小儿非细菌性肺炎病原学研究

Study on the microbiological etiology of non-bacterial pneumonia in children

采集住院肺炎患儿鼻咽部分泌物,≥2岁患儿采集痰标本,应用直接免疫荧光法检测呼吸道病毒,应用荧光定量PCR检测呼吸道标本中的肺炎支原体(MP)和沙眼衣原体(CT);应用ELISA测定血清中的肺炎衣原体(CP)特异性IgM。结果 574例住院肺炎患儿中呼吸道病毒感染185例(32.2%),呼吸道合胞病毒(RSV)感染151例(26.3%),副流感病毒(PIV)感染24例(4.1%),腺病毒(ADV)感染6例(1.0%),流感病毒(IFV)感染4例(0.7%)。呼吸道病毒感染多发生于<2岁的患儿,共148例(40.9%)。非典型病原体感染108例(18.8%),其中MP感染76例(13.2%),CT感染21例(3.6%),CP感染11例(1.9%);≥2岁患儿MP感染率30.5%,<2岁患儿MP感染率为3.0%。结果表明,儿童呼吸道病毒与非典型病原体感染以RSV和MP多见,不同年龄段患儿各种病原体感染率有很大差异。

Samples of nasopharyngeal secretions of juvenile inpatients less than 2 years old and sputum of children over 2 years of age were collected in addition to blood samples from all children.A direct immunofluorescent assay was used to detect respiratory tract viruses and real-time quantitative PCR was used to detect specific IgM antibodies to Mycoplasma pneumoniae（MP） and Chlamydia trachomatis（CT）.Chlamydia pneumoniae（CP） IgM antibody was detected by solid-phase ELISA.The results indicated that out of a total of 574 patients,viruses and atypical pathogens were respectively detected in 185 patients（32.2%） and 108 patients（18.8%）.Among the 185,patients with respiratory syncytial virus（RSV） infection accounted for 26.3%（151 cases）,those with parainfluenza virus（PIV） infection accounted for 4.1%（24 cases）,those with adenovirus（ADV） infection accounted for 1.0%（6 cases）,and those with influenza virus（IFV）infection accounted for 0.7%（4 cases）.Among the 108 patients with atypical pneumonia（18.8%）,76 had an MP infection（13.2%）,21 had a CT infection（3.6%）,and 11 had a CP infection（1.9%）.In a total of 148 cases（40.9%）,children under 2 years old suffered a viral infection of the respiratory tract.The rate of MP infection in children over 2 years old was 30.5% while it was 3.0% in younger children.RSV and MP were the leading pathogens that caused non-bacterial pneumonia in this study.There was a significant difference among age groups in the incidence of pneumonia caused by different pathogens.