重庆地区婴幼儿社区获得性肺炎病原学分析

Etiology of Children with Community Acquired Pneumonia in Chongqing Area

目的:了解重庆地区婴幼儿社区获得性肺炎(CAP)病原学分布特点。方法:回顾性分析重庆医科大学附属儿童医院呼吸病房2009年3月～2010年2月住院治疗的1 106例CAP患儿鼻咽抽吸物细菌培养、呼吸道7种病毒、MP-PCR、CP-PCR及MP、CP血清学检测结果。结果:(1)1 106例患儿病毒检出阳性540例(48.8%),最常见病毒为RSV,共398例,占检出病毒病例的73.7%。(2)细菌检出阳性590例(53.3%),检出的最常见细菌为肺炎链球菌,共126例,占检出细菌病例的21.4%。(3)MP检出阳性67例(6.1%),CP检出阳性126例(11.4%),≤12月组MP和CP检出率低于1～3岁组(P<0.05)。(4)病原体混合检出阳性共427例(38.6%),以细菌-病毒混合检出多见(占检出混合病原体病例的55.7%)。结论:RSV是重庆地区住院治疗的婴幼儿CAP第一位病毒病原体,肺炎链球菌是检出的首位细菌病原体,病毒-细菌混合检出率较高。

Objective： To study the distribution of etiology of children under 3 years old with community acquired pneumonia（CAP） in Chongqing area.Methods： We collected nasopharyngeal specimen by negative pressure suction from 1,106 children with CAP.The specimens were tested for respiratory pathogen by direct immunofluorescence respectively,bacterial culture and polymerase chain reaction（PCR）.Antibodies against Mycoplasma（MP） and Chlamydia（CP） were detected by Enzyme Linked Immunosorbent Assay（ELISA） in sera.Results：（1） The overall positive rate of respiratory viruses was 48.8%,among the viruses,the top detected virus was RSV（73.7%）.（2） The overall positive rate of bacteria was 53.3%,among the bacteria,the top detected bacteria was Streptococcus pneumoniae（SP）（21.4%）.（3） MP and CP were positive in 67 cases（6.1%） and 126 cases（11.4%）,respectively.Mycoplasma and Chlamydia pneumoniae infections were more common in children older than 1 year.（4） Compound infections 427 cases（38.6%）,the mixed infections of bacteria and viruses were common（55.74%）.Conclusions： RSV and SP are the major pathogens of CAP in children under three years old in Chongqing area.The mixed infections of bacteria and viruses are common.