呼吸道感染患者病原学调查分析

Etiological analysis of respiratory tract infections

目的了解冬春季节医院呼吸道感染患者的病原体感染情况，为制定预防措施提供依据。方法选取2011年10月-2012年3月医院就诊的1568例呼吸道急性感染患者，取其静脉血，用间接免疫荧光法（IFA）对其进行9种呼吸道病原体IgM抗体的检测，包括嗜肺军团菌血清1型（LP1）、肺炎支原体（MP）、Q热立克次体（COX）、肺炎衣原体（CPN）、腺病毒（ADV）、呼吸道合胞病毒（RsV）、甲型流感病毒（INFA）、乙型流感病毒（IN—FB）、副流感病毒（PIV），并对检测标本阳性的病例进行统计分析。结果1568份标本中9种病原体IgM抗体阳性共678例，阳性率为43．24％；病原体IgM阳性率由高到低排序依次为MP、LPl、INFB、RSV、ADV、CPN、COX、INFA、PIV，阳性率分别为13．20％、11．93％、8。74％、4．40％、1．98％、1．02％、0．83％、0．57％、0．57％；男性阳性率为25．08％，女性阳性率为37．79％，经χ2检验，两者阳性率比较，差异有统计学意义（P〈0．05）；不同年龄层次呼吸道病原体感染率不同，其中11～18岁患儿病原体感染的阳性率最高为57．89％，41～50岁其次，为42．37％。结论冬春季呼吸道感染患者中以感染肺炎支原体为主，嗜肺军团菌次之；不同性别在呼吸道病原体的总阳性率上表现出显著性差异，女性明显高于男性；11～18岁学生集中在一起，易引起呼吸道病原体的传播。

OBJECTIVE To understand the pathogen infection status of the respiratory tract infection （RI） in winter and spring and provide the reference of developing preventive measures. METHODS A total of 1 568 cases of hospi- talized patients with ARI from Nov. 2011 to Mar. 2012 in the Wuxi people/s hospital were selected, and venous blood was obtained for IgM detection of 9 kinds of respiratory viruses using indirect immunofluorescence （IFA）, including Legionella pneumophila （ LP1 ）, Mycoplasma pneurnoniae （ MP）, Q fever rickettsia （ COX）, Chlarnydia pneumoniae （CPN） ,Adenovirus （ADV）, Respiratory syncytial virus （RSV）, Influenza A virus （IN- FA）, Influenza B virus （INFB）, parainfluenza virus （PIV）, and the cases with positive detection specimen were statistically analyzed. RESULTS Among 1 568 cases, there were total 678 positive cases of 9 kinds of pathogens of IgM antibody, and the positive rate was 43.24%. The positive rates of MP, LP1, INFB, RSV, ADV, CPN, COX, INFA, PIVIgM were 13.20%, 11.93%, 8.74%, 4.40%, 1.98%, 1.02%, 0.83%, 0.57%, 0.57%. The positive rate was 25.08% in men, and 37.79% in women. By chi-square test, the difference of the positive rate in both groups was statistically significant （P〈0.05）. The infection rate of respiratory tract pathogen was dif- ferent in all ages, of which pathogen infection positive rate in children of 11 to 18 years old was the highest （57.89%）, followed by 41-50 years old（42.37%）. CONCLUSION In winter and spring, RI are mainly infected in MP, followed by LP1. The overall positive rate of respiratory tract pathogens in women is significantly higher than in men. The gathering of students aged between 11 and 18 years old may induce the dissemination of respira- tory tract infections.