幼儿园健康学龄前儿童入园前咽部病原体携带状况分析

Analysis of carriers of pharynx pathogens in healthy preschool children in kindergarten

目的健康儿童鼻咽部定植病原体分布在不同地区存在较大差异,这种差异可对儿童上呼吸道感染发生及临床诊疗产生影响。本研究分析健康学龄前儿童咽部定植病原体携带情况,为制定有效的上呼吸道感染预防措施及治疗对策提供参考。方法2017年8月选择漳州市某公立幼儿园119名健康学龄前儿童作为研究对象,体检时采集咽拭子标本进行细菌培养+药敏、支原体、衣原体、呼吸道病毒谱7项检测,分析咽部定植病原体携带状况。结果119名健康学龄前儿童咽部定植菌种类最多5种,最少0种,平均(3.36±0.79)种;除1名细菌培养阴性外,其余118名儿童共检出细菌400株,以奈瑟菌属(27.75%)、草绿色链球菌(21.25%)、凝固酶阴性葡萄球菌(14.50%)、微球菌(12.75%)和革兰阳性杆菌(10.75%)最为常见;细菌鉴定≥2+菌株共135株,常见的是草绿色链球菌(47.41%)、奈瑟菌属(20.00%)、肺炎链球菌(14.81%)、金黄色葡萄球菌(7.41%)和流感嗜血杆菌(6.67%)。男女儿童细菌携带情况差异无统计学意义,χ2=2.089,P=0.352。支原体阳性1例,阳性率为0.84%。衣原体及呼吸道病毒7项均未检出。结论本地区健康学龄前儿童咽部普遍存在细菌定植,以条件致病菌为主,大多数为多种细菌混合定植,男女之间差异不明显,而病毒及支原体、衣原体定植较罕见。

OBJECTIVE The distribution of nasopharyngeal colonization pathogens in healthy children varies greatly in different regions,and this difference has an impact on the occurrence of upper respiratory tract infections and clinical diagnosis and treatment in children.This study analyzes the carrying status of pharyngeal colonization pathogens in healthy preschool children,and provides a reference for formulating effective upper respiratory tract infection prevention measures and treatment strategies.METHODS In August 2017,a total of 119 healthy preschool children from a public kindergarten in Zhangzhou City were selected as the research object.During the physical examination,samples of pharyngeal swabs were collected for bacterial culture+drug susceptibility,mycoplasma,chlamydia,respiratory virus spectrum,and the carrying status of pharyngeal colonization pathogens was analyzed.RESULTS Among 119 healthy preschool children,there were up to 5 species of pharyngeal colonization bacteria,at least 0 species,with an average of 3.36±0.79.In addition to one negative bacterial culture,400 strains of bacteria were detected in 118 children,The most common were Neisseria(27.75%),Streptococcus viride(21.25%),Coagulase-negative staphylococcus(14.50%),Micrococcus(12.75%)and Gram-positive bacteria(10.75%).135 strains of bacteria with 2+or more were identified.The common strains were Streptococcus viride(47.41%),Neisseria(20.00%),Streptococcus pneumoniae(14.81%),Staphylococcus aureus(7.41%)and Haemophilus influenzae(6.67%).There was no significant difference in bacterial carrier between boys and girls(χ~2=2.089,P=0.352).Mycoplasma was positive in 1 case,the positive rate was 0.84%.Chlamydia and respiratory viruses were not detected.CONCLUSION Bacterial colonization generally existed in the pharynx of healthy preschool children in this area,mainly conditional pathogenic bacteria,most of which were mixed colonization of multiple bacteria,the difference between men and women was not obvious,and the colonization of viruses and mycoplasma and chlamydia was rare.