2017—2020流感季节住院肺炎病例的病原学及临床特征分析  

The etiology and clinical characteristics of hospitalized pneumonia patients in influenza seasons from 2017 to 2020

作　　者：田国保[1] 龚成[2] 王笑灵 孙静怡 董建平[1] 黄芳 Tian Guobao;Gong Cheng;Wang Xiaoling;Sun Jingyi;Dong Jianping;Huang Fang(Department of Infectious Diseases,Beijing Haidian Hospital,Beijing 100080,China;Department of Immunization,Beijing Municipal Center for Disease Prevention and Control,Beijing 100013,China)

机构地区：[1]北京市海淀医院感染性疾病科,100080 [2]北京市疾病预防控制中心北京市预防医学研究中心免疫预防所,100013

出　　处：《国际病毒学杂志》2020年第4期336-338,共3页International Journal of Virology

基　　金：国家科技重大专项(2017ZX10103004-002)。

摘　　要：目的初步研究2017—2020流感季节住院肺炎病例的病原学及临床特征。方法以2017—2020流感季节在北京市海淀医院39例住院肺炎病例的下呼吸道标本为对象,采用多重实时荧光定量PCR检测方法进行多种呼吸道多病原(包括16种病毒和15种细菌)检测,同时分析其临床特征。结果2017—2020年流感季节,39例住院肺炎病例的合格下呼吸道标本中,流感病毒核酸检测阳性率51.3%(20/39),肺炎支原体核酸检测阳性率为20.5%(8/39),呼吸道细菌核酸阳性率为33.3%(13/39),结合临床资料综合判断后,仅15.4%(6/39)考虑存在细菌感染;确诊流感病毒相关肺炎病例中仅55%(11/20)经验给予了磷酸奥司他韦,且均为起病48 h之后。结论流感病毒是流感季节住院肺炎病例中最常见的病原体,流感病毒肺炎的经验性抗病毒治疗存在不足。Objective To investigate the etiology and clinical characteristics of hospitalized pneumonia cases in influenza seasons from 2017 to 2020.Methods Lower respiratory tract specimens were obtained from hospitalized pneumonia cases in Haidian Hospital in Beijing within influenza seasons from 2017 to 2020,and multiple respiratory tract pathogens(including 16 viral pathogens and 15 bacterial pathogens)were detected by multiple real-time fluorescent quantitative PCR.The clinical characteristics were also analyzed.Results In the influenza seasons from 2017 to 2020,39 qualified lower respiratory tract specimens were obtained from hospitalized pneumonia patients.The nucleic acid detection rates of influenza virus,Mycoplasma pneumoniae,and the respiratoly bacterial pathogens were 51.3%(20/55),20.5%(8/39)and 33.3%(13/39),respectively.In combination with clinical data,only 15.4%(6/39)of the cases were diagnosed as bacterial infection,and only 55%(11/20)of the confirmed influenza pneumonia cases were empirically prescribed a course of oseltamivir after 48 hours of the onset empirically.Conclusions In the influenza seasons,influenza virus was the most common pathogen in the case of hospitalized pneumonia,and empirical antiviral treatment for influenza pneumonia needed to be improved.

关 键 词：社区获得性肺炎 病原体 呼吸道病毒 流感病毒 

分 类 号：R563.1[医药卫生—呼吸系统] R181.3[医药卫生—内科学]