儿童与成人呼吸道病原体九联检结果对比分析

Analysis of the results of joint inspection of nine respiratory pathogens in children and adults

目的了解呼吸道感染儿童与成人非细菌性感染病原体情况,为临床合理选用抗微生物治疗药物提供依据。方法采集静脉血4.0 ml,离心分离血清,采用间接免疫荧光法（IFA）检查嗜肺军团菌血清1型（LP）;肺炎支原体（MP）、Q热立克次体（CB）;肺炎衣原体（CP）;腺病毒（ADV）;呼吸道合胞病毒（RSV）;甲型流感病毒（Influenza A virus）;乙型流感病毒（Influenza B virus）;副流感病毒1、2、3型（HPIVs1、2、3）病原体Ig M抗体,分析该院2013年1~12月1 650例儿童患者与2 656例成人患者呼吸道感染病原体Ig M抗体检出情况。结果 1 650例儿童患者Ig M抗体阳性775份,其Ig M抗体阳性检出率为46.97%,2 656例成人患者Ig M抗体阳性835份,其Ig M抗体阳性检出率为31.44%;儿童患者同时检出两种Ig M抗体296份,三种54份,两种及以上病原体抗体检出率45.16%。成人患者同时检出两种Ig M抗体162份,三种16份,两种及以上病原体抗体检出率21.32%,儿童与成人均未检出三种以上Ig M抗体;儿童乙型流感病毒Ig M抗体占第一位,成人肺炎支原体Ig M抗体占第一位,嗜肺军团菌血清1型、腺病毒、甲型流感病毒Ig M抗体以成人为主,儿童检出率低。结论呼吸道病原体九联检结果儿童与成人有差异,临床应根据检测结果合理选用抗微生物治疗药物。

Objective To investigate the pathogens in children and adults with respiratory tract infection,and to provide basis for clinical rational use of antimicrobial drugs. Methods Venous blood（4.0 ml） was collected and centrifuged. Blood serum was detected by indirect immunofluorescence（IFA） for Ig M antibody of Legionella pneumophila serotype 1（LP）, Mycoplasma pneumoniae（MP）, Q Coxiella burneti（CB）, Chlamydia pneumonia（CP）, Adenovirus（ADV）, Respiratory syncytial virus（RSV）, Influenza A virus, Influenza B virus, Parainfluenza virus type 1, 2, 3（HPIVs 1, 2, 3）. The detection results of 1 650 children and 2 656 adult patients with respiratory tract infection in our hospital from Jan. to Dec. 2013 were analyzed. Results Among the 1 650 children, 775（46.97%） were Ig M antibody positive. Among the 2 656 adult patients, 835（31.44%） were Ig M antibody positive. 296 and 54 children were detected with two and three kinds of Ig M antibody, respectively, with the detection rate of two or more antibodies of 45.16%. 162 and 16 adults were detected with two and three kinds of Ig M antibody, respectively, with the detection rate of two or more antibodies of 21.32%. No patients were detected with more than three kinds of Ig M antibody. For children, Ig M antibody of Influenza B virus had the highest detection rate, while for adult, Ig M antibody for Mycoplasma pneumoniae had the highest detection rate. Ig M antibody of Legionella pneumophila serotype 1, Adenovirus, Influenza A virus Ig M antibody were mostly detected in adults, with low detection rate in children. Conclusion There are differences in the results of joint inspection of nine respiratory pathogens between children and adults. Clinically, antimicrobial drugs should be applied according to the detection results.