加纳一家教学医院收治的儿童脓胸和肺旁积液。-回顾性审查

S. Kwarteng Owusu, S. Owusu, Haruna Mahama, I. Okyere, Naomi Adjetey, Eugene Martey, Richard Kwaku Kwarteng Owusu
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摘要

背景:肺旁积液(PPE)和脓胸是儿童肺炎的严重并发症,与较高的发病率和较长的住院时间相关。据报道,肺炎球菌结合疫苗(PCV 13)的引入导致儿童并发症肺炎发作的下降。通常与PPE和脓胸相关的生物是肺炎链球菌和金黄色葡萄球菌,尽管也有结核分枝杆菌的报道。加纳缺乏关于儿童感染个人防护装备和脓疱病的数据。我们的目的是描述在Komfo Anokye教学医院接受PPE和Empyema的儿童的概况、表现模式和结果。方法回顾性分析2018年1月至2020年12月肺科收治的PPE和Empyema患儿的病历(文件夹)和电子数据。使用Microsoft Excel提取人口统计记录、免疫状况、临床表现、住院时间和入院结果。然后用STATA version 16分析数据。结果51例患儿有记录;中位年龄42个月,IQR(22.5 ~ 96),男性占68.6% (n=35)。在所有84.2% (n=38)中,接受了所有年龄的免疫接种。就诊时,9.5% (n=4/42)患者血氧饱和度38℃。呼吸频率中位数为47.5 IQR(32.8-57)。白细胞计数中位数为15.84 X10 9/l IQR(11.9-24.73),血红蛋白中位数为9.6 g/dl IQR(8.6-11.7)。胸膜抽吸培养分离金黄色葡萄球菌6例。其余的要么没有,要么没有细菌生长。阿莫西林克拉维酸和头孢曲松是最常用的抗生素。住院时间中位数为9天(7-12),置胸管时间中位数为7天(5.5-9)。7.8例(n-4/51)患者死亡。结论幼儿和大龄儿童均可感染PPE/脓胸。在因PPE/脓胸入院的儿童中,疫苗的吸收率很高,金黄色葡萄球菌是从胸腔抽吸培养中分离出的最常见的细菌。大多数患有复杂PPE/脓胸的儿童存活。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Empyema and Parapneumonic effusions in children admitted to a teaching hospital in Ghana. -A retrospective review
Background Parapneumonic effusions (PPE) and Empyema are serious complications of pneumonia in children that are associated with higher morbidity and prolonged hospital stay. The introduction of the pneumococcal conjugate vaccines (PCV 13) have led to a reported decline in the episodes of complicated pneumonia in children. The organisms commonly associated with PPE and Empyema are Streptococcus pneumoniae and Staphylococcus aureus though Mycobacterium tuberculosis has also been reported. There is paucity of data on children with PPE and Empyema in Ghana. We aimed to describe the profile, mode of presentation and outcomes in children admitted with PPE and Empyema to the Komfo Anokye Teaching Hospital. Methods A retrospective review of medical records (folders) and electronic data on children with PPE and Empyema admitted to the pulmonology unit from January 2018 to December 2020 were retrieved. Demographic records, immunization status, clinical presentation, length of hospital stay and outcome of admission were extracted using a Microsoft Excel. Data was then analysed with STATA version 16. Results Records were available for 51 children; the median age   was 42 months IQR (22.5-96) and 68.6% (n=35) were males. In all 84.2% (n=38), had received all immunisations up to date for age. At presentation, 9.5% (n=4/42) had oxygen saturation <90%, whilst 43.9% (n=18/41) had axillary temperature > 38oC. The median respiratory rate was 47.5 IQR (32.8-57). The Median white cell count was 15.84 X10 9/l IQR (11.9-24.73) and median hemoglobin was 9.6 g/dl IQR (8.6-11.7). Pleural aspirate culture isolated Staphylococcus aureus for 6 patients. The rest were either not available or had no bacterial growth. Amoxicillin clavulanic acid and ceftriaxone were the most commonly used antibiotics. The median length of hospital stay was 9 days IQR (7-12) while the median length of chest tube insertion was 7 days IQR (5.5-9). In all 7.8 (n-4/51) patients died. Conclusion Both young and older children are affected with PPE/empyema. There is a good uptake of vaccines among children admitted for PPE/empyema, Staphylococcus aureus is the most common bacterial isolated from pleural aspirate culture. Most children admitted with complicated PPE/Empyema survived.
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