儿童反复呼吸道感染病原菌临床分布及危险因素研究  

Clinical distribution and risk factors of pathogens in children with recurrent respiratory tract infection

作　　者：胡海赟[1] 王春[2] 姚剑杰 乔蓉[1] HU Haiyun;WANG Chun;YAO Jianjie(Department of Infectious Diseases,Children's Hospital of Shanghai (Children's Hospital of Shanghai Jiaotong University),Shanghai 200040)

机构地区：[1]上海市儿童医院(上海交通大学附属儿童医院)感染科,上海200040 [2]上海市儿童医院(上海交通大学附属儿童医院)检验科,上海200040

出　　处：《陕西医学杂志》2019年第6期781-783,809,共4页Shaanxi Medical Journal

摘　　要：目的:分析儿童反复呼吸道感染(RRTI)常见病原菌的分布情况及危险因素。方法:收集RRTI患儿240例,对其呼吸道分泌物行细菌分离培养检测、药敏试验,分析病原菌具体分布情况及主要危险因素。结果:240例患儿1380份呼吸道分泌物标本中,病原菌阳性1356份,检出率98.26%;分离出病原菌1486株,其中革蓝阴性菌1071株(72.07%),革蓝阳性菌415株(27.93%)。革蓝阴性菌中,流感嗜血杆菌所占比例最大(22.27%),其次为铜绿假单胞菌(13.32%)、大肠埃希菌(11.31%);革蓝阳性菌中,金黄色葡萄球菌所占比例最大(14.20%),其为肺炎链球菌(5.32%)、表皮葡萄球菌(3.30%)。240例中,家长文化水平低、有呼吸道疾病、吸烟家长所占比例显著更高(P<0.05);微量元素缺乏、营养及免疫差、作息情况差、生活环境差、偏食、健康锻炼缺乏所占比例显著更高(P<0.05);家长文化水平、吸烟、呼吸道疾病及儿童生活环境、作息情况、健康锻炼、饮食、微量元素、以营养及免疫状况均与RRTI发生差异存在统计学意义(P<0.05)。结论:儿童RRTI病原菌分布革蓝阴性菌感染为主,且有个体差异,须合理使用抗生素进行治疗;家长状况、儿童机体状况、生活及饮食习惯等均与RRTI发生存在密切相关,临床上应重点监测,及时预防。Objective:To evaluate the distribution and risk factors of common pathogens in children with recurrent respiratory tract infection(RRTI).Methods:Respiratory tract specimens of 240 RRTI children were selected as subjects,the specific distribution of pathogenic bacteria was analyzed by bacterial isolation,culture and susceptibility test,and the main risk factors were also analyzed.Results:Of the 1380 specimens of respiratory secretions from 240 children,the positive rate of pathogenic bacteria was 98.26%;A total of 1486 strains of pathogenic bacteria were isolated,of which 1071 strains(72.07%)were Gram-negative and 415 strains(27.93%)were gram-positive;Among gram-negative bacteria,Haemophilus influenzae accounted for the largest proportion(22.27%),followed by Pseudomonas aeruginosa(13.32%)and Escherichia coli(11.31%);Staphylococcus aureus accounted for the largest proportion(14.20%)of Gram-positive bacteria,including Streptococcus pneumoniae(5.32%)and Staphylococcus epidermidis(3.30%);Among 240 children,the proportion of parents with low educational level,respiratory diseases and smoking was significantly higher(P<0.05),the proportion of trace element deficiency,poor nutrition and immunity,poor work and rest,poor living environment,partial diet and lack of health exercise is significantly higher(P<0.05);Parents'educational level,smoking,respiratory diseases,children's living environment,work and rest,health exercise,diet,trace elements,nutrition and immune status were significantly correlated with RRTI(P<0.05).Conclusion:The pathogenic bacteria of RRTI in children are mainly Gram-negative bacterial infections with different personalities.It is necessary to use antibiotics reasonably to treat RRTI;Parental status and children's body condition,life and dietary habits are closely related to RRTI occurrence,to effectively improve the prevention and treatment effect of RRTI in children,we should strengthen the key monitoring and take preventive measures in time.

关 键 词：反复呼吸道感染 病原菌 分布 危险因素 防治 临床分析 

分 类 号：R725.6[医药卫生—儿科]