Abstrait

Lobar pneumonia and bacterial pathogens in Vietnamese children.

Khai Quang Tran, Hung Van Pham, Phuong Minh Nguyen, Hung Do Tran, Hung Quoc Lu, Vy Gia, Thuy La, Thang Nguyen*

Background: Pneumonia is one of the leading causes of death in children because of its serious clinical manifestations, rapid progress, and a dangerous condition. lobar pneumonia is more severe, more difficult to determine the etiologies if only based on clinical predictors.

Objectives: To describe the clinical and chest X-ray characteristics of lobar pneumonia; and to determine bacterial pathogens and treatment outcomes in Vietnamese children. Materials and Methods: A cross-sectional study on 67 patients with lobar pneumonia admitted to Children’s Hospital 1, Ho Chi Minh City, Vietnam was conducted. All of nasotracheal aspiration (NTA) specimens of patients were collected and cultured. Real-time PCR was performed to identify bacterial pathogens in NTA specimens.

Results: Lobar pneumonia occurred mainly in children from 3 to 7 years old (46.3%). Clinical manifestations were cough (100%), fever (95.5%), tachypnea (98.5%), lower chest-wall indrawing (53.7%), wheezing (44.8%). Of chest X-ray images, right upper lobe pneumonia was the highest (38.8%), left lower lobe pneumonia (16.4%). The most common bacteria were Mycoplasma pneumoniae (69.7%) and Streptococcus pneumoniae (53%). The original antibiotics mostly used were the 3rd generation cephalosporins (C3G) (50.7%) and C3G + azithromycin (47.8%). 58.2% of cases responded well to the original antibiotics. The successful rate of C3G + azithromycin was 81.2%. The responding of second antibiotics was also high (92.9%), mainly based on the results of real-time PCR. 100% of patients were cured. There were 2 cases with tuberculosis that moved to a tuberculosis hospital for treatment.

Conclusions: Lobar pneumonia can be diagnosed by clinical examination and chest X-ray. Real-time PCR efficient supported in causative pathogens quickly and accurately, guided effective antibiotic therapy, especially in cases of poor clinical responses. Additionally, Mycoplasma pneumoniae was found in a younger group of age than the usual group.”