阜阳地区120例发热呼吸道症候群住院患者的细菌病原谱分析

Etiologic study on febrile respiratory illness of 120 inpatients in Fuyang

目的了解阜阳地区发热呼吸道症候群住院患者的细菌病原谱构成,为临床医生的经验性用药提供理论依据。方法对阜阳市第二人民医院自2014年10月—2015年9月符合发热呼吸道症候群定义的120例住院患者行痰培养、血培养、聚合酶链式反应(PCR)、尿抗原检测进行病原学检测,检测病原菌包括肺炎链球菌(SP)、金黄色葡萄球菌(SA)、肺炎克雷伯菌(KP)、流感嗜血杆菌(HI)、铜绿假单胞菌(PA)、A组乙型链球菌(β-HA)、肺炎支原体(MP)、肺炎衣原体(CT)、嗜肺军团菌(LP)。结果 120份病例的阳性率为43.3%,其中各病原菌比例SP为15.8%(19/120)、SA为0.8%(1/120)、KP为5.0%(6/120)、HI为9.2%(11/120)、PA为7.5%(9/120)、MP为9.2%(11/120)、未检测到β-HA、CT、LP,混合感染率为4.2%(5/120)。120例患者均诊断为社区获得性肺炎,其中单纯社区获得性肺炎75例,病原菌感染的阳性率为38.7%(29/75),混合感染2例,混合感染率为2.7%。有基础肺病慢性阻塞性肺病病史的病例45例,病原菌感染的阳性率为48.9%(23/45),混合感染3例,混合感染率为6.7%。结论阜阳市发热呼吸道症候群住院患者的前3位致病菌为肺炎链球菌、流感嗜血杆菌和肺炎支原体,混合感染较常见。发热呼吸道症候群的主要疾病为社区获得性肺炎。单纯社区获得性肺炎患者和有慢性阻塞性肺病病史的社区获得性肺炎患者的细菌病原谱存在差异。

Objective To investigate the composition of bacterial pathogens of the patients suffering from febrile respirato- ry illness（FRI） in Fuyang, and to provide a theoretical basis for the clinicians. Methods The blood, sputum and urine samples from 120 inpatient with febrile respiratory syndrome in our hospital from October,2014 to September,2015 were prepared. The sputum culture, blood culture, urine antigen test and PCR were performed to test the pathogens including Streptococcus pneumoniae （ SP ）, Staphylococcus aureus （ SA ）, Klebsiella pneumoniae （ KP ）, Pseudomonas aeruginosae （ PA）, G-hemolytic streptococcus （ G-HA ）, Heamophilus influenzae （ HI ）, Myeoplasma pneumoniae （ MP ）, Chlamy-dia pneumoniae（ CT）, and Legionella pneumophla（LP）. Results The positive rate of this 120 cases was 43.3%, in which SP accounts for 15.8 %, SA accounts for 0.8 %, KP accounts for 5 %, PA accounts for 7.5 %, and C P accounts for 9.2%. While β-HA,CT and LP were not tested. There were 5 cases with mixed infections, and the mixed infection rate was 4.2%. All of the 120 patients were diagnosed with community-acquired pneumonia, among which 75 patients were com- munity-acquired pneumonia, whose positive rate of pathogen infection was 38.7%, and two patients were with mixed infec- tion, whose mixed infection rate was 2.7%. Besides, there were 45 patients who were diagnosed with chronic obstructive pulmonary disease,their positive rate of pathogen infection was 48.9%, and three patients were mixed infection, their mixed infection rate was 6.7%. Conclusions In Fuyang area, the first three pathogens of febrile respiratory illness are SP, HI and MP, and the mixed infections are more common. The principal disease of febrile respiratory syndrome is com- munity-acquired pneumonia. There are differences in pathogen spectrum for community-acquired pneumonia and the COPD with community-acquired pneumonia.