nítrico/metabolismo , Asma/metabolismo , Criança , Pré-Escolar , Feminino , Volume Expiratório Forçado , Humanos , Masculino , Curva ROC
16.
Zhonghua Er Ke Za Zhi ; 50(9): 672-7, 2012 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-23158816

RESUMO

OBJECTIVE: To investigate drug-resistance and carriage of virulence factors of Pseudomonas aeruginosa (Pa) isolated from children. METHOD: Thirty-eight strains of Pa were collected and isolated in pediatric clinic during 2006-2009, and tests were undertaken to identify bacteria and susceptibility test was performed using VITEK-2 COMPACT GNI and AST-GN13 cards. The virulence factors were confirmed by using polymerase chain reaction (PCR) and sequencing. RESULT: All the 38 strains of Pa were resistant to ampicillin, ampicillin/sulbactam, cefazolin, nitrofurantoin, trimethoprim/sulfamethoxazole, resistance rates were 100%. Except for ceftriaxone (60.53%), the resistance rates to other antibiotics were all below 16%. PCR test showed that all the 38 strains of Pa carried exotoxin A(toxA) and nitric oxide reductase A (norA), however, detective ratio of the other virulence factors, exoenzyme Y (exoY) was 84.21% (32/38), exoenzyme S (exoS) 57.89% (22/38), pyocyanin (pyp) 42.11% (16/38), exoenzyme U (exoU) 34.21% (13/38), and 38 strains of Pa did not carry exoenzyme T (exoT) and elastase B (lasB) without exception. By analyzing tests, we discovered that 3 pan-drug resistant strains of Pa were all combination of exo U+/pyp+, there were 4 strains of Pa which were moderately-resistant to imipenem, including exoU+/pyp+/exoY+ (2 isolates), exo U+/pyp+ (1 isolate), and exoY+/exoS+ (1 isolates). It indicated that the drug-resistance rate of exoU+/pyp+ is much higher, compared with exoS+ and exoY+. Molecular epidemiological detection revealed that 2 of 3 extensive-resistance strains of Pa were the same clone, but another one had 96.3% of homology with them. CONCLUSION: The above mentioned 34.21% of Pa isolated from children carried virulence factors toxA, norA, exoS, exoY, pyp and exoU. The strains with exoU/pyp had rather high resistance. The strains with pyp had strong toxicity, they easily cause generalized infection, the patients with them had very high mortality.


Assuntos
ADP Ribose Transferases/genética , Toxinas Bacterianas/genética , Portador Sadio/microbiologia , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/patogenicidade , Fatores de Virulência/genética , Proteínas de Bactérias/genética , Portador Sadio/epidemiologia , Criança , Farmacorresistência Bacteriana Múltipla/genética , Exotoxinas , Genes Bacterianos , Humanos , Testes de Sensibilidade Microbiana , Reação em Cadeia da Polimerase , Infecções por Pseudomonas/epidemiologia , Infecções por Pseudomonas/genética , Pseudomonas aeruginosa/genética , Pseudomonas aeruginosa/isolamento & purificação
17.
Zhonghua Er Ke Za Zhi ; 50(7): 521-4, 2012 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-22932014

RESUMO

OBJECTIVE: To analyze the clinical characteristics of plastic bronchitis associated with 2009 influenza A virus (H1N1) infection. METHOD: A retrospective investigation of the clinical manifestation, bronchoscopy, and the histology of the cast, clinical course and outcome of 8 children with plastic bronchitis associated with influenza A virus (H1N1) infection during winter of 2009 and 2010 was performed. RESULT: All 8 cases were boys, the range of age was 3 to 6 years. Five cases occurred in 2009 winter, accounting for 3.3% (5/150) of hospitalized children with influenza A (H1N1) infection; 3 cases occurred in 2010 winter, accounting for 15.8% (3/19) of hospitalized children with influenza A (H1N1) infection. Two patients had an underlying chronic disease, 1 had asthma, and the other had allergic rhinitis and atopic dermatitis. All the 8 cases had fever, cough and sputum; 2 had wheezing; 5 had respiratory distress. All 8 cases were diagnosed as influenza A virus (H1N1) infection complicated with pneumonia, of whom 5 patients had atelectasis, 2 had pneumothorax, 1 had pneumomediastinum, 1 had parapneumonic effusion, 2 patients were suspected of foreign body aspiration. Seven cases were admitted to an ICU, 5 patients developed respiratory failure, and 3 patients required mechanical ventilation. Flexible bronchoscopy and bronchial lavage was performed in all cases and showed bronchial cast. Histological examination of the bronchial cast revealed a fibrinous material containing large quantity of eosinophils, neutrophils, and lymphocytes in 7 patients, fibrinous material and necrotic material without inflammatory cells in 1 patient. After the bronchial cast was removed, all patients were improved greatly, no patients died. CONCLUSION: Plastic bronchitis is a life-threatening complication associated with 2009 influenza A (H1N1) virus infection in children. In children with rapid and progressive respiratory distress with lung atelectasis or consolidation on chest radiograph, plastic bronchitis should be considered. Bronchoscopic extraction of casts should be carried out early.


