气道菌群及抗生素对毛细支气管炎患儿未来反复喘息的影响

The role of airway bacteria and antibiotics in recurrent wheezing in children with bronchiolitis

目的 探究毛细支气管炎儿童中痰培养结果和抗生素使用情况与未来发生反复喘息的关系。方法 回顾性分析2017年本院100例诊断毛细支气管炎的住院患儿痰培养结果和抗生素使用情况,在2020年12月电话询问其过去3年有无反复喘息情况,将其分为反复喘息组(RW组)和非反复喘息组(非RW组)。使用GraphPad Prism 5软件进行分析。结果 RW组与非RW组比较,两组间性别、年龄和过敏史/过敏性疾病家族史均无统计学差异(P>0.05),当痰培养阳性而未使用抗生素时,两组间存在统计学差异(OR=5.80,95%CI 1.19~28.39,P=0.04);而痰培养阳性率和抗生素使用率的差异均无统计学意义(均P>0.05)。革兰阳性菌检出率、革兰阴性菌检出率、β内酰胺酶抗生素使用率、大环内酯类抗生素使用率也无统计学差异(均P>0.05)。结论 在毛细支气管炎患儿中,呼吸道细菌定植或感染可能不会对患儿未来反复喘息造成影响,但当痰培养阳性时,抗生素的使用或能降低患儿未来反复喘息的几率,减少哮喘的发病率。

Objective To explore the relationship between respiratory tract bacteria,antibiotics and recurrent wheezing in children with bronchiolitis.Methods The sputum culture results and antibiotic use of 100 children in 2017 hospitalized with bronchiolitis were retrospectively analyzed.In December 2020,parents of the patients were asked whether their child had recurrent wheezing in the past three years,and they were divided into recurrent wheezing group(RW group) and non-recurrent wheezing group(non-RW group).The data were analyzed using GraphPad Prism 5.Results In this study,there were no statistical differences in gender,age,and allergy history/family history of allergic disease between the two groups.The difference of positive sputum culture with negative antibiotic use between the two groups was significant(OR=5.80,95%CI 1.19~28.39,P=0.04).No significant difference in bacteria colonization/infection and antibiotics between RW and non-RW groups were found(P>0.05).In addition,there was no statistical difference in the detection rate of gram-positive bacteria,gram-negative bacteria,lactamase antibiotics,and macrolide antibiotics between the two groups(P>0.05).Conclusion In children with bronchiolitis,respiratory bacterial colonization or infection may not affect recurrent wheezing in the future,but when sputum culture is positive,antibiotics may reduce the chance of recurrent wheezing in the future and reduce the incidence of asthma.