儿童社区获得性肺炎死亡病例中b型流感嗜血杆菌的检测  

Study on Haemophilus influenzae type b: data from autopsy of community-acquired pneumonia among children

作　　者：胡惠丽[1] 胡翼云[1] 何乐健[1] 俞桑洁[1] 高薇[1] 杨永弘[1] 

机构地区：[1]首都医科大学附属北京儿童医院微生物免疫学实验室,北京100045

出　　处：《中华流行病学杂志》2005年第8期604-607,共4页Chinese Journal of Epidemiology

基　　金：国家"十五"科技攻关课题资助项目(2003BA712A1120);北京市科委资助项目(Y0204004040131)

摘　　要：目的明确b型流感嗜血杆菌(Hib)在儿童社区获得性肺炎死亡病例中的地位;探讨直接原位聚合酶链反应(ISPCR)在小儿肺炎病原检测中的使用价值。方法用普通PCR、Southern杂交和直接ISPCR三种方法检测100例死于肺炎的儿童尸检石蜡包埋肺组织标本中的Hib,分析其致病、致死及在肺组织中的分布情况,并对这些方法对比分析。结果不同年代Hib的检出率无明显差异。直接ISPCR对Hib的检出率高于其他方法;Southern杂交阳性率为8%(8/100),其中20世纪50-60年代阳性率为7.1%(4/56),80年代至2002年阳性率为9.1%(4/44),χ2=0.084,P>0.05;直接ISPCR阳性率为17%(17/100),20世纪50-60年代阳性率为14.3%(8/56),80年代至2002年阳性率20.5%(9/44),χ2=0.665,P>0.05;Southern杂交和直接ISPCR均为阳性的占7%。结论Hib是儿童社区获得性肺炎的主要致病细菌之一,与患儿死亡有关系。直接ISPCR用于检测小儿肺炎病原,灵敏、特异、可定位。Objective To evaluate the status of Haemophilus influenza type b（Hib） on death cases of children from community-acquired pneumonia （CAP） and to estimate the value of direct in-situ polymerase chain reaction （ISPCR） on diagnosis of children CAP, pathogenically. Methods Ordinary PCR, Southern blot and direct ISPCR were applied and compared in detecting Hib in 100 paraffinembedded lung tissues of autopsy children died of CAP. Results No major difference on the detection rate of Hib between 50-60s and 80s-2002 was found. The detection rate of Hib by direct ISPCR was higher than the other two methods. By Southern blot, Hib was identified from 8 out of 100 samples（8% ）, including 4 out of 56 in 1950-60s（7.1% ） and 4 out of 44 （9.1% ） （x^2 = 0. 084, P 〉 0.05 ） in 1980s-2002. By ISPCR, Hib was identified from 17 out of 100 samples（ 17% ）, including 8 out of 56 in 1950-60s （14.3%） and9 out of 44（20.5%） with x^2=0.665,P〉0.05, in 1980s-2002. Positive cases diagnosed by both Southern blot and ISPCR were 7% . Conclusion Hib was one of the main bacterial pathogens causing CAP and deaths among children. Direct ISPCR was prefertable to be used in pathogenic diagnosis on children pneumonia, in terms of its sensitivity, specificity and localization.

关 键 词：儿童 社区获得性肺炎 死亡病例 B型流感嗜血杆菌 细菌感染 

分 类 号：R725.6[医药卫生—儿科]