支原体肺炎合并其他病原菌感染的研究

Mixed infections in children with mycoplasma pneumonial pneumonia

目的探讨儿童支原体肺炎合并其他病原菌感染情况。方法对诊断为支原体肺炎的120例住院患儿进行血清肺炎衣原体抗体、呼吸道病毒抗原检测以及痰细菌培养。有支气管镜检查指征的患儿行支气管镜下肺泡灌洗及肺泡灌洗液定量培养。结果 120例支原体肺炎混合其他病原菌感染66例(55.0%),其中肺炎衣原体35例(29.2%),病毒19例(15.8%),细菌12例(10.0%)。呼吸道合胞病毒感染11例(9.2%)。19例支原体混合病毒感染中,3岁以下患儿17例(89.5%)。35例支原体混合衣原体感染者中,3岁以上占27例(77.1%)。结论半数以上支原体肺炎合并其它病原菌感染;合并肺炎衣原体感染最多,其次为病毒,合并细菌感染较少;年幼儿童以合并病毒感染为主,年长儿以合并肺炎衣原体感染为主。

Objective To investigate the incidence and clinical features of mixed infections in children with mycoplasma pneumoniael pneumonia. Methods A total of 120 cases diagnosed as mycoplasma pneumoniael pneumonia were investigated for mixed infections by sputum bacterial culture, respiratory virus antigen detection and serum Chlamydia pneumoniae antibody test. For those with the indications for bronchoscopy, we also did bronchoalveolar lavage and lavage bacterial culture. Results A high incidence （66/120, 55.0%） of mixed infections in children with mycoplasma pneumoniael pneumonia was revealed. The most frequent co-infected pathogen was chlamydia pneumoniae（35, 29.2%）, followed by viruses（19, 15.8%）, and bacteria（12, 10.0%）. Among viruses, respiratory syncytial virus was the most common （11, 9.2%）. Among 19 cases with mycoplasma pneumoniael and virus coinfection, 17 were younger than 3 years （89.5%）, while for mycoplasma pneumoniael and chlamydia pneumoniae coinfection, most of them were older than 3 years （27/35, 77.1%）. Conclusion More than half of cases with mycoplasma pneumoniael pneumonia had mixed infections. Most commonly caused by chlamydia pneumonia followed by viruses. The incidence of mixed infections with bacteria was low. Mixed infections with virus were more common in young children. While mixed infection with chlamydia pneumoniae was more common in older ones. Bacterial infections should be paid more attention.