儿童甲型流感与其他病原共检出现状分析  

The current situation of co-detection of influenza virus with the other pathogens in children with influenza

作　　者：王亚坤[1] 侯伟 张丽君[1] 田利远[1] 安会波[2] 马卫申 WANG Yakun;HOU Wei;ZHANG Lijun(Department of Respiratory Diesases,Hebei Provincial Children’s Hospital,Hebei,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院呼吸科,石家庄市050031 [2]河北省儿童医院病理科,石家庄市050031 [3]河北省大名县妇幼保健院儿科,050031

出　　处：《河北医药》2022年第13期2060-2063,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划(编号:20190830)。

摘　　要：目的 儿童是重症流感的高危人群,流感与细菌共感染是造成高致病性和死亡率的主要原因,本研究回顾性分析儿童甲型流感和其他病原共检出时的病情严重程度。方法 选取2018年10月至2020年3月收治的甲型流感确诊病例1125例为研究对象,按严重程度分为普通流感(n=649)和重型流感(n=476),重型流感又分为重症组(n=375)和危重症组(n=101),收集入组病例的病原学等信息,比较组间检出其他病原时病情严重程度。结果 1125例甲型流感病例中,甲型流感病毒(IVA)单一检出48.5%(546/1125),与其他病原共检出51.5%(579/1125),IVA与其他一种病原共检出67.9%(393/579),与其他两种共检出24.0%(139/579),与其他三种及以上病原共检出8.1%(47/579)。579例与其他病原共检出中,302例(52.2%)与其他病毒共检出,前三位:呼吸道合胞病毒(RSV)165例、腺病毒(ADV)92例、鼻病毒(RV)68例;79例(13.6%)肺炎支原体(MP)检出阳性;194例(34.4%)细菌检出阳性,前三位:肺炎链球菌67例、流感嗜血杆菌57例、卡他莫拉菌22例。重型流感较普通流感在检出其他一种病原时,ADV、MP、细菌检出率高,差异均有统计学意义(P<0.05)。重型流感较普通流感在检出其他两种及以上病原时比例明显升高,差异均有统计学意义(P<0.05)。重型流感中,危重症组细菌检出率明显高于重症组,尤其是耐药菌(P<0.05)。结论 儿童甲型流感与其他病原共检出率高,与腺病毒、肺炎支原体、细菌共检出时可能导致病情加重,尤其检出耐药菌时应警惕危重症;甲型流感与其他两种及以上病原共检出时发生重型流感可能性大。Objective To investigate the current situation of co-detectionof influenza virus with the other pathogens in children with influenza.Methods A total of 1,125 children with influenza A who were treated in our hospital from October 2018 to March 2020 were enrolled in the study.According to the severity of disease,who were divided into ordinary influenza group(n=649)and serious influenza group(n=476)which was redivided into severe influenza group(n=375)and critical influenza group(n=101).The etiology and the other information were collected,and the severity of the disease when the other pathogens were detected was compared among the groups.Results Of the 1125 cases of influenza A,the simple detection rate of influenza A virus(IVA)was 48.5%(546/1,125),and co-detection rate of IVA with the other pathogens was 51.5%(579/1,125),in which,the co-detection rate of IVA with one other pathogen was 67.9%(393/579),and that with two other pathogens was 24.0%(139/579),and that with three other pathgens was 8.1%(47/579).Among the 579 cases,the co-detection rate of IAV with the other pathogens was 52.2%(302 cases),and the top three were respiratory syncytial virus(RSV)165 cases,adenovirus(ADV)92 cases,rhinovirus(RV)68 cases.Mycoplasma pneumoniae(MP)was detected in 79 cases(13.6%),and bacteria was detected in 194 cases(34.4%),and the top three were Streptococcus pneumoniae 67 cases,Haemophilus influenzae 57 cases and Moraxella catarae 22 cases.Compared with the detection rates of common influenza,those of ADV,MP and bacteria were significantly higher than those of the other pathogens(P<0.05).Compared with that of common influenza,the proportion of severe influenza was significantly increased when two or more other pathogens were detected(P<0.05).Moreover the detection rate of bacteria in critical group was significantly higher than that in severe group,especially for the drug-resistant bacteria(P<0.05).Conclusion The co-detection rate of IVA with the other pathogens in children with influenza A is higher,and the co-detection of IAV

关 键 词：儿童 甲型流感 病原 共检出 

分 类 号：R511.7[医药卫生—内科学]