广州地区患儿呼吸道感染病原学研究

Etiology of respiratory tract infections in children in Guangzhou district

目的分析广州地区呼吸道感染患儿病原体检测结果及流行情况,为临床早期诊断及治疗提供依据。方法调查2013年1月-2014年12月医院门诊及住院呼吸道感染患儿29 979例,采用间接免疫荧光法（IFA）对呼吸道感染患儿血液中的腺病毒（ADV）、肺炎衣原体（CP）、甲型流感病毒（Influenza A virus,FA）、乙型流感病毒（Influenza B virus,FB）、嗜肺军团菌血清1型（LP1）、肺炎支原体（MP）、副流感病毒1、2、3型（PIV1、2、3）、Q热立克次体（QFR）,呼吸道合胞病毒（RSV）9种病原体进行检测,采用SPSS19.0软件对数据进行统计分析。结果 29 979份标本中IgM抗体阳性检出率为31.17%,其中MP 5 847株占19.95%;其次为ADV1 036株,占3.47%;女性患儿阳性率为38.24%,显著高于男性27.47%（χ^2=365.685,P〈0.001）;各年龄组中,4~6岁患儿的呼吸道病原体感染率最高,达44.21%;〉6岁组居中,为42.02%;〈3岁组感染率最低,为27.49%,各组差异有统计学意义（χ^2=632.948,P〈0.01）;各病原体感染的全年分布不同,其中MP全年阳性率均较高,ADV、FA、FB、RSV主要为冬春季节高发,LP1为夏季高发,其他病原体全年发病率均较低。结论广州地区引起患儿呼吸道感染的病原体主要是MP、ADV、RSV、FB及LP1;应在不同季节做好重点预防工作。

OBJECTIVE To investigate the detection and epidemiology of the children with respiratory tract infection pathogens in Guangzhou district,and provide a reliable basis for clinical diagnosis and treatment.METHODS The sera of 29 979 children with respiratory tract infections were analyzed by indirect immunofluorescence（IFA）to detect adenovirus（ADV）,Chlamydia pneumonia（CP）,influenza A virus（FA）,influenza B virus（FB）,Legionella pneumophila semgroup 1（LP1）,Mycoplasma pneumonia（MP）,parainfluenza virus 1,2and 3（PIV）,Q Rickettsia（QFR）and respiratory syncytial virus（RSV）.The software SPSS19.0was used for statistical analysis.RESULTS Of totally 29 779 serum specimens detected,the positive rate of IgM was 31.17%,MP（5 847strains）were the dominant pathogens with the positive rate of 19.95%,secondly the positive rate of ADV（1 036strains）was 3.46%.The positive rate of girls was 38.24%,which was higher than that of boys（27.47%）（χ^2=365.685,P〈0.001）.In different age groups,the highest positive rate of pathogens was 44.21%in the children aged from 4to 6years,followed by the children aged more than 6years old（42.02%）;the lowest positive rate of pathogens was 27.47% in the children aged less than 3 years old, with significant difference（χ^2=632.948,P〈0.01）.The distribution of each kind of pathogenic infection was different in the whole year as the detection rate of MP kept at a high level through the whole year,ADV,FA,FB and RSV had higher detection rate in winter and summer,the positive rate of LP1 was the highest in summer and the detection rates of the other pathogens were all low during the whole year.CONCLUSION The most common pathogens causing respiratory tract infections in children in Guangzhou district are MP,ADV,RSV,FB and LP1.It is necessary to focus on the prevention of infections in different seasons.