IFA
Indirect immunofluorescent antibody | Immunofluorescence reaction indirect light | |
ICT | Immunochromatography | |
IgG | Immunoglobulin G | Immunoglobulin G |
IgM | Immunoglobulin M | Immunoglobulin M |
IL | Interleukin | Interleukin |
ICU | Intensive Care Unit | Intensive care unit |
Inc | membrane protein | |
INF - α | Tumor necrosis factor –alpha | Tumor necrosis factor |
JRS | Japan Respiratory | Japan Respiratory Society |
kDa | Kilo Dalton | Kilo Dalton |
KN | Antigen | Antigen |
L. pneumophila | Legionella pneumophila | Legionella pneumophila |
LD | Legionellosis disease | Legionella disease |
LPS | Lipopolysaccharide | Lipopolysaccharide |
M. pneumoniae | Mycoplasma pneumoniae | Mycoplasma pneumoniae |
MOMP | Major outer membrane protein | Major protein in the outer membrane |
MIF | Micro-immuno-fluorescence | - immunoglobulin serum reaction Fluorescence |
NAAT | Nucleic acid amplification techniques | Acid amplification technique nucleic |
Omc | outer memberane protein complex | - Outer membrane protein complex |
RB | reticulate body | Reticular corpuscle |
PA | Partial Aglutination | Particle agglomeration technique |
PCR | polymerase chain reaction | PCR reaction |
PMP | polymorphic memberane protein | - Polymorphic membrane protein |
PPLO | Pleuropneumonia like organisms | Pleuropneumonia like organisms |
Real – time PCR | Real-time polymerase chain reaction | Real-time PCR reaction |
RB | reticulate body | Reticular corpuscle |
rDNA | Ribosomal Deoxyribonucleic Acid | Ribosomal Deoxyribonucleic Acid |
rRNA | Ribosomal Ribonucleic Acid | Ribosomal Ribonucleic Acid |
RT-PCR | Revert Transcription - Polymerase Chain Reaction | Revert Transcription - Polymerase Chain Reaction |
S. pneumoniae | Streptococcus pneumoniae | Streptococcus pneumoniae |
SJS | Stevens Johnson Syntrom | Stevens Johnson syndrome |
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Th
T help | T support | |
Secondary School | Junior High School | |
High School | High school | |
TNF | Tumor necrosis factor | Tumor necrosis factor |
TWAR | Taiwan acute respiratory agent | Taiwan acute respiratory agent |
VP | Pneumonia | |
VPĐH | Typical pneumonia | |
VPKDH (AP) | Atypical pneumonia | Atypical pneumonia |
WHO | World Health Organization | World Health Organization |
INDEX
PROBLEM STATEMENT 1
Chapter 1. OVERVIEW 3
1.1. Some concepts 3
1.2. History of research on atypical pneumonia caused by Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophila 4
1.2.1. Pneumonia caused by Mycoplasma pneumoniae 4
1.2.2. Pneumonia caused by Chlamydia pneumoniae 4
1.2.3. Pneumonia caused by Legionella pneumophila 5
1.3. Epidemiological characteristics of atypical pneumonia caused by Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophila 5
1.3.1. Epidemiological characteristics of pneumonia caused by Mycoplasma pneumoniae 5
1.3.2. Epidemiological characteristics of pneumonia caused by Chlamydia pneumoniae 11
1.3.3. Epidemiological characteristics of pneumonia caused by Legionella pneumophila 15
1.4. Clinical and paraclinical characteristics and treatment of pneumonia caused by Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophila 20
1.4.1. Clinical characteristics of pneumonia caused by Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophila 20
1.4.2. Paraclinical characteristics of pneumonia caused by Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophila 22
1.4.3. Treatment of pneumonia caused by Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophila 26
1.5. Research on atypical pneumonia, severe atypical pneumonia
in children and related factors 27
1.5.1. Research situation of atypical pneumonia in children 27
1.5.2. Study on severe atypical pneumonia and related factors 33
Chapter 2: RESEARCH SUBJECTS AND METHODS 37
2.1. Research subjects 37
2.2. Research location 37
2.3. Research time 37
2.4. Criteria for selecting research subjects 37
2.4.1. Pneumonia case 37
2.4.2. Case of atypical pneumonia caused by 3 bacterial species 38
2.4.3. Severe atypical pneumonia case 38
2.5. Research methods 39
2.5.1. Research design 39
2.5.2. Research sample size 39
2.5.3. How to select samples for research 40
2.6. Research design diagram 42
2.7. Research indicators and criteria for evaluating research indicators 43
2.7.1. Research indicators for objective 1 43
2.7.2. Research indicators for objective 2 51
2.8. Research means 52
2.9. Research data processing method 52
2.9.1. Estimation of disease incidence in epidemiological and clinical studies.. 52
2.9.2. Odds ratio (OR) in descriptive studies of disease series 53
2.9.3. Confidence interval (CI) of odds ratio OR 53
2.9.4. Hypothesis testing using OR 53
2.9.5. Fisher 's exact test 54
2.9.6. Multivariate Logistic Regression Model 54
2.10. Ethical aspects in research 54
Chapter 3: RESEARCH RESULTS 55
3.1. Epidemiological and clinical characteristics of atypical bacterial pneumonia in children 55
3.1.1. General epidemiological characteristics of atypical pneumonia 55
3.1.2. Epidemiological characteristics of atypical pneumonia in the group and co-infected atypical pneumonia outside the group 62
