昆明地区不同年龄段住院儿童大叶性肺炎287例病原学分析

Etiology analysis for 287 children patients with lobar pneumonia at different ages in Kunming Area

目地了解近2年儿童大叶性肺炎的病原学特点,为临床用药提供参考。方法对昆明市儿童医院2014年1月~2015年6月间住院的287例儿童大叶性肺炎的病原学情况分3个年龄段进行回顾性分析,探讨不同年龄段儿童大叶性肺炎的病原学特点。结果 287例中病原阳性194例,病原阳性率67.60%;单纯病原感染158例（55.05%）,混合感染36例（12.55%）;支原体混合EB病毒感染11例（3.83%）;细菌感染（含嗜肺军团菌）58例（20.21%）,其中嗜肺军团菌感染21例（7.32%）;病毒感染34例（11.85%）,支原体感染137例（47.74%）,单纯细菌感染（含嗜肺军团菌）32例（11.15%）,其中单纯嗜肺军团菌感染6例（2.09%）,单纯病毒感染16例（5.57%）;单纯支原体感染109例（37.98%）;立克次体感染1例（0.35%）。儿童3个年龄段间大叶性肺炎肺炎支原体、细菌、病毒、嗜肺军团菌及混合感染阳性率比较,〈3岁和≥3岁组间差异有统计学意义（P〈0.05）;≥3~〈7岁和≥7岁组间差异无统计学意义（P〉0.05）。结论儿童大叶性肺炎已成为多病原体疾病,且病原体随年龄的变化而改变,婴幼儿期以细菌感染为主,学龄前期及学龄期均以支原体感染为主。

Objective To understand the nearly 2 years etiology characteristics of lobar pneumonia in children in order to provide reference for clinical medication. Methods A total of 287 children patients with lobar pneumonia in Kunming children＇s hospital from January 2014 to June 2015 were analyzed retrospectively. These cases were divided into three group based on age, that the etiology characteristic of lobar pneumonia in different age children was discussed.Results Of 287 cases with lobar pneumonia, pathogen positive in 194 cases, positive rate was 67.60%. A single pathogen infection in 158 cases（55.05%）, mixed infection in 36 cases（12.55%）. Mycoplasma and EBV mixed infection was 11 cases（3.83%）. Bacterial infection（including 58 cases）（20.21%）, of which 21 cases（7.32%） were infected with pulmonary infection, 34 cases（11.85%） were infected with virus, mycoplasma infection in 137 cases（47.74%）, legionella pneumophila infection in 21 cases. Pure bacteria infection in 26 cases, pure virus infection in 16 cases（5.57%）, pure mycoplasma infection in 109 cases（37.98%）, pure legionella pneumophila infection in 6 cases, rickettsia infection in 1 case（0.35%）. Positive rate of mycoplasma pneumonia, bacteria, virus, legionella pneumophila and mixed infection in three group with lobar pneumonia in different age children, there were significant differences between less than 3 years old group and more than 3 years old group（P〈0.05）; there was no significant differences between more them 3 to less than 7 years old age group and more than 7 years old age group（P〉0.05）. Conclusion Labar pneumonia in children has become a disease with multiple pathogens, and pathogens change with age. In infants, the primary pathogens is bacteria, and in preschool and school age is mycoplasma pneumonia.