2013年湖南省儿童医院住院患儿急性下呼吸道感染病原体分析

Pathogens of acute lower respiratory tract infection in hospitalized children in Hunan Children's Hospital,2013

目的了解湖南省儿童医院急性下呼吸道感染患儿常见非典型呼吸道病原的感染和流行情况,为临床诊断急性下呼吸道感染患儿提供病原学依据。方法采集该院2013年1-12月诊断为急性下呼吸道感染的1 726例住院患儿的血清标本,用间接免疫荧光法(IFA)快速检测和鉴定肺炎支原体、乙型流感病毒、呼吸道合胞病毒、副流感病毒(1.2.3)、腺病毒、嗜肺军团菌、甲型流感病毒、肺炎衣原体、Q热立克次体九种非典型呼吸道病原体。采用χ2检验分析检出率的人群、季节、时间分布差异。结果 1 726例患儿肺炎支原体检出率为56.78%,其次为乙型流感病毒19.99%、呼吸道合胞病毒12.40%、副流感病毒9.21%、腺病毒5.16%、嗜肺军团菌5.16%,甲型流感病毒2.43%,肺炎衣原体1.10%,Q热立克次体0.9%;其中肺炎支原体检出率存在性别差异(χ2=6.04,P<0.05);副流感病毒、乙型流感病毒、呼吸道合胞病毒、肺炎衣原体、肺炎支原体、腺病毒检出率存在年龄差异(P<0.05);肺炎衣原体检出率不存在季节差异,其它病原体在检出率存在季节差异(P<0.05)。副流感病毒、甲型流感病毒检出率5月达最高峰;Q热立克次体秋冬季未检出;肺炎支原体、乙型流感病毒1月是检出高峰。重复感染率22.25%,其中肺炎支原体合并其他病原体感染率高达16.3%。结论导致该院儿童急性下呼吸道感染的主要病原体是肺炎支原体、乙型流感病毒、呼吸道合胞病毒;肺炎支原体与其它病原体混合感染普遍。

Objective To investigate the prevalence of common pathogens of acute lower respiratory tract infection in hospitalized children in Hunan Children＇ s Hospital, and to provide etiological evidence for its diagnosis. Methods Serum specimens of 1,726 hospitalized children who were diagnosed as acute lower respiratory tract infection in Hunan Children＇ s Hospital were col- lected from January to December, 2013. Indirect immunofluorescence （IFA） was used to detect and identify respiratory pathogens like Mycoplasrna pneumoniae, influenza B virus, respiratory syneytial virus, parainfluenza virus （1.2.3 ） , adenovirus, Legionella pneumophila, influenza A virus, Chlamydia pneumoniae and Coxiella burnetii. The detection rates of each pathogen in different populations and seasons were analyzed by Chi-square test. Results In 1,726 hospitalized children, the detection rates of Mycoplasma pneumoniae, influenza B virus, respiratory syncytial virus, parainfluenza virus （ 1.2.3 ） , adenovirus, Legionella pneumophila, influenza A virus, Chlamydia pneumoniae and Coxiella burnetii were 56.78 %, 19.99%, 12.40%, 9.21%, 5.16%, 5.16%, 2. 43%, 1.10% and 0.9% respectively. The detection rate of Mycoplasma pneumoniae differred significantly between boys and girls （χ2 = 6.04, P〈0.05）. The detection rates of parainfluenza virus, influenza B virus, respiratory syncytial virus, Chlamydia pneumoniae, Mycoplasma pneumoniae and adenovirus differred among ages （P〈0.05 ）. Their detection rates also differred among sea- sons except for Chlamydia pneumoniae （ P〈O.05 ）. The detection rates of parainfluenza virus and influenza A virus peaked in May, and of Mycoplasma pneumoniae and influenza B virus in January. Coxiella burnetii could not be detected in autumn and winter. The detection rate of infections with two or more pathogens was 22.25%. The detection rate of Mycoplasma pneumoniae co-infected with other pathogens was 16.3%. Conclusions The major pathogens of acute lower respiratory tract infection in hospitalized children in Hunan Children ＇ s Hospital were Mycoplasma pneumoniae, influenza B virus, and respiratory syncytial virus. It is common for hospitalized children with acute respiratory infection coinfected by Mycoplasma pneumoniae with other pathogens.