头孢布烯治疗下呼吸道感染60例

我院199？年10月～1998年3月用头抱布烯（先力腾③）于混悬剂口服治疗小儿下呼吸道感染60例,现报道如下。临床资料一、一般资料：均为本院住院或l'］急诊患儿,随机分成观察组60例,男34例,女26例。年龄M3a37例,3～7a23例,其中支气管炎、肺炎各30例。对照组59例,男32例,女27例。年龄＜3a30例,3～7a28例,～12al例,其中支气管炎30例,肺炎29例;两组病情经统计学处理无显著性差异（P＞0．05）。二、治疗方法与疗效评定：观察组采用由美国Sobering－Plough公司生产的先力腾于混居剂,剂量为gmg／（kg·d）·每日1次口服。支气管炎疗…     

头孢羟氨苄治疗小儿急性呼吸道感染疗效观察

目的观察头孢羟氨苄速溶素片和颗粒剂治疗儿童急性呼吸道感染(ARI)的临床疗效和安全性.方法单纯随机抽样ARI患儿376例,给予头孢羟氨苄速溶素片或颗粒剂20～50mg/(kg@d),每天2～3次.结果①临床有效率91.50%,退热时间为(3.34±1.40)d,咳嗽消失时间为(4.29±2.05)d;于7d后复查WBC均下降,其中88.30%恢复正常.②药物不良反应监测(ADR),偶有恶心、呕吐、皮疹,其发生率为3.72%.结论头孢羟氨苄速溶素片和颗粒剂治疗儿童ARI安全有效.     

婴幼儿初次下呼吸道感染与血清IgG亚类缺陷

目的：研究婴幼儿初次下呼吸道感染患者中血清IgG亚类变化情况。方法：随机抽取185例初次下呼吸道感染病儿，用ELISA法检测血清IgG及IgG亚类浓度。并与该地区健康小儿血清浓度进行比较。以低于参考值下限(-1.96s)者为IgG或IgG亚类缺陷，而高于(+1.96s)者视为IgG亚类增高。结果：185例共检出43例IgG缺陷，均有IgG亚类缺陷，而余下的142例IgG正常者，发现IgG亚类缺陷120例，检出率高达 84.5%。其中0～3月4项、3项缺陷合计29例，占该年龄段缺陷总数的 85.3%，在各年龄段中为最高比例。而IgG亚类缺陷中以IgG3缺陷最高，占 47.6%。结论：婴幼儿初次下呼吸道感染伴有IgG亚类缺陷。年龄越小，越易出现IgG亚类联合缺陷。因而在检测Ig时，除注意总IgG外，还应注意IgG亚类水平。     

婴幼儿初次下呼吸道感染与血清ＩｇＧ亚类缺陷

目的　研究婴幼儿初次下呼吸道感染患者中血清IgG亚类变化情况。 方法　随机抽取 185例初次下呼吸道感染病儿 ,用ELISA法检测血清IgG及IgG亚类浓度。并与该地区健康小儿血清浓度进行比较。以低于参考值下限 ( x - 1.96s)者为IgG或IgG亚类缺陷 ,而高于 ( x 1.96s)者视为IgG亚类增高。 结果　 185例共检出 4 3例IgG缺陷 ,均有IgG亚类缺陷 ,而余下的 14 2例IgG正常者 ,发现IgG亚类缺陷 12 0例 ,检出率高达84 .5 %。其中 0～ 3月 4项、3项缺陷合计 2 9例 ,占该年龄段缺陷总数的 85 .3% ,在各年龄段中为最高比例。而IgG亚类缺陷中以IgG3缺陷最高 ,占 4 7.6 %。结论　婴幼儿初次下呼吸道感染伴有IgG亚类缺陷。年龄越小 ,越易出现IgG亚类联合缺陷。因而在检测Ig时 ,除注意总IgG外 ,还应注意IgG亚类水平。     

雾化利巴韦林治疗婴幼儿下呼吸道感染临床观察

目的 观察雾化吸入利巴韦林对婴幼儿下呼吸道感染的临床疗效,了解急性下呼吸道感染患儿的病毒病原学构成.方法 选取年龄3个月至3岁之间因急性下呼吸道感染住院的婴幼儿共179例,行鼻咽分泌物病毒检测,将病毒检测阳性的63例患儿随机分成治疗组（33例）和对照组（30例）,治疗组在常规治疗基础上加利巴韦林10 mg/kg,用生理盐水2～5 ml稀释后雾化吸入,每天2次,连用3～5d.观察比较两组临床症状体征、全身激素使用量、住院时间及费用情况.结果 179例患儿共检出呼吸道病毒阳性63例（35.2％）.其中,呼吸道合胞病毒阳性33例（18.4％）,副流感病毒Ⅲ16例（8.9％）,腺病毒7例（3.9％）,B型流感病毒1例（0.6％）,混合感染3例（1.7％）,呼吸道合胞病毒阳性率最高,占阳性标本的52.4％.治疗组与对照组治疗前症状评分比较无明显差异（P =0.653）.经治疗后两组症状体征均有明显改善,治疗前与治疗3d后症状评分差值比较两组间差异有统计学意义（P＜0.05）,而治疗前与治疗5d后症状评分差值比较两组间无明显差异（P＞0.05）.治疗组患儿全身激素累计使用量、住院天数明显低于对照组（P均＜0.05）,但两组间住院总费用无明显差异（P＞0.05）.结论 婴幼儿急性下呼吸道感染病毒检出率高,以呼吸道合胞病毒最常见.雾化吸入利巴韦林治疗病毒检测阳性的下呼吸道感染患儿临床疗效显著.     

