广州地区269例社区获得性肺炎病原体调查分析

Investigation on 269 patients with community-acquired pneumonia in Guangzhou

目的了解广州地区社区获得性肺炎的病原流行情况,为经验治疗提供依据。方法收集269例肺炎患者的外周血标本,用酶联免疫吸附法测定5种呼吸道病毒(呼吸道合胞病毒、甲型流感病毒、乙型流感病毒、副流感病毒、腺病毒)、4种非典型病原体(肺炎支原体、肺炎衣原体、嗜肺军团菌血清1型、Q热立克次体),并比较此9种病原体在不同年龄组的流行情况及其与基础疾病的相关性。结果 269例患者中,病原抗体呈阳性的有127例(47.21%),其中肺炎支原体占34.94%。43例混合感染中,以肺炎支原体合并其他病毒感染为主(14.50%)。儿童及老年人社区非典型肺炎发病率高于其他年龄患者。结论广州地区5种常见呼吸道病毒、4种非典型病原体在社区获得性肺炎中占一定比例,单项及混合感染均以肺炎支原体感染为主。病毒和非典型病原体的混合感染与年龄和是否有基础病有关。

Objective To provide basis for empirical treatment of pneumonia, based on the awareness of prevalence of pathogens in patients with community acquired pneumonia in Guangzhou. Methods Serum samples of 269 pa- tients with community acquired pneumonia were collected to detect 9 pathogens by Enzyme - linked immunoassay （EL1SA） , including 5 respiratory viruses： respiratory syncytial virus （RSV）, influenza A virus （IFVA） , influenza B virus （IFVB） , parainfluenza virus （PIV） , adenovirus （ ADV）, and 4 atypical pathogens ： Mycoplasma pneumon- iae （ MP）, Chlamydia pneumoniae （Cpn） , Legionella pneumophila typel （ LP1 ） , Query fever Rickettsia （QFR）. The prevalence of 9 pathogens in different age groups was compared. The association between the prevalence of 9 pathogens and the underlying diseases was analyzed. Results In the 269 patients, antibody against pathogens were detected in 127 patients （47.21% ）. Among them, mycoplasma pneumoniae accounted for 34.94%. In 43 patients with mixed infection, the detected pathogens were mainly mycoplasma pneumoniae accompanied with other viruses （ 14.50% ）. The morbidity of community acquired pneumonia in children and the aged people was higher than that in other age. Conclusion Five common respiratory viruses and 4 atypical pathogens viruses - induced community acquired pneumonia accounted for a certain proportion in Guangzhou. Single infection and mixed infection were mainly induced by mycoplasma pneumoniae. The mixed infection of viruses and atypical pathogens was associated with age and the underlying diseases.