2014—2016年河北省石家庄地区儿童重症社区获得性肺炎的病原学分析  

Pathogenic analysis of severe community-acquired pneumonia in children in Shijiazhuang,Hebei province,2014-2016

作　　者：李飞 安淑华[2] 郭佳运 李奇 谢正德 陈祥鹏 Li Fei;An Shuhua;Guo Jiayun;Li Qi;Xie Zhengde;Chen Xiangpeng(Beijing Key Laboratory of Pediatric Respiratory Infection Diseases,Key Laboratory of Major Diseases in Children,Ministry of Education,National Clinical Research Center for Respiratory Diseases,Research Unit of Critical Infection in Children,Chinese Academy of Medical Sciences,2019RU016,Laboratory of Infection and Virology,Beijing Pediatric Research Institute,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing 100045,China;Respiratory Department,Children′s Hospital of Hebei Province,Shijiazhuang 050031,China;Department of Endocrinology,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院,北京市儿科研究所感染与病毒研究室,中国医学科学院儿童危重感染诊治创新单元,国家呼吸系统疾病临床医学研究中心,教育部儿科重大疾病研究重点实验室,儿童呼吸道感染性疾病研究北京市重点实验室,北京100045 [2]河北省儿童医院呼吸科,石家庄050031 [3]首都医科大学附属北京儿童医院内分泌科,北京100045

出　　处：《中华实验和临床病毒学杂志》2024年第5期513-520,共8页Chinese Journal of Experimental and Clinical Virology

基　　金：国家科技重大专项(2017ZX10104001-005-010,2017ZX10103004-004);中国医学科学院医学与健康科技创新工程(2019-I2M-5-026);北京市卫生健康委员会改革与发展项目。

摘　　要：目的了解河北省儿童重症社区获得性肺炎的病原学分布情况。方法收集2014年1月至2016年1月在河北省儿童医院住院的314例被诊断为重症肺炎的儿童的临床数据,同时采集鼻咽拭子样本进行实验室检查。结果在314例患儿中,鼻咽拭子病原阳性为298例(94.94%),其中246例(78.34%)同时检测到多种病原,主要为混合病毒和细菌(206例,占65.61%)。病原体检出总数为848株,其中病毒为483株(56.96%),以呼吸道合胞病毒最常见(A型97株、B型86株);细菌和非典型病原体(肺炎支原体)为365株(43.04%),以肺炎链球菌(220株)和流感嗜血杆菌(119株)为主。不同年龄组中,1岁以下儿童的病原体检出率更高(χ^(2)=21.389,P<0.001)。在不同季节中,病原体检出阳性率没有显著差异,但在秋季、冬季和春季分别检出呼吸道合胞病毒A型、呼吸道合胞病毒B型和肺炎链球菌的比例较高,差异有统计学意义(χ^(2)=22.205,P<0.001;χ^(2)=37.874,P<0.001;χ^(2)=11.380,P=0.009)。结论儿童重症肺炎鼻咽拭子样本检测的病原体通常为混合病毒和细菌,并且不同病原体在不同年龄和季节的检出率有差异,鼻咽拭子样本病原检测对临床病原判断具有一定的参考价值。ObjectiveTo investigate the etiological distribution of severe community-acquired pneumonia(CAP)in children in Hebei Province.MethodsThe nasopharyngeal swab samples and clinical data from 314 children with severe pneumonia were retrospectively analyzed between January 2014 and January 2016.ResultsAmong the 314 children,298(94.94%)showed positive result for pathogens in their nasopharyngeal swab samples,with 246 cases(78.34%)of multiple pathogens,predominantly mixed viruses and bacteria(206 cases,65.61%).A total of 848 strains of pathogens were detected,including 483 strains(56.96%)of viruses,predominantly respiratory syncytial virus with 97 strains of subtype A and 86 strains of B.Bacteria and atypical pathogens(Mycoplasma pneumoniae)had 365 strains(43.04%),mainly Streptococcus pneumoniae(220 strains)and Haemophilus influenzae(119 strains).The detection rate of pathogens was higher in children under one year of age(χ^(2)=21.389,P<0.001).There were no significant differences in different seasons,but the detection rates of respiratory syncytial virus A,respiratory syncytial virus B,and Streptococcus pneumoniae were higher in autumn,winter,and spring,respectively,with statistically significant differences(χ^(2)=22.205,P<0.001;χ^(2)=37.874,P<0.001;χ^(2)=11.380,P=0.009).ConclusionsNasopharyngeal swab sample testing in children with severe pneumonia typically shows a coexistence of viral and bacterial pathogens,with detection rates varying among different age groups and seasons.Nasopharyngeal swab sample testing for pathogens provides valuable references for the identification of clinical pathogens.

关 键 词：重症肺炎 鼻咽拭子 病原学 儿童 

分 类 号：R725.6[医药卫生—儿科]