苏州地区儿童急性肺炎的病原学研究

Study on Etiology of Acute Pneumonia in Children in Suzhou Area

目的探讨苏州地区小儿肺炎病原学,为临床诊疗提供依据。方法选取2005年11月～2006年2月苏州大学附属儿童医院呼吸科住院治疗的急性肺炎患儿,用无菌负压吸引法采集其新鲜痰液,直接免疫荧光法检测病毒,细菌培养检测细菌,酶联免疫吸附试验(ELISA)法检测血清支原体、衣原体抗体。结果532例中360例痰标本检测阳性,总检出率为67.7%。其中单纯病毒感染178例(33.5%),单纯细菌感染23例(4.3%),单纯支原体感染50例(9.4%),单纯衣原体感染19例(3.6%),混合感染90例(16.9%)。病毒以呼吸道合胞病毒为主(44%);细菌则以肺炎链球菌(4.7%)为主,其次为表皮葡萄球菌(2.8%)和流感嗜血杆菌(1.9%)。结论病毒是苏州地区冬春季小儿急性肺炎的最常见病原,其次是肺炎支原体、细菌、肺炎衣原体。支原体感染多见于3岁以上儿童,肺炎衣原体感染则多见于小于3个月的婴儿。混合感染在3岁以下尤其1岁以下小儿明显。

Objective To investigate etiology of acute pneumonia in children in order to pmvid basis for clinical diagnosis and treatment. Methods The children with acute pneumonia who were hospitalized in childreng hospital affiliated to Suzhou university were selected. And the sputum of them were collected. Bacteria and virus were tested using sputum culture and direct immunofluoresence respectively. Anti- bodies against mycoplasma and chlamydia were detected by enzymelinked immunosorbent assay（ELISA） in paired sera. Results Microbial etiology was obtained in 360 cases （67.7%） of 532 patients. Viral infections were in 178 cases （33.5%）. Bacterial infections were in 23 cases （4.3%） ,mycoplasma pneumuniae 50 cases （ 9.4% ） and chlamydia pneumuniae 19 cases （ 3.6% ）, compound infections 90 cases （ 16. 9% ）. Respiratory syncycial virus was the major viral pathogen,streptococcus pneumoniae were the prominent pathogens of bacterial pneumonia, followed by haemophilus influenza. Conclusions Viral infection is the most common cause of acute pneumonia in children in Suzhou area during winter and spring, followed by mycoplasma pneumoniae, bacteria and cldamydia pneumoniae. Mycoplasma pneumoniae infection is more common in children older than 3 years,chlamydia pneumoniae infection is more in infants less than 3 months,most of compound infection children were below the age of 3 years.