The value of bronchoalveolar lavage fluid genechip analysis for the identification of pathogens in children with refractory pneumonia
10.3760/cma.j.cn101070-20220807-00947
- VernacularTitle:支气管肺泡灌洗液基因芯片法病原体检测对难治性肺炎患儿的病原学诊断意义
- Author:
Jiawu YANG
1
;
Liang ZHAO
;
Haifeng LIU
;
Yin LI
;
Feng LI
;
Tingyun YUAN
;
Hongmin FU
Author Information
1. 昆明医科大学附属昆明市儿童医院呼吸与危重症医学科，昆明 650031
- Keywords:
Child;
Refractory pneumonia;
Pathogen;
Genechip technology
- From:
Chinese Journal of Applied Clinical Pediatrics
2023;38(4):281-285
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of bronchoalveolar lavage fluid (BALF) genechip analysis for the identification of pathogens in children with refractory pneumonia.Methods:A retrospective study of 500 children clinically diagnosed with refractory pneumonia in the Department of Respiratory and Critical Care Medicine, Kunming Children′s Hospital, Kunming Medical University between January 2020 to January 2022 was made.During hospitalization, bronchoscopic examination and bronchoalveolar lavage were performed.BALF was collected and analyzed using genechip technology to detect potential pathogens.At the same time, bacterial culture tests of sputum and BALF samples from the patients were performed. χ2 test was used to compare the positive rates of pathogens detected by different detection methods. Results:Of the 500 children patients, 482 cases (96.4%) were positive of BALF genechip analysis for pathogen identification.There were 71 cases (14.7%) infected with a single pathogen, and 411 cases (85.3%) with 2 or more pathogens.The top 3 bacteria were Streptococcus pneumoniae [117 cases (8.3%)], Haemophilus influenzae [63 cases (4.5%)], and Bordetella pertussis [32 cases (2.3%)]. The patients were mostly infected with respiratory syncytial virus [269 cases (19.1%)], followed by parainfluenza virus [217 cases (15.4%)], and adenovirus [132 cases (9.3%)]. Among the 500 patients, 116 cases (23.2%) were positive of BALF genechip analysis for bacteria identification, 47 cases (9.4%) had a positive BALF culture, 43 cases (8.6%) had a positive sputum culture.The bacterial detection rate of BALF genechip analysis was statistically significantly higher than that of BALF culture and sputum culture tests ( χ2=34.90, 39.85; all P<0.001). Conclusions:Most patients with refractory pneumonia have mixed infections.The genechip technology can rapidly and efficiently identify the pathogens, thus providing clinical guidance for anti-infection treatment.
