成人社区获得性肺炎564例咽拭子标本非细菌性病原体检测结果分析  

Analysis of detection results of non-bacterial pathogens in throat swab specimens of 564 adults with community-acquired pneumonia

作　　者：刘策[1] 孙春荣[1] 姜巧巧[2] 马建新[3] LIU Ce;SUN Chunrong;JIANG Qiaoqiao;MA Jianxin(Department of Infectious Disease,Beijing Chuiyangliu Hospital,Beijing100022,China;Department of Disease Control,Beijing Chuiyangliu Hospital,Beijing100022,China;Institute for Infectious and Endemic Disease Control,Chaoyang District Center for Disease Control and Prevention,Beijing100020,China)

机构地区：[1]北京市垂杨柳医院感染科,北京100022 [2]北京市垂杨柳医院疾病控制部,北京100022 [3]北京市朝阳区疾病预防控制中心传染病与地方病控制所,北京100020

出　　处：《中国当代医药》2023年第35期136-139,147,共5页China Modern Medicine

基　　金：“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项项目(2017ZX10103004)。

摘　　要：目的采用咽拭子标本,分析成人社区获得性肺炎(CAP)病原体分布情况,并与前期研究的痰标本作比较,以期为临床诊治提供依据。方法回顾性选取2016年10月1日至2020年5月31日北京市垂杨柳医院收治的564例CAP患者作为研究对象,采集患者咽拭子标本,采用PCR方法进行病原体检测。结果564例CAP患者,共采集咽拭子标本564份,329份未做细菌学检测。细菌检出率为0,病毒检出率为13.3%,肺炎支原体检出率为21.5%,肺炎衣原体检出率为0.4%,均低于前期研究采用痰标本的检出率。检出前四位非细菌性病原体分别为肺炎支原体(121例,21.5%)、鼻病毒(18例,3.2%)、甲型流感(14例,2.5%)、副流感病毒(11例,2.0%)。18~<41岁组肺炎支原体的阳性率最高(31%),41~<60岁组次之(16.6%),年龄≥60岁组最低(8.3%)。肺炎支原体的阳性率在秋季较高(26.8%,62/231)。结论成人CAP的非细菌性病原体以肺炎支原体、鼻病毒、甲型流感、副流感病毒为主。CAP非细菌性病原体的分布与年龄、季节有关。咽拭子标本对CAP病原体的检出率低于痰标本。Objective The distribution of pathogens in adult community-acquired pneumonia(CAP)was analyzed by throat swab specimens and compared with our previous studies using sputum specimens,so as to provide basis for clinical diagnosis and treatment.Methods A total of 564 CAP patients in Beijing Chuiyangliu Hospital from October 1,2016 to May 31,2020 were retrospectively selected as the study objects.Throat swab specimens were collected from the patients and the pathogens were detected by polymerase chain reaction(PCR).Results A total of 564 throat swabs were collected from 564 CAP patients,329 of which were not tested for bacteria.The positive rates of bacteria,virus,mycoplasma pneumoniae and chlamydophila pneumoniae were 0,13.3%,21.5%and 0.4%respectively,the detection rate of all throat swab samples was lower than that of the sputum samples used in our earlier stage.The top four non-bacterial pathogens were mycoplasma pneumoniae(121 cases,21.5%),rhinovirus(18 cases,3.2%),influenza A(14 cases,2.5%)and parainfluenza virus(11 cases,2.0%).The mycoplasma pneumoniae positive rate was the highest in the 18-<41 age group(31%),followed by the 41-<60 age group(16.6%)and the lowest in the≥60 age group(8.3%).The positive rate of mycoplasma pneumoniae was higher in autumn(26.8%,62/231).Conclusion The major non-bacterial pathogens of CAP in adults are mycoplasma pneumoniae,rhinovirus,influenza A and parainfluenza viruses.The distribution of non-bacterial pathogens of CAP was related to age and season.The detection rate of CAP pathogen in throat swab samples was lower than that in sputum samples.

关 键 词：社区获得性肺炎 成人 细菌 病毒 非典型病原体 

分 类 号：R563.1[医药卫生—呼吸系统]