鼻咽拭子细菌培养在儿童细菌性呼吸道感染病原诊断中的价值  

Evaluation of nasopharyngeal swab bacterial culture in pathogenic diagnosis in children with bacterial respiratory tract infection

作　　者：谢永平[1] 华春珍[1] 魏林琳[1] 汪洪姣[1] 王高良[1] 李建平[2] XIE Yongping;HUA Chunzhen;WEI Linlin;WANG Hongjiao;WANG Gaoliang;LI Jianping(Department of Infectious Diseases,the Children's Hospital Affiliated to Zhejiang University School of Medicine,Hangzhou 310003,Zhejiang,China;Department of Clinical Laboratory,the Children's Hospital Affiliated to Zhejiang University School of Medicine,Hangzhou 310003,Zhejiang,China)

机构地区：[1]浙江大学医学院附属儿童医院感染病科,浙江杭州310003 [2]浙江大学医学院附属儿童医院实验检验中心,浙江杭州310003

出　　处：《检验医学》2022年第3期201-204,共4页Laboratory Medicine

基　　金：浙江省基础公益研究计划项目(LGF18H010001)。

摘　　要：目的分析鼻咽拭子细菌培养在儿童呼吸道感染病原诊断中的价值。方法同时采集403例类百日咳综合征或肺炎住院患儿鼻咽拭子和口腔吸取物,以分区划种半定量法接种培养后进行菌种鉴定,“+++”及以上考虑有临床意义。对比2种类型样本培养结果及其与患儿临床表现和疾病转归的吻合程度。结果403例患儿中,鼻咽拭子培养阳性率为31.5%(127/403),居前4位的病原分别为百日咳鲍德特菌(13.4%)、流感嗜血杆菌(7.9%)、卡他莫拉菌(4.0%)和肺炎链球菌(3.5%)。口腔吸取物培养阳性率为12.4%(50/403),百日咳鲍德特菌、流感嗜血杆菌、卡他莫拉菌和肺炎链球菌的分离率分别为0.7%、4.5%、1.0%和1.2%。鼻咽拭子样本4种病原总阳性率均显著高于口腔吸取物样本(P<0.05)。62.0%(31/50)的患儿鼻咽拭子样本病原培养结果与口腔吸取物样本培养结果一致。经鼻咽拭子样本确定的病原中,有98.4%(125/127)经抗菌药物治疗后细菌培养阴转,患儿临床症状有所改善。结论鼻咽拭子样本细菌培养有助于提高儿童呼吸道病原菌的检出率,对临床病原判断有一定参考价值。Objective To evaluate the value of nasopharyngeal swab bacterial culture in pathogenic diagnosis in children with respiratory tract infection.Methods Nasopharyngeal swab and oral aspirate samples were collected from 403 hospitalized children diagnosed as pertussis-like syndrome or pneumonia.The samples were inoculated in partitions on medium discs with semi-quantitative method.Bacteria were identified,and the isolates growing including and more than"+++"were definited as clinical isolates.The positive rates of culture between nasopharyngeal swab and sputum samples were compared and linked with clinical manifestation and treatment outcomes.Results In the 403 cases,the positive rate of nasopharyngeal swab culture was 31.5%(127/403),and the top 4 bacteria were Bordetella pertussis(13.4%),Haemophilus influenzae(7.9%),Moraxella catarrhalis(4.0%)and Streptococcus pneumoniae(3.5%).The positive rate of oral aspirate culture was 12.4%(50/403),and the positive rates of the above 4 bacteria were 0.7%,4.5%,1.0%and 1.2%,respectively.The positive rates of nasopharyngeal swab culture was higher than that of oral aspirate culture(P<0.05).The same bacteria were isolated from both nasopharyngeal swab and sputum samples in 31 of 50 cases(62.0%).After treating with sensitive antibiotics,the results of nasopharyngeal swab culture swithed to negative in 98.4%(125/127)of all the patients.Conclusions Nasopharyngeal swab culture improves the determination of pathgens in respiratory tract in children,which plays a role in pathogenic diagnosis in children with respiratory tract infection.

关 键 词：细菌 鼻咽拭子 呼吸道感染 儿童 

分 类 号：R378[医药卫生—病原生物学]