婴幼儿下呼吸道感染痰检细菌分布和耐药分析

目的 了解武汉地区3岁以下婴幼儿下呼吸道感染病原菌的分布及耐药情况,为临床合理选用抗生素提供依据.方法 选择2008年2月-2009年1月本院呼吸科收治的3岁以下下呼吸道感染婴幼儿4013例,患儿用药前无菌操作取诱导痰标本,标本送细菌培养.药物敏感试验采用琼脂扩散敏感试验(K-B法).结果 共检出细菌3938株,检出率为98.13％.检出的革兰阳性细菌由多到少依次为肺炎链球菌、金黄色葡萄球菌和凝固酶阴性葡萄球菌,其中肺炎链球菌对β内酰胺类抗生素的平均耐药率为47.13％.革兰阴性菌依次为大肠埃希菌、肺炎克雷伯菌、流感嗜血杆菌、铜绿假单胞菌、鲍曼不动杆菌、阴沟肠杆菌、产气肠杆菌、大肠杆菌及黏质沙雷菌等,其中大肠埃希菌和肺炎克雷伯菌主要产超广谱β内酰胺酶,其产酶率分别为54.12％和46.96％;流感嗜血杆菌则主要产β-内酰胺酶,产酶率为65.06％.结论 婴幼儿痰检符合临床诊疗表现的具有病原学诊断意义的致病菌以革兰阴性菌为主,其中产酶耐药者占40％以上,临床首次经验性选药应该充分考虑到这一特点,特别是重症患者抗生素的选用更应该有效覆盖到可能的耐药菌,以降低首次不适当用药的概率,提高重症患儿的治疗有效率和生存率.     

婴幼儿急性下呼吸道感染合胞病毒抗原及特异性抗体检测结果分析

全国儿科呼吸道感染病原学诊断研讨会议提出:各地要总结经验,将病原体分离、快速抗原检测及血清抗体检测结合起来研究。为此,我们采用免疫酶组化法(IPA)和酶联免疫吸附试验(ELISA)同时检测109例急性下呼吸道感染(ALRI)患儿鼻咽分泌物(NPS)脱落细胞合胞病毒抗原(RSV-Ag)、血清特异性IgM、IgG抗体(SIgM、SIgG),并对检测结果进行比较分析,以总结临床应用价值。     

口服头孢克洛与头孢拉定对照治疗儿童急性咽扁桃体炎

为比较口服头孢克洛 (希刻劳 )与口服头孢拉定 (泛捷复 )治疗儿童急性咽扁桃体炎的临床疗效 ,将202例急性咽扁桃体炎患儿随机分为两组治疗 ,希刻劳组105例 ,予希刻劳25mg/(kg·d)×7d ;泛捷复组97例 ,予泛捷复25mg/(kg·d)×7d。结果发现希刻劳组临床有效率为83.8% ,泛捷复组为76.3 % ,P>0.05。提示希刻劳治疗儿童急性咽扁桃体炎与泛捷复同样有效     

静脉用阿齐霉素治疗呼吸道感染疗效分析

目的观察静脉用阿齐霉素(抒罗康)治疗呼吸道感染的疗效及安全性。方法采用随机对照研究,试验组予注射用阿齐霉素10mg/(kg·d)静脉滴注,对照组注射头孢唑啉钠或红霉素,疗程5d。观察两组有效率和不良反应发生率。结果阿齐霉素组总有效率为100.0%,头孢唑啉钠和红霉素对照组总有效率分别为88.6%和65.0%,各组疗效比较均有显著性差异(P均<0.05),不良反应发生率阿齐霉素组和红霉素组分别为7.6%和15.0%,两组比较有显著差异(P<0.05)。结论静脉用阿齐霉素治疗呼吸道感染疗效肯定,不良反应少。     

Acute Respiratory Tract Infections in Children

ABSTRACT. Respiratory tract infections (RTIs) in small children account for a considerable proportion of health care expenditure. In 113 children, followed for the first three years of life, we studied the frequency of acute RTI and its relationship to the factors: type of day-care, age, sex, family size, living conditions, allergic predisposition, family smoking habits, and season. To elucidate the influence of age, the frequency of acute RTI and its relationship to type of day-care was longitudinally studied on a quarterly basis. The frequency of acute RTI diagnosis increased gradually from birth culminating in a peak at the beginning of the second year. Besides age and season, type of day-care was the only factor studied to show any relationship with the frequency of acute RTI diagnosis. Up to the age of almost 2 1/2 years, children attending day-care centres accounted for more RTI diagnoses than did those in home care or family day-care, categories with comparable frequncies.     

