A Study on the Etiologic Characteristics of Bronchoalveolar Lavage Fluid and Correlation with Multidimensional Pathogenic Factors in Children with Lobar Pneumonia

WANG Sisi; KANG Yurong; CHEN Xi; YI Xiaoqing; LEI Simin

doi:10.3639/j.issn.2095-3097.2025.11.006

Abstract：Objective To investigate the pathogenic etiological characteristics of bronchoalveolar lavage fluid(BALF)and the correlation among multidimensional pathogenic factors in children with lobar pneumonia.Methods Children with lobar pneumonia admitted to the Second Affiliated Hospital of Xi'an Jiaotong University from February 2021 to March 2024 were retrospectively selected as the observation group(107 cases),and children hospitalized for non-respiratory diseases during the same period at the same hospital were selected as the control group(87 cases).All children with lobar pneumonia underwent BALF testing for 8 respiratory bacterial nucleic acid targets and 5 respiratory viral+Mycoplasma nucleic acid targets.General clinical data were compared between the two groups.Multivariate stepwise logistic regression was used to analyze the multidimensional pathogenic factors associated with the occurrence of lobar pneumonia,and ROC curve analysis was employed to evaluate the predictive value of these factors for lobar pneumonia.Results BALF nucleic acid detection in 107 children with lobar pneumonia showed that among the 112 detected pathogens,Mycoplasma pneumoniae accounted for the highest proportion,followed by respiratory syncytial virus.Other pathogens included Haemophilus influenzae and adenovirus.The observation group had higher rates of pathogen infection and higher levels of C-reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8),and tumor necrosis factor-α(TNF-α)compared to the control group(P<0.05).Multivariate stepwise logistic regression analysis indicated that CRP,IL-6,IL-8,and TNF-α were multidimensional pathogenic factors associated with the occurrence of lobar pneumonia(OR=1.259,95%CI:1.135-1.396,P<0.01;OR=1.276,95%CI:1.139-1.429,P<0.01;OR=1.093,95%CI:1.029-1.161,P=0.004;OR=1.207,95%CI:1.087-1.339,P<0.01).A predictive model based on these pathogenic factors was constructed,and ROC curve analysis showed that the multidimensional pathogenic factors had an AUC of 0.924,a sensitivity of 0.879,and a specificity of 0.905 for predicting the occurrence of lobar pneumonia.Conclusion Among the main pathogenic microorganisms in children with lobar pneumonia,Mycoplasma pneumoniae infection is the most common.In the presence of pathogen infection,CRP,IL-6,IL-8,and TNF-α are all multidimensional pathogenic factors associated with the occurrence of lobar pneumonia.The combination of these factors demonstrates good predictive value for the occurrence of lobar pneumonia.