910例成人发热呼吸道症候群住院患者病原谱研究  

Pathogenic spectrum study on 910 cases of adult hospitalized patients with febrile respiratory syndrome

作　　者：刘涛[1] 陈明静[1] 李树华[1] 左浩江[1] 裴晓方[1] 

机构地区：[1]四川大学华西公共卫生学院(华西第四医院),四川成都610041

出　　处：《现代预防医学》2017年第13期2485-2488,共4页Modern Preventive Medicine

基　　金：国家卫生计生委科技重大专项项目资助课题(2012ZX10004-212)

摘　　要：目的探讨成人发热呼吸道症候群住院患者病原谱分布情况,为呼吸道感染性疾病的防控提供参考。方法采集2014年3月~2016年2月成都市某医院成人发热呼吸道症候群住院患者的咽拭子或痰液标本,采用RT-PCR和PCR法检测标本中常见的八种呼吸道病毒;用培养法,生化鉴定和微生物全自动鉴定系统,分离鉴定呼吸道感染的细菌和真菌;分析主要病原体和年龄与季节的关系。结果共采集910份标本,病原体检出率为47.58%(433/910);病毒检出率为26.92%(245/910),检出最高的是鼻病毒(9.78%),其冬季感染率高于春,夏,秋季;细菌检出率为13.41%(122/910),肺炎克雷伯菌(6.26%)检出率最高,检出无季节性和年龄差异;真菌检出率为14.51%(132/910),白色念珠菌(11.32%)检出率最高,60岁以上人群感染率高于其他人群(=16.268,P<0.001)。结论发热呼吸道症候群住院患者病原体感染率较高,以白色念珠菌,鼻病毒,肺炎克雷伯菌为主,今后应加强病原学的监测,注重病原体在不同人群感染分布和季节性防治。Objective To analyze fever pathogenic spectrum distribution of hospitalized patients with the respiratory syndrome, and to provide the basis for respiratory infection prevention and control. Methods Swabbing and sputum specimens of hospitalized patients with the febrile respiratory syndrome in March 2014 - February 2016 from a hospital in Chengdu were collected. Eight kinds of common respiratory tract viruses in the sample were detected by RT - PCR and PCR. Sputum culture, biochemical identification and the automatic identification drug susceptibility system （ VITEK2 - COMPACT） were used to detect common bacteria, fungi. The relationship between main pathogens and the age and season was analyzed. Results A total of 910 specimens were collected. The pathogen detection was 47.58% （433/910）. The virus detection rate was 26.92% （245/ 910）. The infection rate of rhinovirus （9.78%） was the highest, and it was higher than that of spring, summer and autumn. Bacterium detection rate was 13.41% （122/910） ,with the highest detection rate of 6.26% in klebsiella pneumoniae, and no statistical significance in seasons and ages. Fungus detection rate was 14.51% （132/910）, with the highest detection rate of 11.32% in candida albicans and the detection rate in people older than 60 was higher than the other populations （χ^2= 16. 268, P 〈 0. 01 ）. Conclusion Febrile respiratory syndrome was most caused by candida albicans, rhinovirus, and klebsiella pneumoniae infections, and monitoring for etiology should be strengthened in the future to understand the change of pathogens in different populations and seasons.

关 键 词：发热呼吸道症候群 鼻病毒 病原谱 

分 类 号：R113[医药卫生—公共卫生与预防医学]