3.1.3. Characteristics of simple atypical pneumonia analyzed according to
bacterial agent 75
3.1.4. Treatment results 83
3.2. Some related factors of severe atypical pneumonia 83
3.2.1. Relationship between age and gender with severity of atypical pneumonia 83
3.2.2. Relationship between obstetric history, feeding and development history and severity of atypical pneumonia 84
3.2.3. Relationship between microbiological etiology and severity of VPKĐH 85
3.2.4. Relationship between paraclinical characteristics and severity of atypical pneumonia 86
3.2.5. Association between duration of illness and pre-admission antibiotic treatment
hospital with severity of atypical pneumonia 87
3.2.6. Analysis of factors associated with severe atypical pneumonia .. 88
Chapter 4: DISCUSSION 89
4.1. General epidemiological characteristics of atypical pneumonia in children treated at the National Children's Hospital 89
4.1.1. Rate of atypical pneumonia 89
4.1.2. Co-infection status 90
4.1.3. Patient distribution by age 91
4.1.4. Gender distribution of patients 93
4.1.5. Time distribution in year 94
4.1.6. Geographical distribution 94
4.1.7. Family characteristics and living environment 95
4.1.8. Characteristics of obstetric history, history of nutrition and development 97
4.2. Epidemiological characteristics of VPKĐH in the group and co-infected VPKĐH outside the group 99
4.2.1. Family characteristics and living environment 99
4.2.2. Reproductive history characteristics 99
4.2.3. Characteristics of the history of nurturing and development 100
4.2.4. Pre-hospital treatment 100
4.2.5. Factors associated with co-infectious pneumonia 101
4.3. Clinical and paraclinical characteristics of VPKĐH in the group and co-infected VPKĐH outside the group 101
4.3.1. Functional symptoms 101
4.3.2. Physical symptoms in the lungs 101
4.3.3. Extrapulmonary manifestations 103
4.3.4. Paraclinical characteristics 103
4.4. Clinical and paraclinical characteristics of atypical pneumonia
simply 105
4.4.1. Functional symptoms 105
4.4.2. Physical symptoms 108
4.4.3. Extrapulmonary manifestations 110
4.4.4. Paraclinical 111
4.5. Treatment results 117
4.6. Some related factors of severe atypical pneumonia 118
4.6.1. About the age of patient 118
4.6.2. Regarding obstetric history, child's history of nutrition and development before
when sick 118
4.6.3. On bacterial origin 119
4.6.4. On co-infection 120
4.6.5. On paraclinical characteristics 121
4.6.6. About the time of illness and antibiotics treated before admission to hospital 123
4.6.7. Multivariate logistic regression model 124
4.7. Limitations of the topic 124
CONCLUSION 126
PROPOSAL 128
LIST OF PUBLISHED WORKS OF THE AUTHOR RELATED TO THE THESIS
REFERENCES APPENDIX
LIST OF TABLES
Table Table Name Page
3.1. Rate of common types of pneumonia 55
3.2. Classification of atypical pneumonia 56
3.3. Classification of pneumonia cases according to the bacterial agent causing the disease
atypical pneumonia 56
3.4. Proportion of patients with atypical pneumonia distributed by age 57
3.5. Family characteristics of patients with atypical pneumonia 60
3.6. Characteristics of living environment of patients with atypical pneumonia .. 61
3.7. Comparison of differences in family characteristics between in-group and out-group co-infected VPKĐH 62
3.8. Comparison of some living environment factors between the VPPKDH group in
Group and co-infected VPPKĐH outside group 64
3.9. Comparison of the distribution of VPKĐH in the group and VPKĐH co-infected outside the group according to obstetric history characteristics 65
3.10. Comparison of the distribution of VPKĐH in the group and VPKĐH co-infected outside the group according to the characteristics of the history of nutrition and development 66
3.11. Factors related to co-infected VPKĐH outside group 68
3.12. Clinical symptoms of patients with atypical pneumonia upon admission 69
3.13. Extrapulmonary clinical characteristics of patients with atypical pneumonia 70 3.14. Causes of coinfection 74
3.15. Family characteristics and living environment 75
3.16. Obstetric history characteristics 76
3.17. Characteristics of the history of nurturing and development 77
3.18. Symptoms of simple atypical pneumonia 78
3.19. Pulmonary physical symptoms of simple atypical pneumonia . 79
3.20. Extrapulmonary clinical symptoms of atypical pneumonia
pure 80
3.21. Paraclinical characteristics of simple atypical pneumonia 81
3.22. Relationship between age and gender and severity of atypical pneumonia83
3.23. Relationship between obstetric history, feeding history and development
severity of atypical pneumonia 84
3.24. Relation between microbiological etiology and severity of VPKĐH 85
3.25. Correlation between paraclinical and severity of atypical pneumonia 86
3.26. Association between Ig and IL6 concentrations and severity of atypical pneumonia 87
3.27. Relationship between duration of illness and prehospital antibiotic treatment
with severity of atypical pneumonia 87
3.28. Factors associated with multivariate analysis 88
4.1. Rates of atypical pneumonia in children in recent studies 89