昆明儿童呼吸道感染9种病原体IgM抗体检测结果分析

Detection of IgM antibodies in respiratory tract infections caused by 9 pathogens in children,Kunming City

目的分析2016年1—12月1 136例门诊及住院拟诊呼吸道感染的4月龄～12岁患者,了解昆明地区儿童呼吸道感染患者中9种常见病原体(嗜肺军团菌、肺炎支原体、肺炎衣原体、Q热立克次体、腺病毒、呼吸道合胞病毒、甲型流感病毒、乙型流感病毒和副流感病毒)的感染情况。方法采用间接免疫荧光法,检测患儿的血清中9种病原体。通过SPSS统计软件比较分析阳性检测率在不同年龄、季节、性别患儿阳性病例数及阳性率的差异。结果1 136例儿童呼吸道感染患者中,IgM抗体检测阳性534例,阳性率为47%。9种病原体IgM抗体阳性率,MP阳性率最高(40.8%),COX最低(0.0%)。单一病原体感染487例,阳性率为42.9%,混合病原体感染47例,阳性率为4.1%。统计分析结果显示,各年龄组(婴儿组、幼儿组、学龄前期组、学龄期组),学龄期组IgM阳性率最高(54.1%),幼儿组最低(39.8%),组间差异有统计学意义(X^2=18.729、P<0.05)。春、夏、秋、冬IgM阳性率分别是44.9%、53.5%、43.8%和45.5%,组间差异无统计学意义(X^2=6.657、P=0.084,P>0.05)。患者男女性别IgM阳性率分别是37.8%和58.8%,组间差异有统计学意义(X^2=49.562、P<0.05)。结论昆明地区儿童呼吸道感染以MP为主,学龄前期及学龄期儿童感染率较高,无季节差异,女性患儿多于男性。

Objective To analyze the respiratory infections in children by nine common pathogens in Kunming. Methods A total of 1 136 serum specimens were collected from outpatients and in-patients who were suspected to occur respiratory infections from January 2016 to December 2016 in Yunnan Traditional Chinese Medicine Hospital. The nine pathogens were: Legionella pneumophila( LP),Mycoplasma pneumoniae( MP),Chlamydia pneumoniae( CP),Q fever rickettsia( COX),Adenovirus( ADV),Respiratory syncytial virus( RSV),Influenza A virus( INFA),Influenza B virus( INFB),and Parainfluenza virus( PIV). The specimens were detected by indirect immunofluorescence. The differences of positive rates among different ages,seasons,and genders of children were compared by SPSS statistical software.Results In all serum specimens,534( 47%) specimens were positive for IgM antibodies. The positive rates of IgM antibodies against the pathogens were as fo0 llows: LP,MP,CP,COX,ADV,RSV,INFA,INFB,and PIV 3.6%,40.8%,0.2%,0.0%,0.2%,0.4%,0.1%,1.1%,and 0.5%,respectively,MP occupied in the highest positive rate and COX was the lowest one. 487( 42.9%) cases were infected by a single pathogen,and 47( 4.1%) cases were infected by mixed pathogens. The IgM positive rates were 40.4%,39. 8%,52. 0% and54.1% in different age groups,no a statistical difference( X^2=18.729 P<0.05). The IgM positive rates were 44.9%,53.5%,43.8% and 45.5%,respectively,in different seasons,no a statistical difference( X^2= 6.657 P = 0.084,P>0.05). The positive rate of IgM in male cases( 37.8%) was clearly lower than that in female cases( 58.8%),with a statistical difference( X^2= 49.562,P<0.05). Conclusions MP was the major non-bacteria pathogen in children occurred respiratory tract infection in Kunming,the infection rate for children in preschool and school-age was high,there was no a season difference,and the female cases were more than male cases.