湖南儿童抗生素使用前呼吸道感染的细菌病原学分析

Analysis of Bacterial Pathogenic Factors in Children with Respiratory Tract Infection Before Using Antibiotics in Hunan Province

【目的】了解湖南地区儿童抗生素使用前呼吸道感染的细菌分布特点，为本地区儿童呼吸道感染的临床诊疗提供病原学依据。【方法】以2012年3月到2014年12月在湖南长沙、湘潭、岳阳、常德、衡阳、邵阳以及郴州等12个哨点单位因急性呼吸道感染就诊且未使用抗生素的患儿为研究对象，采集鼻咽拭子标本进行细菌培养，结合临床资料进行统计分析。【结果]886例细菌检测样本中培养阳性188例（21．22％），其中以肺炎链球菌（8．24％）、卡他莫拉菌（3．05%）、流感嗜血杆菌（2．60％）多见。不同年龄组中，≤6个月组细菌检出率高于其他4组，差异有统计学意义；不同季节细菌检出率差异有统计学意义，以春季检出率最高，夏季最低。样本送检时间对细菌培养阳性率有一定影响，但无统计学差异。【结论】湖南地区儿童抗生素使用前呼吸道感染的最常见细菌为肺炎链球菌，其次为卡他莫拉菌、流感嗜血杆菌。各种细菌在不同年龄、季节阳性检出率有差异。样本送检时间对细菌检出率无显著影响。

[Objective]To evaluate bacterial distribution characteristics of respiratory tract infection in children in Hunan province before using antibiotics for providing etiology basis for clinical diagnosis and treatment in this region [Methods]Chitdren with acute respiratory tract infections who did not use antibiotics in Changsha, Xiangtan, Hunan, Yueyang, Changde, Hengyang, Shaoyang, Chenzhou, and 12 other sentinel units from March 2012 to December 2014 were treated as the objects of study. Nasopharyngeal swab specimens for bacterial culture were collected for bacterial cul- ture, combined with clinical data for statistical analysis. [ResultslAmong 886 nasopharyngeal swab specimens from chil- dren with respiratory tract infection, 188 （21.22% ） cases had positive bacterial culture. Streptococcus pneumoniae （8. 24%）. Moraxella catarrhalis （3.05%）. Haemophilusinfluenzae （2.60%） were most common. Among different age groups, bacteria detection rate in the ≤ 6 months group was higher than in the other 4 groups; there were statistically significant differences.There was also statistically significant differences in the rate of bacteria detection among different seasons; the highest rate being in spring and lowest being in summer. The sample inspection time had a certain effect on the bacterial culture positivity rate, but the difference was not statistically significant. [Conclusion]The most common bacterial pathogen of respiratory tract infections in Hunan province children are Streptococcus pneumoniae, Moraxella ca- tarrhalis, and Haemophilusinfluenzae, in that order. The detection rate of bacterial pathogens varies amongst different a- ges and seasons. Sample inspection time on the bacterial detection rate had no significant effect.