13198例急性呼吸道感染住院患儿肺炎支原体、肺炎衣原体及嗜肺军团菌分布特点分析

Distribution characteristics of Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila in hospitalized children with acute respiratory tract infection: an analysis of 13 198 cases

目的分析急性呼吸道感染（ARTI）住院患儿感染肺炎支原体（MP）、肺炎衣原体（CP）和嗜肺军团菌（LP）的分布特点。方法选取ARTI住院患儿13 198例为研究对象,留取全血和尿液,分别用被动凝集法检测血清MP;ELISA法检测血清CP;免疫层析法检测尿液LP。结果 13 198例ARTI患儿中,MP、CP、LP的检出率分别为25.31%、12.74%、3.27%,MP检出率最高（均P〈0.0125）。2013年与2014年MP检出率均高于2012年（均P〈0.0125）;2013年CP检出率最高,2014年LP检出率最高（均P〈0.0125）。3种病原体一年四季均可检出,各季节MP的检出率均最高（均P〈0.0125）。3种病原体总混合感染检出率为4.35%,以MP＋CP混合感染为最常见（均P〈0.0071）。不同年龄段患儿中,以5~〈16岁年龄段患儿3种病原体总检出率最高（均P〈0.0071）。不同ARTI患儿中,急性支气管肺炎患儿3种病原体总检出率最高（均P〈0.0045）。结论 MP、CP和LP是本地区ARTI患儿重要的病原体,其中以MP感染为主;LP感染呈逐年上升趋势,值得临床重视。

Objective To investigate the distribution characteristics of Mycoplasma pneumoniae（MP）, Chlamydia pneumoniae（CP）, and Legionella pneumophila（LP） in hospitalized children with acute respiratory tract infection（ARTI）. Methods A total of 13 198 hospitalized children with ARTI were enrolled as study subjects. Whole blood and urine were collected. The passive agglutination was used to detect serum MP-Ig M, ELISA was used to detect serum CP-Ig M, and immunochromatography was performed to detect urinary LP antigen. Results Among the 13 198 hospitalized ARTI children, the detection rates of MP, CP, and LP were 25.31%, 12.74% and 3.27%, suggesting that MP had the highest detection rate（P〈0.0125）. The detection rates of MP in 2013 and 2014 were significantly higher than that in 2012（P〈0.0125）. CP had the highest detection rate in 2013, and LP had the highest detection rate in 2014（P〈0.0125）. These three pathogens were detected all around the year, and MP had the highest detection rate in all seasons（P〈0.0125）. The detection rate of mixed infection with three pathogens was 4.35%, and mixed infection with MP and CP was the most common（P〈0.0071）. Among the children in different age groups, the patients aged 5-16 years showed the highest overall detection rate of three pathogens（P〈0.0071）. Among the children with different types of ARTI, the children with bronchopneumonia showed the highest overall detection rate of three pathogens（P〈0.0045）. Conclusions MP, CP, and LP, particularly MP, are important pathogens for children with ARTI in the local area. LP infection tends to increase year by year and should be taken seriously in clinical practice.