贵阳地区住院儿童急性下呼吸道感染病毒与细菌病原学研究

Etiological study on viruses and bacteria in hospitalized children with acute lower respiratory tract infection in Guiyang area

目的:了解贵阳地区急性下呼吸道感染(ALRTI)患儿病毒与细菌感染情况、临床特征及流行病学特点。方法:无菌气压吸引法采集1 070例急性下呼吸道感染住院患儿新鲜痰液,应用直接免疫荧光法(DIF法)检测7种常见呼吸道病毒,包括呼吸道合胞病毒(RSV)、腺病毒(ADV)、流感病毒(IV)A、B型、副流感病毒(PIV)Ⅰ、Ⅱ、Ⅲ型,并常规进行深部痰培养。结果:1 070份标本中,病毒抗原检出阳性281份(占26.3%),其中RSV阳性为最多,共254份(占23.7%),ADV 11份(占1.0%)。RSV感染与年龄、季节及病种有关,与性别无关。痰培养检出阳性519例(占48.5%),最常见的病原菌为大肠埃希菌、肺炎克雷伯菌,检出率分别为12.3%、11.2%。大肠埃希菌多见于1岁以下婴幼儿。病毒合并细菌感染阳性检出132例(占12.3%)。结论:RSV、大肠埃希菌、肺炎克雷伯菌是贵阳地区住院儿童急性下呼吸道感染的最常见呼吸道感染病原体,应加强对这些常见病原体的动态监测,以指导临床治疗。

Objective： To understand viral and bacterial infection situations, clinical characteristics, and epidemiological charac- teristics in children with acute lower respiratory tract infection （ALRTI） in Guiyang area. Methods ： The fresh sputum samples of 1 070 hospitalized children with ALRTI were collected by sterile air pressure drainage; direct immunofluoreseence （DIF assay） was used to detect 7 kinds of common respiratory viruses, including Respiratory syneytial virus （RSV） , Adenovirus （ADV） , Influenza virus A and B, Para in- fluenza virus Ⅰ、Ⅱ、Ⅲ; deep sputum culture was carried out routinely. Results： Among 1 070 samples, 281 samples （26. 3%） were found with positive viral antigen, the detection rate of RSV was the highest, accounting for 23.7% （254 samples） , followed by ADV （ 11 samples, 1.0% ） . RSV infection was correlated with age, season, and types of pathogens, which was not related to gender. A total of 519 positive cases were detected by sputum culture, accounting for 48.5%, the most common pathogens were Escherichia coil and Klebsiella pneumoniae, the detection rates were 12. 3% and 11.2% , respectively. Escherichia coil was commonly found in infants under one year. A total of 132 cases were found with viral infection combined with bacterial infection, accounting for 12. 3%. Conclusion： RSV, Escherichia coil, and KlebsieUa pneurnoniae are most common pathogens of ALRTI in hospitalized children in Guiyang area, dynamic monitoring of these common pathogens should be enhanced to direct clinical treatment.