儿童急性呼吸道感染病毒和非典型病原体的检测

The detection of viral and atypical pathogens in children with acute respiratory infection

目的了解急性呼吸道感染(ARI)患儿呼吸道病毒和非典型病原体感染的情况。方法收集17 048例拟诊断为ARI患儿的血清,采用间接免疫荧光法(IFA)检测9种常见的病毒和非典型病原体,包括肺炎支原体(MP)、乙型流感病毒(FluB)、呼吸道合胞病毒(RSV)、副流感病毒(PIV)、腺病毒(ADV)、甲型流感病毒(FluA)、嗜肺军团菌(LPN)、Q热立克次体(COX)、肺炎衣原体(CPn)的IgM抗体。结果 9种病原体的总体检出率为60.24%(10 269/17 048)。其中,MP的检出率最高,为47.78%(8 146/17 048),其次是FluB,检出率为30.87%(5 262/17 048)。MP各季节检出率都较高;FluB主要在夏季和冬春季有小流行;RSV在冬春季检出率较高;ADV春季检出率较高;FluA在春夏季出现了小流行;PIV和LPN季节性不明显。ADV、CPn、FluA、FluB、LPN、MP、PIV、RSV病原体检出率在各年龄组之间差异有统计学意义(P<0.05)。2种病原体混合感染以MP+FluB最多,占39.58%;3种病原体混合感染以MP+FluB+RSV多见,占13.68%。4种病原体混合感染,以MP+FluB+RSV+PIV居多,占3.84%。其他混合感染模式的阳性例数较少。结论武汉地区引起儿童ARI的病毒和非典型病原体主要是MP、FluB和RSV;各种病原体检出率具有一定季节性且不同年龄段间有一定差异;混合感染比较普遍,主要是MP+FluB混合感染。

Objective To investigete the viral and atypical pathogens in children with acute respiratory infection （ARI） .Methods A total of 17 048 serum samples were collected from children ,who were intended to diagnose as ARI .Indirect immunofluores-cence assays were performed to detect IgM antibodies against 9 common pathogens ,including mycoplasma pneumonia（MP） ,influen-za virus B（FluB） ,respiratory syncytial virus（RSV） ,parainfluenza virus（PIV） ,adenovirus（ADV） ,influenza A virus（FluA） ,legio-nella pneumophila（LPN） ,coxiella burnetii（COX） ,chamydophila pneumonia（CPn） .Results The total detection rate of the 9 patho-gens was 60 .24% （10 269/17 048） .The detection rate of MP was 47 .78% （8 146/17 048） which was the highest ,followed by FluB which was 30 .87% （5 262/17 048） .The detection rate of MP kept at a high level through the whole year ;FluB appeared a little popular in the summer ,winter and spring ;RSV had higher detection rate in winter and spring ;ADV had higher detection rate in spring ;FluA appeared a little popular in spring and summer ;PIV and LPN didn′t show any seasonal change .There were significant differences in the detection rates of ADV ,CPn ,FluA ,FluB ,LPN ,MP ,PIV and RSV among different age groups （P〈 0 .05） .In mixed infection with 2 kinds of pathogens ,MP＋FluB was the most common pattern which accounted for 39 .58% of mixed infec-tion .In mixed infection with 3 kinds of pathogens ,MP＋FluB＋RSV was the most common pattern which accounted for 13 .68% .In mixed infection with 4 kinds of pathogens ,MP＋ FluB＋ RSV＋ PIV was the most common pattern which accounted for 3 .84% . Other mixed infection pattern was rare .Conclusion The most common pathogens causing ARI in children of Wuhan were MP ,FluB and RSV .The detection rate of each pathogen displayed specific seasonal variations and variations among different age groups . Mixed infections were more common than single infections ,and the most common pattern was MP＋ FluB .