Nasopharyngeal aspirates in children with severe community-acquired pneumonia collected within 3 days before bronchoscopy can partially reflect the pathogens in bronchoalveolar lavage fluids

BMC Infectious Diseases

Research

Fei Li¹  Jun Shen¹  Peng Shi²  Junli Zhou³  Lin Yuan³  Xiaoliang Lin³  Yi Lu³  Zhiqiang Zhuo³  Qiguo Zhu³ 

[1]Infectious Disease Department, Children’s Hospital of Fudan University, National Children’s Medical Center, 201102, Shanghai, China

[2]Statistics and data management center, Children’s Hospital of Fudan University, National Children’s Medical Center, 201102, Shanghai, China

[3]Xiamen Children’s Hospital, Xiamen Branch of children’s Hospital of Fudan University, 361006, Xia Men, China

关键词: Bronchoalveolar lavage fluid;    Nasopharyngeal aspirate;    Severe community-acquired pneumonia;    Etiology;    Children;   

DOI  :  10.1186/s12879-022-07749-w

 received in 2022-06-11, accepted in 2022-09-23,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundThere is little evidence about consistency between nasopharyngeal and pulmonary pathogens in children with severe pneumonia. This study aims to compare the difference of pathogens between nasopharyngeal aspirates (NPAs) collected before bronchoscopy and bronchoalveolar lavage fluids (BALFs) in children with severe community-acquired pneumonia (SCAP).MethodsNPAs and BALFs were collected form pediatric SCAP cases hospitalized from January 2018 to March 2019. NPAs were colleced within 3 days before bronchoscopy. Samples were detected by direct immunofluorescence assay (DFA) for seven respiratory viruses and by routine bacterial culture in the clinical microbiology laboratory. Respiratory syncytial virus (RSV), Adenovirus (ADV), Influenza virus types A, B (IV-A and IV-B), Parainfluenza virus 1–3 (PIV1-3) were detected with a commercial assay. The virological and bacteriological detention results of NPAs were compared with the results of BALFs.ResultsIn total 204 cases with mean age of 3.4 ± 2.8 years (IQR, 1 month-14 years) were included in the study. Both NPA and BALF were collected from those cases. The positive rates of pathogen in NPAs and BALFs were 25.0% (51/204) and 36.7% (75/204), respectively (x2 = 6.614, P = 0.010). Respiratory viruses were found in 16.1% (33/204) from NPAs and 32.3% (66/204) from BALFs (x2 = 14.524, P < 0.001). RSV and ADV were the two most frequent detected viruses in NPAs and BALFs. High consistentcy of pathogens between NPAs and BALFs was observed, and 96.9% (32/33) viruses detected in NPAs were also found in BALFs. While bacteria were isolated from 12.7% (26/204) and 10.7% (22/204) of the two kinds of samples, respectively (x2 = 0.378, P = 0.539). In addition, Haemophilus influenzae (HI) was the dominant germ in both samples.ConclusionThe DFA method used to detect seven respiratory viruses from NPAs collected within 3 days before bronchoscopy can partially reflect the pathogens in the lungs in children with SCAP.

【 授权许可】

CC BY   
© The Author(s) 2022

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