PROTRACTED BACTERIAL BRONCHITIS IN CHILDREN: ETIOLOGY, CLINICAL OPTIONS, X-RAY SEMIOTICS, COMORBIDITY

Q4 Medicine

Pediatriya - Zhurnal im G.N. Speranskogo Pub Date : 2023-04-21 DOI:10.24110/0031-403x-2023-102-2-57-64

E. Makarenko, D. Ovsyannikov, M. Karpenko, T. Illarionova, O.V. Alekseeva, M. Kantemirova, N. Grigoriadis, A. Tsverava, P. V. Berejansky, Sh.A. Gitinov, V. V. Gorev, L. V. Smirnova, A. Vybornov, E. Boitsova, M. Khaled

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引用次数: 0

Abstract

Cough in childhood is one of the most common reasons for and symptoms when contacting a pediatric physician. Chronic (lasting over four weeks) wet/productive cough is of particular diagnostic difficulty when it is caused by protracted bacterial bronchitis (PBB). The purpose of this research was to study the etiology, clinical options, X-ray semiotics and comorbid diseases in children with PBB. Materials and methods used: clinical observation and analysis of case histories of 76 children aged starting 4.5 months up to 16 years old with PBB were carried out from Mar. 2017 to Jun. 2022. Research methods: microbiological, radiography and computed tomography (CT) of the chest, bronchoscopy, allergy diagnostics, spirometry. The design of the study was as follows: multicentre, non-comparative, open-label, non-randomized, ambispective pilot study. Results: PBB is more common in boys (57%) aged 3 to 7 y/o (59%) and is rare in infancy (7%). The majority of patients met the clinical definition of PBB (86%) and responded to 2 weeks of antibiotic therapy with amoxicillin/clavulanate (78%). The microbiological diagnosis of PBB was confirmed in 14% of children based on bronchoscopy with microbiological examination of bronchoalveolar lavage (BAL) fluid or sputum examination. The most common pathogens encountered in BAL, sputum and discharge from the nasopharynx, oropharynx are as follows: S. aureus, M. catarrhalis, H. influenzae and S. pneumoniae. The chest X-ray showed bronchitis changes; the chest CT, which was performed in 10 patients, had showed thickening of the bronchial walls. Bronchial dilatation was found in 3 children, bronchiectasis was found in a single patient. Bronchial asthma was comorbid with PBB, occurred in 22% of PBB cases. Conclusion: it is necessary for a pediatric physician to keep PBB in mind as one of the reasons for chronic wet/productive cough in children in order to correctly and timely diagnose the disease and prescribe its adequate treatment.

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儿童慢性细菌性支气管炎:病因学、临床选择、x线符号学、合并症

在儿童时期咳嗽是最常见的原因和症状之一，当联系儿科医生。慢性(持续四周以上)湿咳/咳痰是特别难以诊断的，当它是由慢性细菌性支气管炎(PBB)引起的。本研究的目的是研究PBB患儿的病因、临床选择、x线符号学和合并症。采用的材料和方法:对2017年3月至2022年6月76例4.5月龄至16岁的PBB患儿进行临床观察和病史分析。研究方法:微生物学，胸部x线摄影和计算机断层扫描(CT)，支气管镜检查，过敏诊断，肺活量测定。本研究设计如下:多中心、非比较、开放标签、非随机、双视角先导研究。结果:PBB多见于3 - 7岁的男孩(57%)(59%)，在婴儿期少见(7%)。大多数患者(86%)符合PBB的临床定义，并对阿莫西林/克拉维酸2周的抗生素治疗有反应(78%)。基于支气管镜检查支气管肺泡灌洗液或痰液的微生物学检查，14%的儿童确认了PBB的微生物学诊断。鼻咽部、口咽部痰液和分泌物中最常见的病原体如下:金黄色葡萄球菌、卡他性分枝杆菌、流感嗜血杆菌和肺炎链球菌。胸部x线示支气管炎改变;10例胸部CT显示支气管壁增厚。支气管扩张3例，支气管扩张1例。支气管哮喘是PBB的合并症，发生率为22%。结论:儿科医师有必要将PBB作为儿童慢性湿咳/生产性咳嗽的原因之一，以便正确、及时诊断并给予适当的治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatriya - Zhurnal im G.N. Speranskogo Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.60

自引率

0.00%

发文量

150

期刊介绍： Journal “Pediatria” named after G.N. Speransky (the official short names of the Journal are “Journal «Pediatria»,” “Pediatria,” and “«Pediatria,» the Journal”) is the oldest Soviet-and-Russian (in the Russian Federation, the CIS and former Soviet Union) scientific and practical medical periodical assigned for pediatricians that is published continuously since May, 1922, and distributed worldwide. Our mission statement specifies that we aim to the ‘raising the level of skills and education of pediatricians, organizers of children’s health protection services, medicine scientists, lecturers and students of medical institutes for higher education, universities and colleges worldwide with an emphasis on Russian-speaking audience and specific, topical problems of children’s healthcare in Russia, the CIS, Baltic States and former Soviet Union Countries and their determination with the use of the World’s best practices in pediatrics.’ As part of this objective, the Editorial of the Journal «Pediatria» named after G.N. Speransky itself adopts a neutral position on issues treated within the Journal. The Journal serves to further academic discussions of topics, irrespective of their nature - whether religious, racial-, gender-based, environmental, ethical, political or other potentially or topically contentious subjects. The Journal is registered with the ISSN, - the international identifier for serials and other continuing resources, in the electronic and print world: ISSN 0031-403X (Print), and ISSN 1990-2182 (Online). The Journal was founded by the Academician, Dr. Georgiy Nestorovich SPERANSKY, in May, 1922. Now (since 1973) the Journal bears his honorary name.