Respiratory Tract Infections in Children with Recurrent Episodes as Preschoolers

ABSTRACT. The occurrence of respiratory tract infections (RTI) in 41 school-age children, who had recurrent RTIs treated with antibiotics as preschoolers, was followed prospectively for two years through diary reports by parents and medical consultations, and compared with that in 29 children of the same age and socio-economic background, who had few or no such infections as preschoolers. During the two-year follow-up, a greater number of episodes of RTI and a longer mean duration of such episodes were reported in the diaries concerning the children with recurrent bacterial RTIs as preschoolers compared with the controls ( p <0.01). The annual incidence of bacterial RTI from birth onwards decreased with age among the children with recurrent episodes as preschoolers, unlike in the control group, where the incidence remained consistently low, the difference in incidence being significant up to the age of eight years ( p <0.01). Acute otitis media was the predominant bacterial RTI in preschoolers, and acute tonsillitis in school-age children. There was a tendency toward a greater incidence of other types of disease and complication/sequelae of infections among the RTI-afflicted group than among the controls, both as preschoolers and as school children. Our findings suggest that certain children constitute a group with high morbidity, susceptible to RTIs and other illnesses over a rather long period of years.     

Prevalence of Respiratory Syncytial Virus Infection among Hospitalized Children Presenting with Acute Lower Respiratory Tract Infections

Objective  

To evaluate the prevalence of RSV among hospitalized young children presenting with ALRI in Bangalore, India.     

Children with Recurrent Respiratory Tract Infections Tend to Belong to Families with Health Problems

ABSTRACT. Children (7-11 years of age) who had recurrent respiratory tract infections (RTI) treated with antibiotics as preschoolers ( n =41), and their families were compared with regard to medical and social factors to families with children of comparable age who had had no such infections as preschoolers, or only isolated episodes (controls; n =29). All the children studied had attended day-care centres as preschoolers. The two groups of children did not differ with regard to socio-economic conditions or age at admission to day-care centres. There was a difference in the two groups with regard to signs noted at physical examination ( p <0.05), eardrum changes being observed in 34% of the children with recurrent episodes of RTI as preschoolers and in none of the controls ( p < 0.001). Questionnaires answered by parents indicated diseases, particularly cardiovascular diseases, to be significantly more frequent in the families of the children with recurrent RTIs as preschoolers than in those of the controls ( p <0.01). Parents of the controls were more often satisfied with their own health ( p <0.05) and reported fewer symptoms of minor illness ( p <0.05), as compared with parents of the children with recurrent RTIs as preschoolers. Thus, the results of the present study support the idea that children with recurrent bacterial RTIs as preschoolers tend to belong to families with health problems.     

Frequency of Common Viruses in Etiology of Acute Respiratory Tract Infections

Objective

To determine the frequency rate of C. pneumoniae, rhinovirus, respiratory syncytial virus (RSV), influenza virus, metapneumovirus, adenovirus’, parainfluenza virus and coronavirus in acute respiratory tract infections in children.

Methods

One hundred nine pediatric patients having respiratory tract infections were included in this study. Real time PCR, DFA and cell culture method were used for detection of C. pneumoniae, RSV antigen and influenza virus respectively. Multiplex PCR was used for detection of other viruses.

Results

No C. pneumoniae DNA was detected in the samples. Virus was detected in 43 cases from larynx swabs (43/109, 39.4 %). The frequency order of the viral agents detected were as follows; rhinoviruses 14.7 %, RSV B 7.3 %, influenza A 6.4 %, metapneumovirus 3.6 %, adenovirus 3.6 %, coronavirus 0.9 %, parainfluenzavirus type 3, 0.9 %, parainfluenzavirus type 4, 0.9 % and RSV A 0.9 %. Sensitivity of the PCR and DFA methods for the diagnosis of RSV infections were detected as 100 % and 100 %, respectively. Specificity of the PCR and DFA methods for RSV infections were detected as 97 % and 100 % respectively. Sensitivity of the PCR and cell culture methods for influenzavirus infections were detected as 100 % and 100 %, respectively. Specificity of the PCR and DFA methods for RSV infections were detected as 96 % and 100 % respectively.

Conclusions

Prevalence of viral agents was detected as 39.4 %. Influenza viruses and RSV were common. Metapneumovirus was also frequent (3.6 %). C. pneumoniae was not found to be a common agent for acute respiratory disease in children.