婴幼儿社区获得性肺炎病原学特征分析  

Etiological analysis of community-acquired pneumonia in infants

作　　者：苏布德格日乐 斯琴格日勒 牧兰 宝高娃 吴春霞[1] SUBUDE Gerile;SIQIN Gerile;MU Lan;BAO Gao-wa;WU Chun-xia(Affiliated Hospital of Inner Mongolia University for The Nationalities,TongLiao 028000,Neimenggu,China)

机构地区：[1]内蒙古民族大学附属医院蒙西医结合儿科,内蒙古通辽028000

出　　处：《中国病原生物学杂志》2022年第5期559-562,共4页Journal of Pathogen Biology

基　　金：内蒙古自然科学基金(No.2021MS08140)。

摘　　要：目的研究本地区婴幼儿婴幼儿社区获得性肺炎(CAP)患儿的临床体征及病原学特征,为临床工作者提供参考依据。方法统计本院2016年1月-2020年12月收治的548例CAP患儿临床资料,根据患儿年龄,将其分为婴儿组和幼儿组。回顾性分析患儿的临床症状与主要体征。采用PHOENIX-100全自动细菌鉴定仪鉴定菌株,应用直接免疫荧光法检测呼吸道病毒抗原,使用间接免疫荧光法检测呼吸道非典型感染病原体IgM抗体。结果婴儿组(≥12个月)共计331例患儿,其中发热98例(29.61%)、腹泻111例(33.53%),皮疹11例(3.32%)。幼儿组(12~36个月)共计217例患儿,其中发热129例(59.45%)、腹泻29例(13.36%),皮疹9例(4.15%)。咳嗽、鼻塞和呼吸急促为CAP婴幼儿常见临床特征,皮疹在各年龄段发生概率均低于5%。发热症状在幼儿组较为常见,腹泻症状在婴儿组较为常见。婴儿组出现湿啰音314例,伴有喘鸣92例。幼儿组出现湿啰音187例,伴有喘鸣55例。婴儿组湿啰音发生率高(P<0.05)。肺炎链球菌在幼儿组检出率较高(P<0.05),肺炎克雷伯菌和金黄色葡萄球菌在婴儿组检出率较高(P<0.05)。呼吸道合胞病毒(RSV)为主要病毒,婴儿组检出率偏高(P<0.05)。幼儿组非典型病原体总检出率高于婴儿组(P<0.05),其中MP为主要非典型病原体。345例阳性病例中,春季检出72例,夏季检出67例,秋季检出94例,冬季检出率112例。结论本地区婴幼儿CAP阳性病例主要为病毒感染,以RSV为主,不同细菌、病毒、非典型病原体在不同年龄分布呈现差异化,病例多发于秋冬季。Objective By studying the clinical signs and pathogen distribution of infants with CAP in this area,we can provide reference for clinical workers.Method Statistics of 548 children with clinical diagnosis of CAP treated in our hospital from January 2016 to December 2020,the children were divided into infant group and infant group according to their age.The clinical symptoms and main signs of children were analyzed retrospectively.The strains were identified by PHOENIX-100 automatic bacterial identification instrument,the respiratory virus antigen was detected by direct immunofluorescence method,and the IgM antibody of atypical respiratory infection pathogen was detected by indirect immunofluorescence method.Result There were 331 children in the infant group(≥12 months),including 98 cases of fever(29.61%),111 cases of diarrhea(33.53%)and 11 cases of rash(3.32%).There were 217 children in the infant group(12-36 months),including 129 cases of fever(59.45%),29 cases of diarrhea(13.36%)and 9 cases of rash(4.15%).The results showed that cough,nasal congestion and shortness of breath were common clinical features of cap in infants,and the incidence of rash in all age groups was less than 5%.Fever symptoms were more common in the infant group and diarrhea symptoms were more common in the infant group.The results of lung auscultation showed that 314 cases of wet rales and 92 cases of wheezing appeared in the infant group.There were 187 cases of wet rales and 55 cases of wheezing in the child group.The probability of wet rales in the infant group was higher(P<0.05).The detection rate of Streptococcus pneumoniae was higher in the infant group(P<0.05),and the detection rates of Klebsiella pneumoniae and Staphylococcus aureus were higher in the infant group(P<0.05).RSV was the main virus,and the detection rate in infant group was high(P<0.05).The total detection rate of atypical pathogens in the child group was higher than that in the infant group(P<0.05),MP was the main atypical pathogen.Among 345 positive cases,72 cases we

关 键 词：婴幼儿社区获得性肺炎 细菌 病毒 非典型病原体体 年龄 季节 

分 类 号：R378[医药卫生—病原生物学]