OBJECTIVETo investigate the incidence and clinical features of mixed infections in children with Mycoplasma pneumoniae (MP) pneumonia.

METHODA total of 201 cases diagnosed as MP pneumonia were investigated for mixed infections by sputum bacterial culture, respiratory virus antigen detection and serum Chlamydia pneumoniae antibody test. For those with the indications for bronchoscopy, we also did bronchoalveolar lavage and lavage bacterial culture.

RESULTA high incidence (103/201, 51.2%) of mixed infections in children with MP pneumonia was revealed. The most frequent co-infected pathogen was Chlamydia pneumoniae (52, 25.9%), followed by viruses (29, 14.4%), and bacteria (22, 10.9%). Among viruses, respiratory syncytial virus was the most common (17, 8.5%), followed by adenovirus (6, 3.0%), parainfluenza virus type III (4, 2.0%) and influenza virus type B (2, 1.0%). Sputum bacterial culture was positive in 14/201 (7.0%) cases, Streptococcus pneumonia being most common (6, 3.0%). BALF culture yielded positive results in 11.6% (8/69), Streptococcus pneumonia was also common (5, 7.3%). Among 29 cases with MP and virus coinfection, 26 were younger than 3 years (89.7%), while for MP and Chlamydia pneumoniae coinfection, most of them were older than 3 years (40/52, 76.9%). Compared with non-mixed infections, those with mixed infections had longer fever duration (24.5% and 40.8% longer than 10 d), more frequently developed pleural effusion (11.2%, 23.3%) and large area of shadow in chest imaging (35.7%, 51.5%). White blood cell [(14.28 ± 4.99) × 10(9)/L], C-reactive protein (CRP) [69(32.5 - 99.5) mg/L] and neutrophil ratio in BALF [0.86 (0.63 - 0.91)] were much higher in children with mixed bacterial infections than that in non-mixed infections [(9.06 ± 3.47) × 10(9)/L, 3 (0 - 31.0) mg/L, 0.44 (0.03 - 0.88)]. But no significant difference was found in peripheral blood neutrophil proportion between mixed bacterial infections (0.38 ± 0.25) and non-mixed infections (0.51 ± 0.19).

CONCLUSIONMore than half of cases with MP pneumonia had mixed infections, most commonly caused by Chlamydia pneumonia followed by viruses. The incidence of mixed infections with bacteria was low. Mixed infections with virus were more common in young children, while mixed infection with Chlamydia pneumoniae was more common in older ones. Bacterial infections should be paid more attention, especially those caused by Streptococcus pneumoniae, for those with high peripheral white blood cell counts, high CRP levels and high proportion of neutrophils in BALF.

Adolescent ; Child ; Child, Preschool ; Chlamydophila pneumoniae ; isolation & purification ; Coinfection ; Female ; Humans ; Infant ; Inpatients ; Male ; Mycoplasma pneumoniae ; isolation & purification ; Pneumonia, Mycoplasma ; diagnosis ; microbiology ; virology ; Pneumonia, Viral ; diagnosis ; Respiratory Syncytial Viruses ; isolation & purification

Objective:To explore the feasibility and recent efficacy of iliac vein molding and stenting in daytime treatment mode in patients with iliac vein stenosis.Methods:Medical records of iliac vein molding and stenting performed in the ipsilateral great saphenous vein approach conducted from February 2017 to March 2022 were retrospective reviewed.There were 21 cases,6 males and 15 females.Age ranged from 37 to 79 years[(62.5±10.2)years].The stenosis in the 21 limbs simply involved the common iliac veins in 16 patients,2 patients had the simple and external iliac veins,and both the total and external iliac veins in 3 patients.Both iliac vein molding and iliac vein stenting were performed through the ipsilateral great saphenous vein approach.The patients with simple iliac vein stenosis with great saphenous vein valve insufficiency also underwent radiofrequency closure of great saphenous vein and flexural vein sclerosis therapy simultaneously.Regular postoperative direct oral anticoagulants therapy and stress therapy were followed.All the patients were hospitalized for less than 24 h.Results:All the 21 patients operations were successful(the success rate was 100％),without any intraoperative compli-cations.Immediate postoperative complications were puncture point bleeding in 1 case.The bandage gauze was completely wet.The bleeding was stopped after 5min of recompression.All the patients were hospitalized for less than 24 h.Follow-up results:The 3-month follow-up rate after operation was 100％.Absolute effective 18 cases(18/21,85.7％).Relatively effective(postmentation still after surgery,but with less extent)in 3 cases(3/21,14.3％).The iliac vein stents were unobstructed,and the trunk of the great saphenous vein was well closed in the patients with great saphenous vein radiofrequency treat-ment.The 6-month follow-up rate after operation was 71.4％(15/21).Of these,14 cases(14/15,93.3％)were absolutely effective.Relatively effective(postmentation still after surgery,but with less ex-tent)in 1 case(1/15,6.7％).The iliac vein stents were no restenosis or obstruction,and the trunk of the great saphenous vein was well closed in the patients with great saphenous vein radiofrequency treat-ment.Conclusion:The interventional treatment technique of iliac vein stenosis is feasible in the daytime treatment mode,with clear advantages and satisfactory recent efficacy.