5岁以下下呼吸道感染儿童嗜肺军团菌检测的意义

Detection of Legionella Pneumophila in Low Respiratory Tract Infection in Children Less Than 5 Years Old

目的了解5岁以下下呼吸道感染小儿嗜肺军团菌(Lp)的感染情况。方法选取5岁以下下呼吸道感染患儿300例。男191例,女109例;年龄27 d-5岁;病程1 d-6个月。用ELISA检测其血清Lp 1-7型IgMI、gG抗体。结果Lp抗体阳性17例,阳性率5.67%;IgM阳性10例,IgG阳性7例。其中男11例(阳性率5.76%),女6例(阳性率5.50%)。27 d-1岁4例(阳性率2.53%),1-3岁7例(阳性率7.37%),3-5岁6例(阳性率12.77%)。冬春季7例(阳性率5.19%),夏秋季10例(阳性率6.06%)。来自城市11例(阳性率11.83%),农村6例(阳性率2.90%)。结论5岁以下下呼吸道感染患儿有一定的Lp感染率。不同年龄Lp感染阳性率有显著差异,且随年龄增长,阳性感染率增加,城区阳性感染率明显高于农村。

Objective To study the present situation of legionella pneumophila（Lp） infection of low respiratory tract infection in children less than 5 years old. Methods Three hundred hospitalized patients with the diagnosis of low respiratory tract infection were enrolled in the study, 191 males, 109 females, aged 27 d to 5 years old, course from 1 d to 6 months. Serum antibody（IgM, IgG） of Lp serngroup 1 - 7 was detected by enzyme- linked immunosorbent assay（ELISA）. Results In the patients, 17 cases were positive, and the positive rate was 5.67 %. Of the 17 children, the males（ n = 11 ） and females（ n = 6 ） did not significantly influence the positive rate（5.76 % vs 5.50% ）. Four of them were between 27 days and 1 year old; 7 were 1 to 3 years old,6 were 3 to 5 years old. The positive rates were significantly different among the 3 groups （2.53% vs 7.37% vs 12.77% ） and tendentially increased following the increase of age（χ^2 = 7.8164 P 〈 0.05）. The spring and winter seasons（ n = 7 ）, or summer and autum seasons（ n = 10 ） did not significantly affect the positive rates（5.19% vs 6.06% ）. Univariate analysis demonstrated that the positive rates were different between children come from cities （ n = 11） or countyside（ n = 6） （11.83 % vs 2.90 % ）. Conclusions There are certain cases of Lp infection in children less than 5 years old in low respiratory tract infection. The infection rates are different among children of different ages and tendentially increased following the increase of age. Children coming from urban areas have a higher positive rate than those coming from rural areas.