2～3岁幼儿上呼吸道菌群分析

Analysis of pathogens in upper respiratory tracts of 2to 3-year-old children

目的从微生态学角度分析幼儿上呼吸道菌群组成，为预防幼儿呼吸道感染发生提供科学的支持。方法随机自愿原则选取沈阳市某幼儿园31名2～3岁健康幼儿进行上呼吸道微生态指标检测，用无菌棉拭子采集咽后壁标本，并对标本进行稀释、分离培养、纯化、染色镜检及ATB鉴定，观察幼儿咽后壁的优势菌群和病原菌分布特点。结果31名幼儿需氧菌检出率在前5位依次为唾液链球菌74．2％、微黄奈瑟菌属64．5％、缓症链球菌58．1％、口腔链球菌51．6Vo、灰色奈瑟菌属51．6％、厌氧菌检出率占前3位依次为韦容球菌属96．7％、麻疹孪生球菌67．7％、脆弱类杆菌51．6%，检出率较高的菌种其分布率也较高；需氧菌95％可信区间（4．8～7．2）×10^4，厌氧菌95％可信区间（5．0-7．5）×10^4，需氧菌和厌氧菌之比为1：1．03。结论幼儿上呼吸道菌群十分有限，多样性低，需氧菌中的链球菌属、奈瑟氏菌属和厌氧菌中的韦容球菌属、麻疹孪生球菌、脆弱类杆菌是其优势菌群，可为临床研究提供理论依据。

OBJECTIVE To analyze the constitute of pathogens in the upper respiratory tract of young children in order to provide the scientific basis for the prevent of respiratory infections. METHODS Thirty-one 2- to 3-year-old healthy children were selected voluntarily and randomly from a kindergarten in Shenyang for the microecological index detection in upper respiratory tract. The pharyngeal specimens were collected with sterile swabs. Bacteria from those specimens were isolated and cultured after the dilution of the specimen, then the purified bacteria were gram-stained and identified by ATB tests. The dominant floras and pathogen distribution on the posterior pharyngeal wall were characterized based on observation. RESULTS In the 31 specimens collected, Streptococcus salivarius had the highest detection rate （74. 2%） in the aerobic bacteria, followed by Neisseria subflava （64.5%）, Streptococcus mitis （58. 1%）, Streptococcus sanguis （51.6%）, and Neisseriacinerea （51.6%）. The anaerobic bacteria with the top 3 highest detection rate were Veillonella Prkvot （96. 7%）, Measles gernella （67.7 % ）, and Bacteroides fragilis （51.6 %）. The 95 % confidence interval for aerobic bacteria was 4.8 × 10^4- 7.2×10^4; and that for anaerobic bacteria was 5 × 10^4- 7. 51 × 10^4. The ratio between aerobic and anaerobic bacteria was 1 ： 1.03. CONCLUSION The floras in the upper respiratory tract of young children are limited and not diverse. The dominant aerobic floras are Streptococcus salivarius and Neisseria subflava. The dominant anaerobic floras are Veillonella Prkvot, Measles gernella, and Bacteroides fragilis. The determination of dominant floras can provide theoretical basis for future clinical research.