儿童社区获得性肺炎患儿嗜血杆菌属感染及共感染病原谱的特征分析  

Characteristic analysis of Haemophilus infection and co-infection pathogen spectrum in children with community acquired pneumonia

作　　者：史茜 伊贝拜汗·买买提 查贺飞 张新[1,2] SHI Qian;YIBEIBAIHAN Maimaiti;ZHA Hefei;ZHANG Xin(Department of Clinical Laboratory,Xinjiang Production and Construction Corps Hospital/the Second Affiliated Hospital of Shihezi University School of Medicine,Urumqi,Xinjiang 830002,China;Clinical Medical Research Center for Laboratory Medicine of Xinjiang Production and Construction Corps,Urumqi,Xinjiang 830002,China)

机构地区：[1]新疆生产建设兵团医院/石河子大学医学院第二附属医院检验科,新疆乌鲁木齐830002 [2]兵团医学检验临床医学研究中心,新疆乌鲁木齐830002

出　　处：《检验医学与临床》2025年第8期1009-1013,共5页Laboratory Medicine and Clinic

基　　金：国家临床重点专科建设项目[兵财社(2023)16号];兵团重点领域科技攻关计划项目(2024AB072);新疆生产建设兵团医院科技计划项目(2024008)。

摘　　要：目的 分析社区获得性肺炎(CAP)患儿嗜血杆菌感染及共感染病原谱的特征。方法 回顾性分析2023年10月1日至2024年6月30日新疆生产建设兵团医院收治1 187例CAP患儿的痰液细菌培养结果。比较不同性别、年龄、季节嗜血杆菌属感染的检出情况,抗菌药物耐药情况及共感染病原谱特征。结果 1 187例CAP患儿的痰液培养结果显示,主要分离病原体为副流感嗜血杆菌,分离率为15.67%,其次是流感嗜血杆菌,分离率为10.36%。自2023年10月1日起,副流感嗜血杆菌阳性检出高峰期为第1~17周,即2023年10月1日至2024年1月27日(秋、冬季),峰值为第9周(40.00%)。流感嗜血杆菌阳性检出高峰期为第1~15周,即2023年10月1日至2024年1月13日(秋、冬季),峰值为第1周(35.00%)。自2024年2月(春季)起,嗜血杆菌阳性检出率呈现下降趋势。13~<18岁患儿流感嗜血杆菌感染的阳性检出率高于0~<7岁、7~<13岁患儿,差异均有统计学意义(P<0.05)。秋、冬季副流感、流感嗜血杆菌阳性检出率高于春、夏季,差异均有统计学意义(P<0.05)。副流感、流感嗜血杆菌对β-内酰胺酶的阳性检出率分别为80.65%和92.68%。药敏试验结果显示,在11种抗菌药物中,副流感、流感嗜血杆菌对氨苄西林的耐药率最高,分别为79.03%和94.31%。870例患儿的嗜血杆菌共感染病原谱分析结果显示,副流感嗜血杆菌单独感染的阳性检出率为13.82%,合并2种以上病原体感染的阳性检出率为21.21%。流感嗜血杆菌单独感染的阳性检出率为9.35%,合并呼吸道合胞病毒感染的阳性检出率最高,为19.05%。结论 2023-2024年秋、冬季CAP患儿中可能出现嗜血杆菌的流行,春季流行率下降,易与病毒共感染。Objective To analyze the characteristic of Haemophilus infections and co-infection pathogen spectrum in children with community-acquired pneumonia(CAP).Methods A retrospective analysis was conducted on the results of sputum bacterial cultures from 1187 children with CAP admitted to Xinjiang Production and Construction Corps Hospital from October 1,2023 to June 30,2024.The detection rates of Haemophilus infections were compared across different genders,age groups,and seasons.Additionally,the antibiotic resistanc e patterns and characteristics of the co-infection pathogen spectrum were evaluated.Results Sputum c ulture results from 1187 children with CAP revealed that the predominant isolated pathogen was Haemophilus parainfluenzae,with a detection rate of 15.67%,followed by Haemophilus influenzae at 10.36%.From October 1,2023,the peak detection period for Haemophilus parainfluenzae positivity was weeks 1-17,corresponding to October 1,2023 to January 27,2024(autumn and winter),with the highest peak at week 9(40.00%).For Haemophilus influenzae,the peak detection period was weeks 1-15,from October 1,2023 to January 13,2024(autumn and winter),with the highest peak at week 1(35.00%).Starting from February 2024(spring),the positive detection rates of Haemophilus showed a declining trend.The positive detection rate of Haemophilus influenzae was significantly higher in children aged 13-<18 years compared with those aged 0-<7 years and 7-<13 years(P<0.05).The positive detection rates of both Haemophilus parainfluenzae and Haemophilus influenzae were significantly higher in autumn and winter than in spring and summer(P<0.05).The positive detection rates of Haemophilus parainfluenzae and Haemophilus influenzae toβ-lactamases were 80.65%and 92.68%respectively.The results of drug susceptibility test showed that the drug resistance rates of Haemophilus influenzae and parainfluenza to ampicillin were the highest among the 11 antibiotics,which were 79.03%and 94.31%respectively.The positive detection rate of Hemophilus paraininfl

关 键 词：社区获得性肺炎 流感嗜血杆菌 副流感嗜血杆菌 共感染 病原谱 

分 类 号：R725.6[医药卫生—儿科] R563.1[医药卫生—临床医学]