婴幼儿社区获得性肺炎病原学特征分析  

Etiological characteristics analysis of community-acquired pneumonia in infants and young children

作　　者：薛格艳 薛莎 石佳鑫 赵旭晶 廖莎莎[5] XUE Geyan;XUE Sha;SHI Jiaxin;ZHAO Xujing;LIAO Shasha(DepartmentofClinical Medicine,Yuncheng Vocational Nursing College,Yuncheng 044000,Shanxi,China;Department of Medical Technology,Yuncheng Vocational Nursing College,Yuncheng 044000,Shanxi,China;School of Basic Medical Sciences,Capital Medical University;Neonatology Department,Yuncheng Maternal and Child Health Hospital;Ganzhou People's Hospital)

机构地区：[1]运城护理职业学院临床医学系,山西运城044000 [2]运城护理职业学院医学技术系,山西运城044000 [3]首都医科大学基础医学院 [4]运城市妇幼保健院新生儿科 [5]赣州市人民医院

出　　处：《中国病原生物学杂志》2025年第4期512-516,共5页Journal of Pathogen Biology

基　　金：山西省职业教育教学改革与实践研究项目(No.202303111)。

摘　　要：目的 探讨婴幼儿社区获得性肺炎(community-acquired pneumonia, CAP)的病原体分布及其影响因素。方法 回顾性分析本院接诊的273例CAP患儿临床资料,采集患儿标本进行细菌病原学检查及九项呼吸道感染病原体IgM抗体检测,对比不同分组患儿病原菌分布特征。结果 273例患儿中,165例为婴儿组,108例为幼儿组。婴儿组中,发热、咳嗽、喘息和肺部湿啰音的发生率分别为36.97%、90.3%、75.76%和78.79%。幼儿组的发生率分别为70.37%、90.74%、50.93%和59.26%,两组间发热、喘息、肺部湿啰音的发生率差异有统计学意义(P<0.05)。婴儿组中,细菌感染占30.30%,主要为大肠埃希菌、铜绿假单胞菌等。幼儿组中,细菌感染占29.63%,以肺炎链球菌为主。两组间大肠埃希菌和肺炎链球菌比例差异有统计学意义(P<0.05)。婴儿组病毒感染占33.94%,幼儿组占39.81%,其中呼吸道合胞病毒在两组间差异有统计学意义(P<0.05)。非典型病原体感染在婴儿组占33.33%,幼儿组占20.37%,特别是肺炎支原体在两组间差异有统计学意义(P<0.05)。混合感染在婴儿组占2.42%,幼儿组占10.19%,差异有统计学意义(P<0.05)。273例患儿中,180例有喘息症状,93例无喘息。喘息组中,呼吸道合胞病毒检出率为17.78%,甲型流感病毒为5.00%,乙型流感病毒为6.11%,副流感病毒为3.33%,腺病毒为3.89%。无喘息组中,相应病毒检出率分别为6.45%,12.90%,5.38%,8.60%,3.23%。两组在呼吸道合胞病毒和甲型流感病毒的检出率差异有统计学意义(P<0.05)。结论 婴幼儿CAP的病原体分布具有明显特点,不同年龄患儿病原体感染类型有所差异,大肠埃希菌、肺炎链球菌、呼吸道合胞病毒、肺炎支原体及混合感染比例差异显著。合并喘息的患儿病毒感染中,呼吸道合胞病毒和甲型流感病毒的检出率较高。Objective To explore the pathogen distribution and influencing factors of community-acquired pneumonia(CAP)in infants and young children.Methods A retrospective analysis was conducted on the clinical data of 273 children with CAP admitted to our hospital.Specimens from the children were collected for bacterial etiological examination and detection of IgM antibodies against 9 respiratory tract infectious pathogens.The distribution characteristics of pathogenic bacteria in children in different groups were compared.Results Among the 273 children,165 were in the infant group and 108 were in the toddler group.In the infant group,the incidences of fever,cough,wheezing and pulmonary moist rales were 36.97%,90.3%,75.76% and 78.79%,respectively.The incidences in the toddler group were 70.37%,90.74%,50.93% and 59.26%,respectively.There were significant differences in the incidences of fever,wheezing and pulmonary moist rales between the two groups(P<0.05).In the infant group,bacterial infection accounted for 30.3%,mainly Escherichia coli,Pseudomonas aeruginosa,etc.In the toddler group,bacterial infection accounted for 29.63%,mainly Streptococcus pneumoniae.There was a significant difference in the proportions of Escherichia coli and Streptococcus pneumoniae between the two groups(P<o.05).Viral infection accounted for 33.94% in the infant group and 39.81%in the toddler group.Among them,respiratory syncytial virus showed a significant difference between the two groups(P<0.05).Atypical pathogen infection accounted for 33.33% in the infant group and 20.37%in the toddler group.In particular,Mycoplasma pneumoniae showed a significant difference between the two groups(P<0.05).Mixed infection accounted for 2.42% in the infant group and 10.19%in the toddler group,with a significant difference(P<0.05).Among the 273 children,180 had wheezing symptoms and 93 had no wheezing.In the wheezing group,the detection rate of respiratory syncytial virus was 17.78%,influenza A virus was 5.00%,influenza B virus was 6.11%,parainfluenza virus was

关 键 词：婴幼儿 社区获得性肺炎 病原体 

分 类 号：R725.6[医药卫生—儿科] R446.5[医药卫生—临床医学]