肺炎支原体和沙眼衣原体致儿童急性下呼吸道感染的研究

Study of Mycoplasma pneumonia and Chlamydia trachomatis in children with acute lower respiratory tract infection

本文旨在研究儿童社区获得性急性下呼吸道感染(ALRTI)中肺炎支原体(MP)和沙眼衣原体(CT)的感染特征。采用实时荧光定量聚合酶链反应(PCR)检测2006年10月～2008年2月因ALRTI收入复旦大学附属儿科医院的患儿呼吸道标本中MP和CT的DNA,并分析2种病原体感染患儿的临床特征与实验室检查结果。在1312份深部鼻咽分泌物标本中,MP和CT检出率分别为7.85%(103/1312)和2.97%(39/1312)。MP在5岁以上患儿中的检出率为33.33%(30/90),而CT在3个月以内患儿中的检出率为6.28%(31/494)。MP感染后易出现40℃以上高热,较少发生发绀与重症呼吸道感染;白细胞计数常无明显升高,但C反应蛋白升高较多见。CT感染后40℃以上高热和重症呼吸道感染少见,C反应蛋白升高也较少见。结果提示,在5岁以上儿童的社区获得性ALRTI中,MP是重要的病原体;而在3个月以内儿童中,CT为常见病原体之一。

To investigate the infection characteristics of Mycoplasma pneumonia （MP） and Chlamydia trachomatis （CT） in hospitalized children with community-acquired acute lower respiratory tract infection （ALRTI） in Shanghai,1 312 deep nasopharyngeal secretion samples from 1 312 children with ALRTI were collected from October 2006 to February 2008.Real-time polymerase chain reaction （PCR） was conducted for detection of MP and CT DNA.Clinical characteristics and laboratory examinations of the positive cases were analyzed.The detection rate of MP was 7.85% （103/1 312） and that of CT was 2.97% （39/1 312）.MP was identified most commonly in children 5 years old with a detection rate of 33.33% （30/90）.CT was mainly detected in infants 3 months old with a detection rate of 6.28% （31/494）.Children with MP infection were prone to high fever （above 40 ℃）,with rare cyanosis or severe respiratory tract infection.The peripheral white blood cell count was within normal range,but the level of C-reaction protein （CRP） was increased.CT infection seldom resulted in fever above 40 ℃ or severe respiratory tract infection,and CRP level was normal.The results suggest that,in this sample,MP is an important pathogen of community-acquired ALRTI in children 5 years old,and CT infection was commonly found in infants 3 months old.