辽宁省三家医院儿童肺炎支原体感染临床表现及流行病学特征  

Clinical manifestations and epidemiological characteristics of children with Mycoplasma pneumoniae infection in 3 hospitals of Liaoning Province

作　　者：王菲[1] 程琪[1] 景淑军 李静 周宪东 尚云晓[1] 陈宁[1] 张晗[1] WANG Fei;CHENG Qi;JING Shu-jun;LI Jing;ZHOU Xian-dong;SHANG Yun-xiao;CHEN Ning;ZHANG Han(Shengjing Hospital of China Medical University,Shenyang,Liaoning 110001,China;不详)

机构地区：[1]中国医科大学附属盛京医院儿科,辽宁沈阳110001 [2]大连市妇女儿童医疗中心集团儿科,辽宁大连116000 [3]锦州医科大学附属第一医院儿科,辽宁锦州121000

出　　处：《中华医院感染学杂志》2024年第23期3611-3617,共7页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金(81800029);辽宁省应用基础研究计划(2023JH2/101600022)。

摘　　要：目的调查中国辽宁省部分地区小儿内科住院患儿中肺炎支原体(MP)感染情况,并分析重症肺炎支原体肺炎(SMPP)住院患儿的临床特征及支气管镜下表现。方法自2017年1月1日—2023年12月31日,辽宁省三家三级医院,共有340681例住院患儿被纳入本研究,按月分析住院患儿MP感染阳性率的变化,并探讨MP感染患儿年龄分布、呼吸道疾病谱变化和SMPP患儿的临床及镜下表现。结果住院患儿MP感染占比为27.25%,发病率较高的季节为秋冬季,从2023年8月开始,住院患儿MP感染率急剧上升;MP感染的住院患儿中,>1~4岁(46.34%)及>4~7岁患儿(22.97%)居多;支气管肺炎是MP感染引起的呼吸道疾病的主要表现,占55.74%;SMPP占比为23.12%,支气管镜下黏膜多表现为黏膜充血(63.91%)和黏膜皱襞(28.84%),分泌物表现主要为絮状痰(51.26%)和黏液栓阻塞(24.63%),但值得注意的是,2023年支气管镜下出现塑型性痰栓的占比明显升高(8.61%)。结论中国辽宁省部分地区MP为儿童住院的主要感染病原,多见于>1-7岁儿童,秋冬季节高发。在2023年新冠疫情结束后,MP感染呈延迟暴发趋势,重症患儿及并发症数量明显增加,值得重视。OBJECTIVE To investigate the prevalence of Mycoplasma pneumoniae infection in children hospitalized in pediatric internal medicine in some parts of Liaoning Province of China,and to analyze the clinical characterics and bronchoscopic manifestations of children with severe M.pneumoniae pneumonia(SMPP).METHODS From Jan.1,2017 to Dec.31,2023,a total of 340,681 hospitalized children from three tertiary hospitals in Liaoning Province were enrolled in this study and the positive rate of M.pneumoniae infection were analyzed every month.In addition,the age distribution and respiratory disease spectrum changes of M.pneumoniae infection in children,and clinical and microscopic manifestations of children with SMPP were also explored.RESULTS The proportion of M.pneumoniae infection in hospitalized children was 27.25%;it occurred highly in autumn and winter and showed a sharp increase since Aug.2023.The majority of hospitalized children with M.pneumoniae infection are children aged 1 to 4 years(46.34%)and 4 to 7 years(22.97%).Bronchopneumonia was the main manifestation of respiratory tract disease caused by M.pneumoniae infection(55.74%);meanwhile,it account for 23.12%in SMPP.It was manifested by bronchoscope that most of the mucosa presented congestion(63.91%)and plica(28.84%),and the sputums presented mainly flocculent(51.26%)and mucus casts(24.63%).It was noteworthy that in 2023 the proportion of plastic sputum casts rised significantly(8.61%).CONCLUSION:In some parts of Liaoning Province of China,M.pneumoniae is the main pathogen for the infection of hospitalized children.M.pneumoniae infection is most common in hospitalized children aged 1 to 7 years with a high occurance in autumn and winter.After the COVID-19,it shows a delayed outbreak trend,and the number of severe cases and complications increases significantly.It is worthy of attention.

关 键 词：肺炎支原体 重症肺炎支原体肺炎 支气管镜表现 年龄分布 疾病谱 辽宁省 

分 类 号：R725.6[医药卫生—儿科]