摘要
目的探讨宁夏人民医院收治的儿童社区获得性肺炎(community acquired pneumonia,CAP)病原学和临床流行病学特征,为临床经验性治疗提供依据。方法对确诊CAP的309例住院患儿,取呼吸道分泌物做细菌培养及药敏,用酶联免疫吸附测定法检测其中273例血清呼吸道合胞病毒(RSV),腺病毒(ADV),流感病毒(IFV)A、B型,副流感病毒(PIV)Ⅰ~Ⅲ型,人偏肺病毒(h MPV)等8种呼吸道病毒及肺炎支原体Ig M抗体,并对患儿性别、年龄及发病季节进行分布统计。结果分离培养出病原菌87株,阳性率28.16%,以肺炎链球菌、肺炎克雷伯菌最为常见。血清呼吸道病毒检测92例阳性,总阳性率33.70%,2岁以下儿童阳性检出率最高,检出率高的前3种病毒依次为:RSV、h MPV和PIV,RSV检出率达17.22%。肺炎支原体Ig M抗体检测阳性者31例,总阳性率11.36%,多见于2岁以上儿童,感染率随着年龄的增长而增加。混合感染病原以细菌-病毒混合检出率为高。病原检出率冬春季高于夏秋季。结论本组儿童CAP病原菌以肺炎链球菌、肺炎克雷伯菌最为常见。病毒感染多见于2岁以下小儿,以RSV、h MPV最为常见,细菌-病毒混合为最常见的混合感染模式,冬春季是儿童CAP发病高峰。
Objective To explore the etiologic and epidemiological characteristics of community-acquired pneumonia( CAP) in Yinchuan,so as to provide evidence for empirical treatment. Methods 309 hospitalized children diagnosed as CAP were enrolled. Their deep respiratory secretions were collected for bacterial culture and sensitivity. Serum were collected in 273 of all the cases and the virus Ig M,including respiratory syncytial virus( RSV),gland virus( ADV),influenza virus( IFV) A and B,parainfluenza virus( PIV) ⅠtoⅢ,human metapneumovirus( h MPV) were detected by enzyme-linked immunosorbent assay. Results Bacteria were isolated in 87 cases,with the positive rate of 28. 16%. Streptococcus pneumoniae,Klebsiella pneumoniae were the most common bacteria. Positive result of virus was seen in 92 cases with the positive rate of 33. 70%,which is more common in children under 2 year of age. The most frequently detected viruses were RSV,h MPV and PIV in order and the positive rate of RSV was as high as 17. 22% 。The Ig M antibody of Mycoplasma pneumoniae was positive in 31 cases,with the total positive rate of 11. 36%,which was more common in children over 2 years old and the rate of infection increased with age. The co-infection of bacteria and viruses was common and the detection rate of the pathogens was much higher in winter and spring than that in summer and autumn. Conclusion Streptococcus pneumoniae,Klebsiella pneumoniae are the most common bacteria in Yinchuan area. Virus infection mainly occurs in children under 2 years of age and RSV,h MPV is most common. The co-infection of bacteria-viruses is the most common pattern. The incidence peak of CAP in children in Yinchuan area is in winter and spring.
出处
《宁夏医科大学学报》
2015年第8期931-933,937,共4页
Journal of Ningxia Medical University
基金
宁夏回族自治区科技厅攻关项目(2010Jgg)
关键词
社区获得性肺炎
儿童
病原学
community acquired pneumonia
children
etiology
