儿童急性呼吸道感染的病原体检测

Detection of pathogens causing acute respiratory tract infections in children

目的应用间接免疫荧光法检测医院儿童急性呼吸道感染的病原体,探讨其在临床的实用价值,为临床诊断儿童呼吸道感染提供最佳的检测技术。方法检测502例诊断为急性呼吸道感染儿童的急性期静脉血样本,使用间接免疫荧光技术检测呼吸道主要病原体的IgM抗体。结果检出病原体总阳性率为67.93%,其中肺炎支原体最多见,占40.84%,其他依次为呼吸道合胞病毒、腺病毒、乙型流感病毒、嗜肺军团菌1型、副流感病毒1、2、3型、肺炎衣原体、甲型流感病毒、Q热立克次体阳性检出率分别为11.95%、8.96%、6.37%、2.99%、1.99%、1.59%、1.39%、0.60%;42例首次检测为阴性,重复采血复查后8例阳性,1～3岁年龄组感染阳性率最高。结论间接免疫荧光法检测9项呼吸道感染病原体IgM抗体对于儿科呼吸道感染病原体的早期发现及病原学的流行病学调查具有重要意义。

OBJECTIVE To approach the clinical value of indirected mmunofluorescence （IFA） identifying the pathogens of acute respiratory infections （ARTI） in children so as to provide the optimal assay technique for clinical diagnosis. METHODS The serum from 502 children with ARTI in acute phase was collected for detection of IgM of major pathogens by IFA. RESULTS The total positive rate of infection was 68%. MP （40.84%） was predominant, followed by RSV（ll. 95%）, ADV（8. 96%）, IFB（6. 37%）, LP1 （2. 99%）, PIVS（1.99%）,CP （1.59）,IFA（ 1. 39%） and COX （0. 60%）. 42 children whose tests were negative in the first detection were retested, 8 of them were positive. The positive rate of infections in the children aged between 1 and 3 years old was the highest. CONCLUSION It is of great clinical significance to use nine IFA items combined reagents to detect IgM against pathogens of ARTI for the early and rapid discovery and the epidemiology of ARTI in children.