7岁以下儿童急性下呼吸道感染病原学研究

An etiology investigation of acute lower respiratory tract infections in children under 7 years old

目的探讨苏州地区7岁以下儿童急性下呼吸道感染的病原学分布。方法对2007年10月至2008年3月间苏州大学附属儿童医院呼吸科住院患儿中7岁以下急性下呼吸道感染住院患儿810例,采用无菌负压吸引法采集新鲜痰液,进行细菌培养,直接免疫荧光法检测病毒,酶联免疫吸附试验(ELISA)法检测血清支原体、衣原体抗体。结果810例患儿中556例病原检测阳性(68.6%),单纯病毒感染181例(22.3%),单纯细菌感染124例(15.3%),单纯支原体感染72例(8.9%),单纯衣原体感染10例(1.2%),混合感染169例(20.9%)。病毒以呼吸道合胞病毒为主(35.8%),细菌则以肺炎链球菌为主(13.8%),其次为流感嗜血杆菌(4.6%)。结论苏州地区7岁以下儿童急性下呼吸道感染最常见病原是病毒,其次是细菌、支原体、衣原体。支原体感染多见于1岁以上儿童,混合感染则多见于3岁以下儿童。

Objective To investigate etiology of acute lower respiratory tract infections （ ALRTIs ） in children under 7 years old in Suzhou. Methods Bacteria and virus were tested using sputum culture and direct immunofluoresence respectively. Antibodies against mycoplasma and chlamydia were detected by enzyme-linked immunosorbent assay （ ELISA ） in paired sera. Results Etiological agents were identified in 556 cases out of 810 patients （ 68.6% ）. Viral infections were in 181 cases（22. 3% ） ,bacteria infections were in 124 cases（ 15.3% ）, mycoplasma pneumoniae 72 cases（8. 9% ） and chlamydia pneumoniae 10 cases （ 1.2% ） , compound infections 169 cases （ 20. 9% ）. Respiratory syneycial virus was the major viral pathogen, streptococcus pneumoniae were the prominent pathogens of bacteria pneumonia, followed by haemophilus influenzae. Conclusion Viral infection is the most common cause of ALRTIs in children under 7 years old in Suzhou, followed by bacteria pneumoniae, mycoplasma and chlamydia pneumoniae. Mycoplasma pneumoniae infection is more common in children older than 1 year,compound infection is more common in children less than 3 years.