婴儿下呼吸道合胞病毒感染的临床特点及流行病学分析

Clinical and epidemiological characteristics of lower respiratory tract syncytial virus infections in neonates

目的探讨婴儿下呼吸道合胞病毒（RSV）感染的临床及流行病学特点，为临床合理用药提供依据。方法收集2006年6月-2011年3月儿科住院确诊为下呼吸道感染的年龄〈1岁婴儿551例，应用直接免疫荧光法检测RSV抗原，根据检测结果分为RSV阳性组和RSV阴性组，对两组患儿临床及流行病学资料进行分析。结果551例患儿中RSV阳性176例，阳性率31．94％；RSV阳性组年龄≤6月龄131例，占74．4％，7～12月龄45例，占25．6％；RSV阳性组较RSV阴性组喘息和鼻阻的临床表现显著增多；RSV阳性组与细菌混合感染90例，合并感染的常见细菌依次为大肠埃希菌、肺炎克雷伯菌、流感嗜血菌及肺炎链球菌，与RSV阴性组比较差异无统计学意义。结论RSV是贵阳地区婴儿下呼吸道感染重要病原之一，除咳嗽外常有喘息、鼻阻表现，可合并细菌感染，对这类婴儿应根据痰培养选择合理抗菌药物。

OBJECTIVE To investigate the clinical and epidemiological characteristics of infants with lower respiratory tract respiratory syncytial virus （RSV） infections so as to provide basis for reasonable clinical use of antibiotics. METHODS A total of 551 infants aged less than one year, who were with confirmed lower respiratory tract infections and were treated in the pediatric department from Jun 2006 to Mar 2011, were enrolled in the study, then the RSV antigens were detected with the use of direct immunofluorescence method, the subjects were divided into the RSV-positive group and the RSV-negative group according to the detection results, and the clinical and epidemiological data were analyzed. RESULTS Of totally 551 infants investigated, there were 176 （31.94%） cases with RSV tested positive, among which 131 （74.4%） cases were with no more than 6 months of age, 45 （25.6%） cases with the age between 7 and 12 moths. As compared with the RSV-negative group, the clinical manifestations including the wheezing and nasal resistance increased significantly in the RSV-positive group. There were 90 cases of mixed bacterial infections in the RSV-positive group, the common species of pathogens causing the mixed infections included the Escherichia coli, Klebsiella pneumoniae, I-Iaemophilus influenzae and Streptococcus pneumoniae, as compared with the RSV-negative group, the difference was not significant. CONCLUSION RSV is one of predominant species of pathogens causing lower respiratory tract infections in the infants of Guiyang area; in addition to cough, the clinical manifestations include wheezing and nasal resistance, with mixed bacterial infections complicated; it is necessary to reasonably use antibiotics in accordance with result of sputum culture.