儿童社区获得性肺炎1613例病原学特点分析

Pathogen detection of 1613 cases of hospitalized children with community acquired pneumonia

目的 了解重庆地区儿童社区获得性肺炎（CAP）患儿病原分布及特点。方法 选取2014年1～12月住院治疗的1 613例CAP患儿为研究对象,采集患儿的鼻咽抽吸物进行细菌培养、呼吸道7种病毒及肺炎支原体检测,并对其特点进行分析。结果 1 613例患儿中,有810例细菌检出阳性,阳性率为50.22%,其中检出副流感嗜血杆菌346株（40.8%）,肺炎链球菌252株（29.7%）,卡他莫拉菌62株（7.3%）;病毒阳性者559例,阳性率为34.66%,其中检出呼吸道合胞病毒342株（58.3%）,副流感病毒3 102株（17.4%）,腺病毒84株（14.3%）;MP阳性者481例,阳性率为29.82%;病原体混合感染检出519例（32.18%）,以细菌、病毒混合检出为主（47.4%）。结论 副流感嗜血杆菌为重庆地区CAP住院患儿感染的首位细菌病原,RSV为首位病毒病原,支原体感染亦较为普遍,混合感染以细菌、病毒混合感染为主。

Objective To investigate the distribution of pathogens of children with community acquired pneumonia（CAP） from the Chongqing area. Methods Nasopharyngeal specimens and blood specimens of 1 613 children with CAP were collected between January 2014 and December 2014 for bacterial culture and detection of 7 respiratory viruses and antibodies against Mycoplasma pneumoniae（MP）. Results The overall positive rate of bacteria was 50.22%（810 cases）. Hemophilus parainfluenzae（40.8%）, Streptococcus pneumonia（29.7%） and Moraxelle catarrhalis（7.3%） were the predominant ones. Among the viruses, the top detected virus was respiratory syncytial virus（RSV, 58.3%）, followed by parainfluenza virus type3（17.4%） and adenovirus（14.3%）. A total of 481 cases（29.82%） were MP-positive. The co-infection rate was 32.18%（519 cases）, and the mixed infections of bacteria and viruses were common（47.4%）. Conclusions RSV and Hemophilus parainfluenzae are the major pathogens of CAP in children from the Chongqing area. MP is also an important pathogen. The co-infection of bacteria and viruses is prevalent.