九项呼吸道病原联合检测对小儿急性下呼吸道非细菌感染临床意义

Nine-item assay for combined detection of nonbacterial pathogens in acute lower respiratory infection among children

目的探讨九项呼吸道病原联合检测在诊断小儿急性下呼吸道感染非细菌病原学中的临床应用价值,并了解小儿急性下呼吸道感染的病原学特点。方法应用九项呼吸道联合检测试剂(间接免疫荧光法),检测小儿急性下呼吸道感染1 389例血清标本的九项病原体IgM抗体,包括嗜肺军团菌、肺炎支原体、Q热立克次体、肺炎衣原体、腺病毒、呼吸道合胞病毒、甲型流感病毒、乙型流感病毒、副流感病毒1、2和3型。结果总感染率为42.6%(592/1389),其中以肺炎支原体最为多见,其次为乙型流感病毒;混合感染率达14.5%(201/1 389),以支原体感染与乙型流感病毒混合感染最多。但1岁以下组阳性率较低。结论间接免疫荧光法九项呼吸道病原体联合检测是检测小儿急性下呼吸道感染病原体的一种具有高灵敏度和高特异性且操作简便的方法,适合1岁以上小儿的临床应用。

Objective To study the diagnosis of 9assays for nonbacterial pathogens in acute lower respiratory infection（ALRI）among children,and to investigate the pathogenic characteristics.Methods Nine-item combined assays were used to detect IgM antibody of nine pathogens in serum specimens of 1 389 children with acute lower respiratory tract infection,including Legionella pneumophila,Mycoplasma pneumophila,Coxiella burneti,Chlamydia pneumophila,adenovirus,respiratory syncytial virus（RSV）,influenza A virus,influenza B virus and parainfluenza virus types 1,2and3,via indirect immunofluorescence assay.Results The total infection rate was 42.6%（592/1 389）,and Mycoplasma pneumoniae was the most common pathogen,followed by influenza B virus;mixed infection rate was 14.5%（201/1 389）,in which the mixed infection of Mycoplasma and influenza B virus was most common.However,the positive rate of patients under the age of 1year old was lower.Conclusion Nine-item combined assay is a method with the features as high sensitivity,high specificity and easy doing in detecting pathogens of children with acute lower respiratory tract infection,and it is suitable for clinical application in more than 1-year-old children.