白银地区5岁以下儿童社区获得性肺炎不同年龄、季节及细菌分布特征分析

Analysis of the Ages, Seasons and Bacterial Distribution Features of the Children under Five Years with Community-acquired Pneumonia

目的：对白银地区5岁以下儿童社区获得性肺炎（Community acquired pneumonia,CAP）细菌病原特征进行调查研究,以了解主要细菌种类、分布特征、感染特点、流行的优势菌株。探讨儿童CAP不同年龄、季节的流行规律。方法：2012年4月至2014年8月间,将≤5岁的CAP住院患儿1 300例,划分为1~2月,〉2月~≤1岁,〉1~≤2岁,〉2~≤5岁4个年龄段,春、夏、秋、冬4个季节,了解CAP的发病特点,采集急性期呼吸道深部痰标本培养了解主要细菌种类、分布特征。结果：1 300例CAP患儿中,1 126例采集到了深部痰标本,采样率86.62%,细菌培养阳性标本440例,阳性率达39.08%,其中1~2月,〉2月~≤1岁,〉1~≤2岁,〉2~≤5岁CAP不同年龄段、不同季节发病率及革兰阳性（G＋）菌株革兰阴性（G-）菌株构成比例不同。结论：白银地区5岁以下患儿,年龄越小,CAP发病率越高;冬春季节发病率均高;深部吸痰培养分离菌株中年龄越小阳性率越高;革兰氏阴性杆菌感染较革兰氏阳性球菌发病率高;不同年龄段的优势菌不同。

Objective：To survey main bacterial sorts, distribution features, infection characteristics, epidemic dominant bacterial strains by investigating bacterial pathogenic features of the children with community-acquired pneumonia（CAP） under five years in Baiyin region. To explore epidemic rules of CAP in different ages and seasons.Methods： All 1 300 CAP inpatients under five years were randomized into one to two months, two months to one year, one to two years, and two to five years according to their ages, spring, summer, autumn and winter four seasons from April, 2012 to August, 2014, to investigate morbidity features of CAP, the sputum species in the deep of respiratory tract at acute stage were collected to investigate the sorts and distribution features of main bacteria. Results：Among 1 300 CAP children, the samples of deep sputum were collected from 1 126 cases, sampling rate was86.62%, there were 440 cases with positive samples of bacterial cultivation and positive rate reached 39.08%, the proportions of CAP morbidity rates in different ages and seasons, G＋and G-were different for the children aged one to two months, two months to one year, one to two years, two to five years. Conclusion： The younger CAP children under five years in Baiyin region are, the higher the morbidity rates are; the higher morbidity rate is in winter and spring; the younger CAP children are, the higher positive rate of bacterial strains isolated from deep sputum culture is;the morbidity rate is higher when G-infection is compared with G＋; dominant bacterial strains are different in CAP children at different ages.