宁夏某医院300例肺炎病例病原谱分析  

Pathogen Spectrum Analysis of 300 Pneumonia Cases in A Hospital of Ningxia

作　　者：刘翔[1] 杨丽娟 沈梅[1] 郝琼[1] 郭邦成[1] 李刚[2] LIU Xiang;YANG Lijuan;SHEN Mei;HAO Qiong;GUO Bangcheng;LI Gang(Ningxia Center For Diseases Prevention and Control,Yinchuan 750004,China;General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏回族自治区疾病预防控制中心,银川750004 [2]宁夏医科大学总医院,银川750004

出　　处：《宁夏医科大学学报》2023年第7期717-721,共5页Journal of Ningxia Medical University

基　　金：国家科技重大专项“艾滋病和病毒性肝炎等重大传染病防治”(2018ZX10713-003)。

摘　　要：目的 掌握肺炎病例病原谱构成,为肺炎的临床诊断和防治提供参考。方法 采集2019年1月至2020年12月宁夏医科大学总医院300例住院肺炎病例肺泡灌洗液样本,用实时荧光PCR方法检测流感病毒、鼻病毒、冠状病毒、副流感病毒、偏肺病毒、博卡病毒、呼吸道合胞病毒、腺病毒、肠道病毒、肺炎支原体、肺炎衣原体、嗜肺军团菌、肺炎克雷伯菌、百日咳鲍特菌、流感嗜血杆菌、铜绿假单胞菌、A组乙型链球菌、金黄色葡萄球菌和肺炎链球菌,共19种病原体。结果 300份肺泡灌洗液标本检出阳性病例123份,总阳性率41%,病毒感染以冠状病毒、鼻病毒、博卡病毒和腺病毒为主,细菌感染以肺炎支原体、流感嗜血杆菌、肺炎链球菌和铜绿假单胞菌为主。各年度病原谱有较大差异,2019年感染病原以肺炎支原体、博卡病毒、冠状病毒和流感嗜血杆菌为主,2020年感染病原以流感嗜血杆菌、肺炎链球菌、铜绿假单胞菌和鼻病毒为主。各年龄组中,细菌感染均高于病毒感染。混合感染病例中,以细菌和病毒合并感染和细菌间混合感染为主,占97.0%以上。结论 该医院肺炎病例感染以细菌为主、病毒为辅,5岁以下婴幼儿和5~15岁儿童肺炎支原体感染严重,是防控的重点人群。Objective To grasp the pathogen composition of pneumonia cases in a hospital of Ningxia,and provide reference for the prevention and treatment of pneumonia.Methods Alveolar lavage fluid samples were collected from 300 hospitalized pneumonia cases in General Hospital of Ningxia Medical University from January 2019 to December 2020.A total of 19 pathogens were detected by the method of real-time fluorescence PCR,which contained influenza virus,rhinovirus,coronavirus,parainfluenza virus,metapneumovirus,boca virus,respiratory syncytial virus,adenovirus,enterovirus,mycoplasma pneumoniae,chlamydia pneumoniae,legionella pneumophila,klebsiella pneumophila,bordetella pertussis,haemophilus influenzae,pseudomonas aeruginosa,group A betastreptococcus,staphylococcus aureus and streptococcus pneumoniae.Results 123 positive cases were detected from 300 alveolar lavage fluid samples,the total positive rate was 41%.The main viral infection was coronavirus,rhinovirus,bocavirus and adenovirus.The primary bacterial infection was mycoplasma pneu-moniae,haemophilus influenzae,streptococcus pneumoniae and pseudomonas aeruginosa.The pathogen spec-trum varied greatly each year.The dominating pathogens were mycoplasma pneumonia,boca virus,coronavirus and haemophilus influenzae in 2019,the major pathogens were haemophilus influenzae,streptococcus pneumo-niae,pseudomonas aeruginosa and rhinovirus.In all age groups,the bacterial infection rates were higher than the viral infection rate.In the cases of mixed infection,the main infections were bacterial virus co-infection and interbacterial mixed infection,which accounted for 97.0%.Conclusion The major cause of the pneumonia cases in the hospital was bacteria infection,and the secondary was virus infection.The infants,young children under 5 years old and the children from 5 to 15 years old were the focus groups of prevention and control,who were infected by mycoplasma pneumoniae seriously.

关 键 词：肺炎 病原谱 细菌感染 病毒感染 

分 类 号：R446.5[医药卫生—诊断学]