广西儿童腺病毒肺炎共检出其他病原情况及其临床特征分析  

Analysis on co⁃detection of other pathogens in adenovirus pneumonia children in Guangxi and their clinical characteristics

作　　者：秦霞 龙兴江[3] 黄晓利 劳金泉 林琨 陈健平 韦小红 杨昌融[1] 谭钧尹 李凯[7] 蒋敏[1] QIN Xia;LONG Xingjiang;HUANG Xiaoli;LAO Jinquan;LIN Kun;CHEN Jianping;WEI Xiaohong;YANG Changrong;TAN Junyin;LI Kai;JIANG Min(Department of Pediatrics,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Pediatrics,Guigang City People′s Hospital,Guangxi 537100,China;Department of Pediatrics,Liuzhou People′s Hospital,Guangxi 545006,China;Department of Pediatrics,Liuzhou Maternity and Child Healthcare Hospital,Guangxi 545000,China;Department of Pediatrics,Liuzhou Worker′s Hospital,Guangxi 545005,China;Department of Pediatrics,Wuming Hospital of Guangxi Medical University,Nanning 530100,China;Department of Radiology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院儿科,南宁530021 [2]贵港市人民医院儿科,广西537100 [3]柳州市人民医院儿科,广西545006 [4]柳州市妇幼保健院儿科,广西545000 [5]柳州市工人医院儿科,广西545005 [6]广西医科大学附属武鸣医院儿科,南宁530100 [7]广西医科大学第一附属医院放射科,南宁530021

出　　处：《中国临床新医学》2024年第11期1221-1226,共6页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西医疗卫生适宜技术开发与推广应用项目(编号:S2020022)。

摘　　要：目的分析广西地区儿童腺病毒肺炎共检出其他病原的种类分布情况及患儿的临床特征,为临床诊疗提供参考。方法回顾性分析2019年1月至2022年2月广西地区5家医院169例腺病毒肺炎住院患儿的临床资料,根据是否共检出其他病原分为单纯腺病毒感染组(26例)、有其他病原共检出组(143例)。分析共检出病原的分布情况及临床特征、对临床转归的影响。结果169例腺病毒肺炎患儿中,轻症100例(59.2%),重症69例(40.8%);单纯腺病毒感染26例(15.4%),有其他病原共检出143例(84.6%);共检出1种病原最常见(52.4%,75/143),以单一共检出细菌最多(25.9%,37/143),主要为肺炎链球菌、流感嗜血杆菌,但未检出耐药菌。有其他病原共检出组的重症比例为43.4%(62/143),高于单纯腺病毒感染组的26.9%(7/26),差异有统计学意义(P<0.05);单一共检出细菌、共检出真菌+细菌、共检出真菌+肺炎支原体患儿的重症比例分别为64.9%(24/37)、100.0%(13/13)、100.0%(6/6),均比单纯腺病毒感染组更高(P<0.05)。轻症患儿前3位共检出病原组合为肺炎支原体+其他病毒(34.0%,34/100)、单一共检出其他病毒(18.0%,18/100)和单一共检出细菌(13.0%,13/100)。共检出细菌患儿更易出现呼吸困难、肺实变。结论儿童腺病毒肺炎患儿其他病原共检出率高,最常见的共检出病原为细菌,主要为肺炎链球菌、流感嗜血杆菌,未检出耐药菌。轻症患儿以共检出病毒和肺炎支原体为主。儿童腺病毒肺炎与细菌、真菌+细菌、真菌+肺炎支原体共检出时更易于进展为重症。了解腺病毒肺炎患儿共检出的病原谱可为抗菌药物合理应用提供参考。Objective To analyze the species distribution of other pathogens co-detected in pediatric patients with adenovirus pneumonia in Guangxi region and to analyze the pediatric patients′clinical characteristics,providing reference for clinical diagnosis and treatment.Methods The clinical data of 169 pediatric inpatients with adenovirus pneumonia in 5 hospitals in Guangxi region from January 2019 to February 2022 were retrospectively analyzed.According to whether other pathogens were co-detected in the pediatric patients,they were divided into simple adenovirus infection group(26 cases)and other pathogens co-detected group(143 cases).The distribution of co-detected pathogens and the clinical characteristics of the pediatric patients were analyzed,and effects of the co-detected pathogens on the clinical outcomes of the pediatric patients were analyzed.Results Among the 169 pediatric patients with adenovirus pneumonia,100 patients(59.2%)were mild and 69 patients(40.8%)were severe,and 26 patients(15.4%)were infected with adenoviruses alone,and 143 patients(84.6%)were co-detected with other pathogens.Among other co-detected pathogens in the 143 pediatric patients,one kind of pathogen co-detected was most common(52.4%,75/143)and co-detected bacteria alone were most common(25.9%,37/143),and the co-detected bacteria alone were Streptococcus pneumoniae and Haemophilus influenzae,but no drug-resistant bacteria were detected.The proportion of pediatric patients with severe disease in the other pathogens co-detected group(43.4%,62/143)was higher than that in the simple adenovirus infection group(26.9%,7/26),and the difference was statistically significant(P<0.05).In the other pathogens co-detected group,the proportions of severe disease pediatric patients with co-detected bacteria alone,co-detected fungi+bacteria,and co-detected fungi+Mycoplasma pneumoniae were 64.9%(24/37),100.0%(13/13)and 100.0%(6/6),respectively,which were higher than those in the simple adenovirus infection group(P<0.05).Among the mild disease pediatric pat

关 键 词：儿童 腺病毒肺炎 病原 共检出 临床特征 

分 类 号：R725.6[医药卫生—儿科]