摘要
目的了解冬季儿童急性下呼吸道感染病原谱及临床流行病学特征,为临床抗感染及病原检测提供依据。方法对我院2006年12月～2007年2月急性下呼吸道感染住院患儿采用一次性无菌吸痰管经鼻腔插入7～8cm,达到咽部以下负压吸取1～2ml深部鼻咽分泌液送细菌培养,并对呼吸道合胞病毒(RSV),腺病毒(ADV),A、B型流感病毒(IFV),1、2及3型副流感病毒(PIV)等7种常见呼吸道病毒抗原进行检测及运用荧光定量聚合酶链反应(PCR)技术检测标本中支原体和衣原体DNA。结果①381份下呼吸道感染儿童痰标本中细菌培养阳性81份,病毒检测阳性133份,支原体和衣原体阳性分别12份与6份,混合感染标本44份,总标本病原学检出率为50.66%(193/381)。②RSV阳性标本112份,为最重要的感染病原,连续3个月RSV检出率均在30%左右,6月龄以下儿童占61.61%,2岁以下儿童占86.61%,阳性标本中78.57%的患儿有喘息表现。③大肠埃希菌(16株)、肺炎链球菌(14株)、肺炎克雷伯菌及金黄色葡萄球菌(各10株)、卡他莫拉菌布兰汉亚种(8株)、流感嗜血杆菌和副流感嗜血杆菌(各6株)表现为主要的致病菌。结论RSV感染仍为儿童冬季急性下呼吸道感染最主要的病原,尤其在2岁以下儿童,且易表现为喘息发作。仍有40%以上感染病原未明,儿童急性下呼吸道感染病原谱需进一步完善。
Objective To investigate the etiology and clinical characteristics of children hospitalized for acute lower respiratory tract infection in winter. Methods A total of 381 nasopharyngeal secretion （NPS） samples horn children hospitalized for acute low respiratory tract infections during December 2006 to February 2007 were collected. Bacterial cultures were conducted with the NPS samples and DFA was applied to identify 7 different viruses,including respiratory syncytial virus （RSV） ,influenza virus （IFV） type A and type B,parainfluenza virus （PIV） type 1,2,3 and adenovirus （ADV）.The specimens were also tested for Mycoplasma pneumoma and Chlamydia pneumonia DNA by polymerase chain reaction （PCR） .Results Specific pathogens were identified in 381 samples, among them 81 samples were positive for bacterial infections, 133 samples were positive for viral infections and 12 and 6 samples were positive for Mycoplasma pneumonia and Chlamydia pneumonia DNA,respectively. Forty-four samples showed a mixed infection and 50.66% samples were positive for at least one pathogen. RSV was the dominate pathogen for 3 consecutive months with 112 out of 381 specimens positive for RSV infection. About 61.61% of RSV cases were found in children younger than six months old and 86.61% of the cases were found in two years old. In 78.57% of RSV victims, ＇wheezing＇ was the primary symptom associated with infection. Evidence of a bacterial infection was demonstrated in 81 samples （21.26%）. Infection with Mycoplasma pneumoniae and Chlamydia pneumoniae was found in 3.15 % and 1.57 % of the cases, respectively. Conclusion RSV is still a main cause of acute lower respiratory tract infection in children in winter, especially in infants and younger children. The causative agent for more than 40% of acute lower respiratory tract infections in children was undiagnosed in this study indicating that a more extensive analysis on the causes of respiratory tract infection is needed which is important for the development of a
出处
《微生物与感染》
2007年第3期144-147,共4页
Journal of Microbes and Infections
关键词
急性下呼吸道感染
儿童
病原学
临床特征
Acute low respiratory tract infection
Children
Etiology
Clinical characteristics