Assuntos
Bronquite/complicações , Bronquite/virologia , Corpos Estranhos/complicações , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/complicações , Antivirais/administração & dosagem , Antivirais/uso terapêutico , Bronquite/diagnóstico , Bronquite/terapia , Broncoscopia , Criança , Pré-Escolar , Glucocorticoides/administração & dosagem , Glucocorticoides/uso terapêutico , Humanos , Influenza Humana/virologia , Unidades de Terapia Intensiva , Masculino , Atelectasia Pulmonar/diagnóstico , Atelectasia Pulmonar/terapia , Atelectasia Pulmonar/virologia , Doenças Raras , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/terapia , Insuficiência Respiratória/virologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
19.
Zhonghua Er Ke Za Zhi ; 50(1): 38-44, 2012 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-22456074

RESUMO

OBJECTIVE: To investigate the molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) isolates from Chinese children in seven cities. METHOD: A total of 134 MRSA isolates were collected from nine hospitals. Multilocus sequence typing and spa typing were analyzed by polymerase chain reaction (PCR), and staphylococcal chromosomal cassette mec (SCCmec) type was analyzed by multiplex PCR. The Panton-Valentine leukocidin (pvl) gene was also detected. RESULT: Most MRSA strains were isolated from pneumonia and skin and soft tissue infection (SSTIs) patients, accounting for 82.1%. Overall, 16 sequence types (STs) were obtained, and CC59 (51.7%) was found to be the most prevalent, which included ST 59 and ST 338, followed by ST239 (16.4%). SCCmec types II, III, IV, and V were also identified in the current study. SCCmec type IV was the most predominant type at 50.0%, followed by SCCmec type V at 23.9% and III at 23.9%. SCCmec subtypes IVa, IVc, and IVg were found among SCCmec type IV strains, whereas IVa was the main subtype at 77.6%. Twenty-six spa types were also identified, among which the predominant type was t437 (47.8%). The prevalence of pvl genes and the SCCmec type of strain was relevant, and the pvl gene positive rate was higher in SCCmec type IV and V-type strains than in SCCmec type II and III strains (58.6% vs. 14.3%, P < 0.05); there was a significant difference between them. In the strains isolated from pneumonia and SSTIs, ST59-MRSA-IVa(t437) was the predominant clone. There were five clones detected from the strains isolated from septicemia, with ST59-MRSA-IVa(t437) and ST59-MRSA-V(t437) as the main clones (57.1%). Various predominant clones existed in different regions. ST59-MRSA-IVa(t437) was the prevalent clone in the Guangzhou, Beijing, Chongqing, and Shenzhen areas, whereas ST239-MRSA-III(t037) was the prevalent clone in the Shanghai area. Fifty percent of the isolates from the Wenzhou area belonged to ST910-MRSA-V(t318), whereas three clinical strains isolated from the Shenyang region belonged to three different types. CONCLUSION: The results indicate that MRSA isolates from Chinese children are largely associated with the ST59-MRSA-IV(t437) and ST239-MRSA-III(t037) clones. These two may belong to community-acquired MRSA and hospital-acquired ones, respectively. Different prevalent clones were detected in different diseases and different regions. Therefore, there is a need to conduct further research on clinical isolates, which can guide the choice of antibiotic treatment and the examination of MRSA prevalence.


Assuntos
Staphylococcus aureus Resistente à Meticilina/genética , Infecções Estafilocócicas/microbiologia , Adolescente , Técnicas de Tipagem Bacteriana , Criança , Pré-Escolar , China/epidemiologia , DNA Bacteriano/genética , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Staphylococcus aureus Resistente à Meticilina/classificação , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Prevalência , Infecções Estafilocócicas/epidemiologia
20.
Vaccine ; 29(12): 2296-301, 2011 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-21276441

RESUMO

A prospective study was performed to determine serotype distribution and antimicrobial resistance in Streptococcus pneumoniae (S. pneumoniae) from Chinese children <5 years old meeting pneumonia criteria. A total of 3865 children were enrolled and 338 S. pneumoniae isolates were obtained. The most frequent serotypes were 19F (55.6%), 19A (13.9%), 23F (10.1%), 6B (4.7%), and 14 (3.6%). The 7-, 10- and 13-valent conjugate vaccines, respectively, covered 76.3%, 76.9%, and 92.3% of isolates. Out of the isolates, six (1.8%) were penicillin resistant. All except 1 of the isolates were resistant to erythromycin. Serotype 19A showed the highest drug resistance. The use of PCV7 has the potential to prevent a substantial number of pneumococcal infections. However, PCV13 is likely to prevent more episodes of pneumococcal disease in China because of the high rates of 19A.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla , Infecções Pneumocócicas/epidemiologia , Streptococcus pneumoniae/classificação , Streptococcus pneumoniae/efeitos dos fármacos , Pré-Escolar , China/epidemiologia , Humanos , Lactente , Testes de Sensibilidade Microbiana , Infecções Pneumocócicas/microbiologia , Vacinas Pneumocócicas/administração & dosagem , Estudos Prospectivos , Sorotipagem , Streptococcus pneumoniae/isolamento & purificação
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