急性毛细支气管炎儿童非典型细菌感染分析

目的探讨急性毛细支气管炎婴幼儿下呼吸道非典型细菌肺炎支原体、肺炎嗜衣原体及沙眼衣原体的感染情况。方法获取1～24月婴幼儿的鼻咽分泌物,利用多重PCR检测鼻咽分泌物中的肺炎支原体和肺炎嗜衣原体,并用限制性内切酶片段长度多态性分析沙眼衣原体的感染情况。结果在所获得的120例急性毛细支气管炎婴幼儿标本中,共检测出阳性标本28例(23.3%),其中以肺炎支原体最常见(12/120,10%),肺炎嗜衣原体4例,沙眼衣原体4例。混合感染8例,其中5例为肺炎支原体合并肺炎嗜衣原体感染,2例为肺炎嗜衣原体合并沙眼衣原体感染,1例合并有3种感染。感染患儿年龄大部分分布于6～12月之间(50例)。此外,在这个年龄组所有感染病例中,6例为肺炎支原体感染,4例为肺炎嗜衣原体感染。结论在急性毛细支气管炎婴幼儿中,这些非典型细菌可能是重要的感染因子,可诱导严重的急性毛细支气管炎。

Objective To analysis the atypical bacterial pathogens,including Mycoplasma pneumoniae,Chlamydophila pneumoniae and C.trachomatis infection in children with acute bronchiolitis.Methods Nasopharyngeal secretions of children between 1 month and 2 years of age admitted with acute bronchiolitis to hospitals were collected.The M pneumoniae and C pneumoniae in the nasopharyngeal secretions were detected using multiplex-polymerase chain reaction（PCR）,whereas PCR and restriction fragment length polymorphism were used to investigate C trachomatis.Results 23.3% were infected with atypical bacteria of the 120 samples taken from hospitalized children with acute bronchiolitis,.M pneumoniae was the most common atypical bacterial pathogen（12/120,10%）,4 cases were C.pneumonia,4 were C trachomatis.8 children were polyinfection,including 5 cases of Mycoplasma pneumoniae combined with C.pneumonia,2 were C.pneumonia and C trachomatis and 1 children were infected with three pathogens.Most of the patients infected with it were between 6 and less than 12 months of age（50 cases）.Of the infected cases in this age group,6 were infected with M pneumoniae and 4 with C pneumoniae.Conclusion These result suggests that in children with acute bronchiolitis coinfection with M pneumoniae,C pneumoniae,or C trachomatis can be expressed differently in each age group.These atypical bacteria may be the important infectious agents that induce severe illness of acute bronchiolitis.