常州地区儿童急性呼吸道感染病原体的流行病学研究

An epidemiological study of pathogens in children with acute respiratory infection of Changzhou region

目的探讨常州地区儿童急性呼吸道感染(ARI)的病原体种类和流行病学特征。方法应用间接免疫荧光技术检测2 259例ARI患儿血清中9种病原微生物IgM型抗体,包括嗜肺军团菌1型(LP-1)、肺炎支原体(MP)、Q热立克次体(QFR)、肺炎衣原体(CP)、腺病毒(ADV)、呼吸道合胞病毒(RSV)、甲型流感病毒(FluA)、乙型流感病毒(FluB)和副流感病毒(PIV),并进行统计分析。结果 2 259例患儿IgM型抗体阳性例数达856例,检出率为37.9%。单一感染601例,占70.2%(601/856),其中以MP为主,阳性率达43.6%;而FluB、RSV、PIV阳性率分别为11.4%、6.3%和5.3%。混合感染占29.8%(255/856),主要以MP合并FluB感染为主,占8.4%;而MP合并PIV、MP合并RSV、MP合并LP-1、MP合并PIV和RSV感染分别为5.8%、2.9%、2.4%和1.4%。856例阳性病例中,MP在<1岁组、1～4岁组、5～8岁组、>8岁组中所占比例分别为34.4%、64.0%、51.5%和54.6%,1～4岁组高于其他组(χ2=18.127,P<0.01)。RSV、FluB和PIV阳性构成情况相似(P>0.05)。儿童ARI检出率在秋、冬季节最高,分别为11.8%和13.6%。结论常州地区儿童ARI中以MP为主要病原体,并合并病毒感染。1～4岁儿童为易感人群,好发于秋、冬季节,大环内酯类抗菌药物联合病毒唑治疗效果明显。

Objective To investigate the pathogens in children with acute respiratory infection（ARI） and epidemiological characteristics in Changzhou region.Methods The sera were collected from 2 259 children with ARI,and IgM antibodies against 9 kinds of pathogenic microorganisms,including Iegionella pneumophila type 1（LP-1）,mycoplasma pneumonia（MP）,Q fever rickettsia（QFR）,chlamydia pneumonia（CP）,adenovirus（ADV）,respiratory syncytial virus（RSV）,influenza A virus（FluA）,influenza B virus（FluB） and parainfluenza virus（PIV）,were detected by indirect immuno-fluorescence assay.The results were analyzed statistically.Results Among 2 259 children with ARI,856 cases were detected positively,which accounted for 37.9%.Of the 856 cases,there were 601 cases of infection with unique microorganism（70.2%）.MP infection was predominant,and the positive rate was 43.6%.The positive rates of FluB,RSV and PIV were 11.4%,6.3% and 5.3%,respectively.There were 29.8%（255 /856） mixed infection,and the main mixed infection was MP ＋ FluB（8.4%）,followed by MP ＋ PIV（5.8%）,MP ＋ RSV（2.9%）,MP ＋ LP-1（2.4%） and MP ＋ PIV ＋ RSV（1.4%）.Among the 856 positive cases,the percentages of MP were 34.4%,64.0%,51.5% and 54.6% respectively in 1 year old,1-4 years old,5-8 years old and 8 years old groups.The highest positive rate was noted in the 1-4 years old group（χ2 = 18.127,P〈0.01）.The positive rates of RSV,FluB and PIV had no significant difference in every age group（P〈0.05）.The rate of children infected with ARI was higher in autumn and winter,which accounted for 11.8% and 13.6%,respectively.Conclusions MP are major pathogens among children with ARI and complicated with virus infection in Changzhou region.The 1-4 years old children as susceptible populations occur in the autumn and winter,and the therapy of macrolide antibiotics in combination with ribavirin is effective.