Infection and Drug Resistance (Mar 2024)

Analysis of the Risk Factors for Plastic Bronchitis in Children with Severe Adenovirus Pneumonia: A Retrospective Study

  • Xu XH,
  • Cai JR,
  • Fan HF,
  • Shi TT,
  • Yang DY,
  • Huang L,
  • Zhang DW,
  • Lu G

Journal volume & issue
Vol. Volume 17
pp. 1011 – 1019

Abstract

Read online

Xue-hua Xu,1,* Jie-rong Cai,2,* Hui-feng Fan,1,* Ting-ting Shi,1 Di-yuan Yang,1 Li Huang,3 Dong-wei Zhang,1 Gen Lu1 1Department of Respiratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China; 2Department of Pediatrics, Guangzhou Panyu District Central Hospital, Guangdong, Guangdong, People’s Republic of China; 3Pediatric Intensive Care Unit, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Gen Lu, Department of Respiratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510120, People’s Republic of China, Tel +86 20 38076135, Fax +86 20 38076626, Email [email protected]: Plastic bronchitis (PB), a rare complication of respiratory infection characterized by the formation of casts in the tracheobronchial tree, can lead to airway obstruction and severe condition. Adenovirus is one of the common pathogens of PB caused by infection. This study aimed to evaluate the clinical features and risk factors for PB in children with severe adenovirus pneumonia.Methods: A retrospective study of children with severe adenovirus pneumonia with bronchoscopy results at Guangzhou Women and Children’s Hospital between January 2018 and January 2020 was performed. Based on bronchoscopy, we divided children with severe adenovirus pneumonia into two groups: PB and non-PB. Binary logistic regression analysis was used to identify independent risk factors for PB in patients with severe adenovirus pneumonia after univariate analysis.Results: Our study examined 156 patients with severe adenovirus pneumonia with bronchoscopy results in hospital. Among them, 18 developed PB and 138 did not. On multivariate analysis, the independent risk factors of PB in children with severe adenovirus pneumonia were history of allergies (OR 10.147, 95% CI 1.727– 59.612; P=0.010), diminished breath sounds (OR 12.856, 95% CI 3.259– 50.713; P=0.001), and increased proportion of neutrophils (> 70%; OR 8.074, 95% CI 1.991– 32.735; P=0.003).Conclusion: Children with severe adenovirus pneumonia with a history of allergies, diminished breath sounds, and increased the proportion of neutrophils > 70% may show higher risk of PB.Keywords: plastic bronchitis, severe adenovirus pneumonia, risk factors, children

Keywords