儿童鼻部致病菌携带状况与急性细菌性呼吸道感染的前瞻性研究

Prospective cohort study on the relationship between pathogenic bacteria in the nasal middle meatus and acute bacterial respiratory infection in children

摘要:

目的：探讨儿童鼻部致病菌的携带状况与急性细菌性呼吸道感染的关系。方法：在鼻内窥镜协助下取中鼻道附近的黏液标本做细菌培养,按培养结果分为暴露组和非暴露组进行前瞻性队列研究,以5d后血白细胞是否升高作为判定细菌感染的标准。结果：暴露组患儿的细菌感染的发生率(51.2%)明显高于非暴露组(13.1%),呼吸道感染儿童鼻部检出致病菌存在时继发或并发细菌感染的相对危险度为3.9002。结论：儿童鼻部存在致病菌时,呼吸道感染容易发展为细菌性感染。

Abstract:

OBJECTIVE: To study the relationship between pathogenic bacteria in the nasal middle meatus and acute bacterial respiratory infection in children. METHODS: Three hundred and twenty eight children with respiratory infection (mean age 8 years) were included into the prospective cohort study. The mucosal fluid specimens from the nasal middle meatus were collected under an endoscope for bacterial culture. The patients with bacterial culture positive were defined as the Exposed group and those with bacterial culture negative as the Non-exposed group. The grouping of the patients was blinded to the patients, patients' parents and physicians. Both groups received anti-virus and symptomatic treatments, without antibiotic administration. Five days later, the patients were evaluated as to whether they had bacterial infection based on the leucocyte count and CRP results. RESULTS: Of the 328 patients, 168 had a positive nasal bacterial culture. The incidence of bacterial respiratory infection in the Exposed group [51.2% (86/168)] was significantly higher than in the Non-exposed group [ 13.1% (21/160)] (P<0.01). The relative risk of bacterial respiratory infection occurrence in patients with nasal bacterial culture positive was 3.9002. CONCLUSIONS: The children with respiratory infection who had potential pathogenic bacteria in the nasal middle meatus were more prone to develop bacterial respiratory infection.