我院2011年11月-2012年10月急性呼吸道感染患儿肺炎支原体感染的分布及耐药性分析

Distribution and Analysis of Drug Resistance of Mycoplasma Pneumonia Infection in Children with Acute Respiratory Infection in Our Hospital during Nov. 2011-Oct. 2012

目的:了解我院儿童肺炎支原体感染在年龄、性别、季节及疾病种类的分布情况,并对肺炎支原体的耐药性进行分析。方法:选取我院2011年11月-2012年10月儿科住院治疗的急性呼吸道感染患儿2397例,入院当天采集静脉血检测肺炎支原体抗体IgM。采集咽拭子标本进行支原体分离培养鉴定,并做药敏试验。结果:2397例患有急性呼吸道感染的患儿,肺炎支原体抗体IgM检测阳性的有688例,总阳性率28.70%,其中≤1岁者有108例(11.33%);>1～3岁者有262例(36.49%);>3～6岁者有208例(44.35%);>6～14岁者有110例(42.80%)。按季节分布,夏季肺炎支原体抗体IgM检测阳性率高于其他季节。按疾病分布,肺炎支原体抗体IgM检测阳性上呼吸道感染284例(36.18%),下呼吸道感染404例(25.06%)。肺炎支原体培养阳性的有486例(20.28%),其中≤1岁者有82例(8.60%);>1～3岁者有201例(27.99%);>3～6岁者有133例(28.36%);>6～14岁者有70例(27.24%)。药物敏感试验,强力霉素敏感458例(94.24%);美满霉素敏感449例(92.39%);交沙霉素敏感95例(19.55%);克拉霉素敏感341例(70.16%);罗红霉素敏感307例(63.17%);阿奇霉素敏感445例(91.56%);氧氟沙星敏感185例(38.07%);左氧氟沙星敏感458例(94.24%);司帕沙星敏感460例(94.65%)。结论:1岁以内儿童肺炎支原体感染较少,之后随年龄的增长感染率逐渐增加;夏季感染率高可能与气候相关;上呼吸道感染所占比率较高与患儿年龄增大、免疫功能成熟有关。强力霉素、美满霉素、阿奇霉素、左氧氟沙星、司帕沙星对肺炎支原体敏感,交沙霉素、氧氟沙星对肺炎支原体耐药。

OBJECTIVE： To investigate the distribution of mycoplasma pneumonia （MP） infection by age, gender, season and diseases in children of our hospital, and to analyze the drug resistance of MP. METHODS： From Nov. 2011 to Oct. 2012, 2 397 children with acute respiratory tract infection were selected in pediatric department of our hospital. MP-IgM of venous blood was tested on the first day in hospital. Pharyngeal swab samples were collected for MP cultivation identification and drug sensitive test was conducted. RESULTS： Among 2 397 children with acute respiratory infection, MP-IgM test was positive in 688 patients with total positive rate of 28.70%, among which 108 cases were in ≤ 1 years old （11.33%）, 262 cases in 〉 1-3 years old （36.49%）, 208 cases in 〉3-6 years old （44.35%）, and 110 cases in 〉6-14 years old （42.80%）. According to season distribution, positive rate of MP-IgM test in summer was higher than in other seasons. According to the distribution of disease, there were 284 cases of upper respiratory tract infection （36.18%）, and 404 cases of lower respiratory tract infection （25.06%）. 486 cases were MP culti-vate positive（20.28%）, among which 82 cases were in ≤1 years old （8.60%）, 201 cases in 〉1-3 years old （27.99%）, 133 cas-es in 〉3-6 years old （28.36%） and 70 cases in 〉6-14 years old （27.24%）. In drug sensitive test, 458 cases were sensitive to dox- ycycline （94.24%）, 449 cases sensitive to minocycline （92.39%）, 95 cases sensitive to josamycin （19.55%）, 341 cases sensitive to clarithromycin （70.16%）, 307 cases sensitive to roxithromycin （63.17%）, 445 cases sensitive to azithromycin （91.56%）, 185 cases sensitive to ofloxacin （38.07%）, 458 cases sensitive to levofloxacin （94.24%） and 460 cases sensitive to sparfloxacin （94.65%）. CONCLUSIONS： Less MP infection has been found in children younger than 1 year old, and the infection rate increase gradually along with the growth of the age; high infection rates in summer may be related with climate; the percentage of upper re-spiratory tract infection is higher, associated with the age and the mature of immune function. Doxycycline, minocyeline, azithro-mycin, levofloxacin and sparfloxacin are sensitive to MP, and josamycin and ofloxacin are resistant to MP.