600例儿童社区获得性肺炎病原学特点分析  

Analysis of the etiological characteristics of community-acquired pneumonia in 600 children

作　　者：陈金妮[1] 

机构地区：[1]海南省人民医院,海南海口570311

出　　处：《中国病原生物学杂志》2016年第12期1126-1130,共5页Journal of Pathogen Biology

摘　　要：目的 了解儿童社区获得性肺炎（CAP）病原学分布特点,为临床合理用药提供参考依据。方法选取自2014年1-12月在海南省人民医院儿内科就诊的600例CAP患儿作为研究对象,采集所有患儿的鼻咽抽吸物作细菌培养、呼吸道7种病毒及肺炎支原体的检测,以及痰MP-PCR定量测定,同时采集静脉血行MP血清学抗体检测,观察并分析其结果。结果600例患儿中痰液标本中共分离细菌314株,分离率为52.33%,检出副流感嗜血杆菌137株（43.63%）,肺炎链球菌93株（29.61%）,卡他莫拉菌27株（8.60%）;其中,副流感嗜血杆菌感染多见于婴幼儿（≤3岁）,冬春季高发。共分离出病毒221株（36.83%）,检出呼吸道合胞病毒128株（57.92%）,副流感病毒3 38株（17.19%）,腺病毒29株（13.12%）;其中,RSV感染随年龄增长而递减,差异有统计学意义（χ^2=133.476,P〈0.05）,且秋冬季多见。支原体阳性180例,阳性率为30.00%,夏季为感染高发季节;且随年龄增长而逐渐递增,差异有统计学意义（χ^2=125.289,P〈0.05）。病原体混合感染检出179例（29.83%）,以细菌、病毒混合检出为主（42.46%）,且随年龄增长而递减,差异有统计学意义（χ^2=52.191,P〈0.05）。结论 细菌为儿童CAP首位检出病原,低龄婴儿组（〈1岁）细菌感染率相对较高,且易发于春、冬两季。RSV为主要病毒病原,MP逐渐成为重要病原,且混合感染较高。临床上对儿童呼吸道疾病的检查应行多病原学监测,有助于及早诊断及合理联合用药。Objective To ascertain the etiological characteristics of community acquired pneumonia （CAP） in children in order to provide a scientific basis for rational drug use in clinical settings. Methods Subjects were 600 patients with CAP seen by Pediatrics at the People＇s Hospital of Hainan Province between January and December 2014. Respiratory tract specimens were collected to detect bacteria, 7 viruses, and PCR was performed to quantify the amount of Mycoplasma pneurnoniae in sputum. Blood was also collected to serologically test for antibodies against M. pneumoniae. Findings were noted and results were analyzed. Results In total, 314 strains of bacteria were isolated from 600 sputum specimens from children, and bacteria were isolated at a rate of 52. 33% （309 patients）. Detected strains consisted of 137 strains of Haemophilus parainfluenzae （43. 63%）, 93 strains of Streptococcus pneurnoniae （29.61%）, and 27 strains of Moraxella catarrhalis （8.60%）. H. parainfluenzae infection was more prevalent in infants or babies （43 years） and had a high incidence in the winter or spring. Viruses were isolated at a rate of 36.83% （221 patients）. Detected strains consisted of 128 strains of respiratory syncytial virus （57.92%）, 38 strains of parainfluenza virus 3 （17.19%）, and 29 strains of adenovirus （13. 12%）. RSV infection had a high incidence in the winter or spring and was significantly less prevalent （χ^2=133. 476, P〈0.05） with age. Mycoplasma strains were isolated at a rate of 30.00%（180 patients） and bad a high incidence in the summer. The incidence of those strains gradually increased with age, and the incidence differed significantly （χ^2=125. 289, P〈0.05）. A mixed infection was detected in 179 patients （29.83%）. That infection mainly consisted of an infection with a bacterium and a virus （42.46%）. The incidence of a mixed infection decreased with age, and that incidence differed significantly （χ^2=52. 191, P〈0.05）. Conclusion Bacteria were the m

关 键 词：儿童 社区获得性肺炎 病原学特点 

分 类 号：R563.1[医药卫生—呼吸系统]