武汉地区12125例呼吸道感染患儿非细菌病原体IgM抗体检测结果分析

Analysis of non-bacterial pathogen IgM antibody testing in 12 125 children with respiratory tract infection in Wuhan area

目的检测武汉地区住院呼吸道感染患儿非细菌病原体IgM抗体,为临床诊疗提供依据。方法取诊断为呼吸道感染的12 125例住院患儿的血清,采用间接免疫荧光法检测9种呼吸道感染非细菌病原体的IgM抗体。结果 3 597份标本(29.7%)非细菌病原体IgM抗体检测阳性,其中肺炎支原体(MP)的阳性率最高为21.6%,其次为腺病毒(ADV)和乙型流感病毒(Flu B),阳性率最低为肺炎衣原体(CP)和Q热立克次体(COX);混合感染563例,其中主要是2种病原体的混合感染。各年龄组(0～30 d、～6个月、～1岁、～3岁、～9岁)的总检出率分别为30.4%、18.7%、35.4%、68.4%、55.2%,各组间差异有统计学意义(χ2=89.5,P<0.05)。冬季非细菌病原体检出率最高(53.4%),秋季最低(24.9%),差异有统计学意义(χ2=760.3,P<0.05)。结论武汉地区呼吸道感染患儿的非细菌病原体主要是MP、ADV和Flu B;MP和其他非细菌病原体的混合感染比较普遍;1～3岁幼儿感染率较高;冬季更易感。

Objective To detect non-bacterial pathogen IgM antibody in hospitalized children with respiratory tract infection in Wuhan area; provide evidence for clinical diagnosis and treatment. Methods Nine of non-bacterial pathogen IgM antibodies in serum of 12 125 hospitalized children diagnosed as respiratory tract infections were tested by indirect immunofluorescence assay. Results Non-bacterial pathogen IgM antibodies positive were found in 3 597 specimens （29.7%）, among these results the MP-positive rate is highest （21.6%）, followed by adenovirus （ADV） and influenza B virus （FluB）, the lowest positive rate was Chlamydia pneumoniae （CP） and Q fever Coxiella＇s body （COX）. Mixed infections were found in 563 children with mainly two kinds of mixed infection. The total detection rate were 30.4%, 18.7%, 35.4%, 68.4% and 55.2% respectively in age groups （0 - 30 d, - 6 months, - 1 y, - 3 ys, - 9 ys） and the differences among groups were statistically significant （X^2 = 89.5, P 〈 0.05）. The highest detection rate of pathogens was found in winter （53.4%） and the lowest was in autumn （24.9%） with significant difference between （X^2 = 760.3, P 〈 0.05）. Conclusions The main non-bacteria pathogens in children with respiratory tract infection in Wuhan are Mycoplcasma pneumoniae, adenovirus and influenza B virus. Mixed infections of MP and other pathogens are common, the infection rate in children aged 1 to 3 is high and winter is susceptible season.