反复呼吸道感染儿童鼻咽部细菌学特征及主要危险因素  

Nasopharyngeal bacteriological characteristics and main risk factors of children with recurrent respiratory tract infections

作　　者：张琦 韩旭 ZHANG Qi;HAN Xu(Department of General Practice,Daxing Teaching Hospital of Capital Medical University,Beijing 102600,China;Department of Ear Nose Throat Pharynx,Daxing Teaching Hospital of Capital Medical University,Beijing 102600,China)

机构地区：[1]首都医科大学大兴教学医院全科医学科 [2]首都医科大学大兴教学医院耳鼻喉科

出　　处：《中国妇幼健康研究》2021年第10期1458-1462,共5页Chinese Journal of Woman and Child Health Research

摘　　要：目的分析反复呼吸道感染儿童的鼻咽部细菌学特征及主要危险因素。方法选取2019年1月至2020年8月首都医科大学大兴教学医院收治的106例反复呼吸道感染患儿为观察组,另选取同时期进行健康体检的106例儿童为对照组。106例患儿入院当天对鼻咽部细菌进行检测,按革兰阳性菌、革兰阴性菌进行分类统计。收集儿童性别、年龄、日常生活活动等多方面的资料,对其进行单因素和多因素回归分析,确定危险因素。结果在106例患儿的鼻咽部分泌物标本中共分离出病原菌141株,其中革兰阳性菌48株,以金黄色葡萄球菌、肺炎链球菌为主;革兰阴性菌93株,以大肠埃希菌、流感嗜血杆菌、铜绿假单胞菌为主。Logistic多因素回归分析结果显示,早产(OR=2.348,95%CI:1.227~4.492,P<0.05)、居住地农村(OR=2.154,95%CI:1.208~3.840,P<0.05)、抗菌药应用≥3次/月(OR=3.262,95%CI:1.688~6.302,P<0.05)、同住家人吸烟(OR=2.573,95%CI:1.495~4.428,P<0.05)、经常外出至公共场所(OR=2.756,95%CI:1.441~5.273,P<0.05)、户外活动<2小时/日(OR=3.017,95%CI:1.450~6.280,P<0.05)是儿童反复呼吸道感染的独立危险因素。结论反复呼吸道感染儿童的病原菌以革兰阴性菌为主,早产、居住地农村、抗菌药应用频繁、同住家人吸烟、经常外出至公共场所、户外活动少是主要危险因素,需采取针对性的预防措施,以减少感染风险。Objective To analyze the nasopharyngeal bacteriological characteristics and main risk factors of children with recurrent respiratory tract infections.Methods 106 children with recurrent respiratory tract infections admitted to Daxing Teaching Hospital of Capital Medical University from January 2019 to August 2020 were selected as observation group,and another 106 healthy children who underwent physical examination in our hospital during the same period were selected as control group.The nasopharyngeal bacteria were tested among 106 children on the day of admission,and given classification statistics according to Gram-positive bacteria and Gram-negative bacteria.The data such as gender,age and activities of daily living were collected among children,and univariate analysis and multivariate regression analysis were conducted to determine the risk factors.Results A total of 141 pathogenic bacteria were isolated from the nasopharyngeal secretions of 106 patients,of which were 48 strains of Gram-positive bacteria(mainly Staphylococcus aureus and Streptococcus pneumoniae)and 93 strains of Gram-negative bacteria(mainly Escherichia coli,Haemophilus influenzae and Pseudomonas aeruginosa).Logistic multivariate regression analysis showed that premature birth(OR=2.348,95%CI:1.227~4.492,P<0.05),rural residence(OR=2.154,95%CI:1.208~3.840,P<0.05),use of antibacterial drugs≥3 times/month(OR=3.262,95%CI:1.688~6.302,P<0.05),smoking of family members(OR=2.573,95%CI:1.495~4.428,P<0.05),frequent outings to public places(OR=2.756,95%CI:1.441~5.273,P<0.05)and outdoor activities<2 h/d(OR=3.017,95%CI:1.450~6.280,P<0.05)were independent risk factors for children with recurrent respiratory tract infections(P<0.05).Conclusion The pathogenic bacteria in children with recurrent respiratory tract infections are mainly Gram-negative bacteria.Premature birth,rural residence,frequent use of antibacterial drugs,smoking of family members,frequent outings to public places and less outdoor activities are the main risk factors,and it is necessary to

关 键 词：反复呼吸道感染 鼻咽部 病原菌 危险因素 

分 类 号：R725.6[医药卫生—儿科]