住院儿童下呼吸道非典型病原体感染5年流行病学分析

Epidemiological analysis of acute lower respiratory infection children hospitalized infection by atypical pathogens in five years

【目的】对昆明地区5年间急性下呼吸道感染(acute lower respiratory infection,ALRI)进行流行病学分析,为该病的预防提供理论依据。对住院儿童进行三种常见非典型病原体感染临床流行病学回顾性分析。【方法】应用间接免疫荧光法(IFA)对2003—2007年12 083例本院收治的ALRI住院患儿,进行肺炎支原体(M-pneumoniae,MP)、嗜肺军团菌1型(L-pneumoniae,LP1)、肺炎衣原体(chlamydia pneumoniae,CPn)血清Ig M抗体联合检测,根据研究结果对5年间病原谱、病原流行概况、阳性患儿病原年龄分布特点进行临床流行病学资料汇总分析。【结果】5年间ALRI儿童非典型病原体感染总阳性率30.1%。MP、Lp1、CPn阳性率分别为17.3%、11.3%、1.4%。MP感染率秋、冬季最高,2003年夏秋季、2007年秋冬季出现MP流行趋势;Lp1夏、秋季感染率高于春、冬季;CPn全年均可发病,呈散发。MP是1岁以上ALRI儿童的重要病原;Lp1、CPn随年龄增长呈上升趋势,是年长儿ALRI的主要病原。【结论】昆明地区儿童非典型病原体感染病原以MP、Lp1感染为主;感染率存在季节差异。随年龄增长非典型病原体感染率增高。

【Objective】 To recognize the clinical epidemiological characteristics of acute lower respiratory infection（ALRI） children patients infected by three kinds of atypical pathogens through investigated it between the year 2003 and 2007 in Kunming region. 【Methods】 Based on indirect immunofluorescence assay,simultaneously detected blood IgM levels of M-pneumoniae（MP）,L-pneumoniae（LP1） and Chlamydia pneumoniae（CPn） from 12 083 hospitalized children patients between 2003 and 2007,so that acquired statistics results through investigations of the age and gender distribution characteristics,of atypical pathogen infection and of the epidemiological features of the five years＇ results. 【Results】 The combined infection rate by atypical pathogen in Kunming region between the year 2003 and 2007 was 30.1%;the infection rate by Mp,LP1 and CPn were 17.3%,11.3% and 1.4%,respectively.In autumn and winter the infection rates were the highest.In the summer and autumn of 2003 and in the autumn and winter of 2007,there seemed Mp outbreaks in the local area.The infection rates by Lp1 in summer and autumn were higher than those in spring and winter.Children infected by CPn showed the epidemiological characteristics or sporadic infection all year round.Atypical pathogen infection rate increased as the children grew up.Mycoplasma pneumoniae was the main local causative agent responsible for ALRI children aged above one yers＇s old in Kunming region. 【Conclusions】 MP and Lp1 are the two leading atypical pathogen lnfection of children in Kunming region.Infection rate varied from seasons.The atypical pathogen infection rate increases with children grow up.