冬春季儿童肺炎感染病原分析

Research on etiology of children pneumonia during winter and spring

目的分析冬春两季儿童肺炎感染病原学构成,为儿童肺炎的防治提供依据。方法以我院2013年11月-2014年4月肺炎患儿1943例为研究对象,进行痰培养、7种呼吸道病毒抗原及巨细胞病毒、肺炎支原体、肺炎衣原体检测,并对检测结果进行回顾性分析。结果 1943例肺炎患儿中,病原阳性946例,阳性率48.7%,感染病原中病毒感染633例(66.9%),细菌感染195例(20.6%),支原体感染147例(15.5%),衣原体感染39例(4.1%),混合感染221例(23.4%)。病毒感染以呼吸道合胞病毒阳性率最高(62%),其次是巨细胞病毒(30.2%),流感/副流感(9.3%),腺病毒(5.5%)。细菌病原以肺炎链球菌最多见(12.5%),其次为流感嗜血杆菌(9.8%)。1岁以下肺炎感染病原阳性率(64.8%)高于其他年龄段,以RSV、CMV感染为主,肺炎支原体是3岁以上儿童肺炎主要感染病原。重症肺炎218例,病原阳性146例,阳性率67.0%,以RSV感染为主,占62.2%,重症肺炎混合感染多,占24.3%。结论儿童肺炎发病以1岁以下儿童常见,病毒是冬春两季儿童肺炎最常见感染病原,且主要以RSV感染为主,多种病原混合感染率高,尤其是重症肺炎更为明显。

Objective To explore the etiology construction of children pneumonia and to provide a basis for the diagonsis and treatment. Methods Totally 1943 children with pneumonia in our hospital between Noveber 2013 and April 2014 were enrolled into the study.Sputum culture,detection of cytomegalovirus（CMV）,mycoplasma pneumonia（MP）,chlamydia pneumonia （CP） and i-dentification of seven kinds of respiratory viral antigents by direct immunoflurescence assay were conducted. The results were ana-lyzed retrospectively. Results 1943 cases were included in the study,with 946cases were positive infections （48.7%）,Virus infec-tion for 633（66.9%）,bacterial infection for 195（20.6%）,MP for 147（15.5%）and CP for 39（4.1%）,mixed infection for 221（23.4%）. The respiratory syncytial virus （RSV） were the main pathogens for children pneumonia （62%）. CMV（30.2%）,influenza/parainfluen-zavirus（9.3%）,adenovirus（5.5%）. The top two of bacterial detection rates were Streptococcuspneumoniae（12.5%）,Haemophilusin-fuenzae （9.8%）. The infection rate was higher in children aged under one year （64.8%） than in those aged over one year. RSV and CMV were the main pathogens.MP infection was more common in children older than 3 years. The severe pneumonia was 218cas-es. The etiological detected rate was 67.0%（146/218）. RSV was the main pathogen（62.2%）. The mixed infection was common in the severe pneumonia（24.3%）. Conclusion The children pneumonia is more common in infants less than 1 year. Virus infection is the most common pathogen,RSV is the main pathogen. Mixed infection rate of pathogens is high,especially in severe pneumonia.