泸州地区儿童急性呼吸道感染病原体检测结果分析

Pathogen analysis in children with acute respiratory tract infection in Luzhou region

目的 了解泸州地区儿童急性呼吸道感染病原体的流行特点,为临床早期诊断和治疗提供客观依据。方法 收集急性呼吸道感染患儿2 861例,采用间接免疫荧光法检测血清中9种非典型呼吸道病原体Ig M抗体,分别为：嗜肺军团菌血清1型（LP）、肺炎支原体（MP）、Q热立克次体（QF-R）、肺炎衣原体（CP）、腺病毒（ADV）、呼吸道合胞病毒（RSV）、甲型流感病毒（IAV）、乙型流感病毒（IBV）、副流感病毒1~3型（PIVs）。根据不同年龄、季节和性别的呼吸道病原体阳性率以及合并感染情况进行统计学分析。结果 2 861例急性呼吸道感染患儿总阳性例数为1 697例,阳性率为59.31%,其中MP阳性率最高为46.56%,其次依次为IBV（28.98%）、LP（10.98%）、PIVs（7.48%）。两种及两种以上非典型病原体混合感染率为31.28%,占总感染例数的52.74%,其中两种病原体混合感染率为28.70%;3种及以上病原体混感染率为2.59%。1岁以下、1~3岁、4~6岁、7~9岁、10~14岁各年龄组总阳性检出率分别为28.01%、78.10%、92.78%、86.84%、83.78%,在各年龄组中病原体感染总阳性检出率差异有统计学意义（P〈0.01）。夏季病原体检出率最高为72.55%,其次依次为春（61.93%）、秋（55.03%）、冬（53.06%）,各季节病原体总阳性检出率差异有统计学意义（P〈0.01）。结论 泸州地区急性呼吸道疾病患儿与非典型病原体感染密切相关,主要以MP、IBV、LP、PIVs以及两种病原体的混合感染为主。各年龄组检出阳性率存在差异,以4~6岁感染率为最高,且春夏季更易感。

Objective To investigate the pathogenic characteristics of acute respiratory tract infection in children in Luzhou area, and thus to provide evidence for clinical diagnosis and treatment. Methods A total of 2861 serum samples were collected from children with acute respiratory tract infection in the Affiliated Hospital of Xinan Medical University from January 2015 to December 2015, Indirect immunofluorescence assay was used to investigate the IgM antibodies of 9 types of respiratory tract pathogens, including Legionella pneumophila （LP）, Mycoplasma pneumophila （MP）, Q fever rickettsial （ QF - R）, Chlamydia pneumophila （ CP）, Adenovirus （ ADV）, Respiratory syncytial virus （ RSV）, Influenza A virus （ IAV）, Influenza B virus （IBV） and Parainfluenza virus （PIV）. The pathogen positive rate and co - infections rate were analyzed statistically according to genders, ages and seasons. Results Totally 1697 cases of positive samples were detected with the positive rate of 59.31%. Among 9 pathogens, the positive rate of MP was the highest （46.56%）, followed by IBV （28.98%）, LP （ 10. 98% ）, and PIVs （7.48%）. While co - infections were found in children with mainly two and three kinds of mixed infection, which accounted for 31.28%. The total detection rates were 28.01%, 78. 10%, 92. 78%, 86. 84%, and 83.78%, respectively, in age groups （0 -12month; 1 -3ys; 4 -6ys; 7 -9ys; and 10 - 14ys）, with significant differences among them （P 〈 0. 01 ）. The highest positive rate was found in summer, followed by spring, autumn, and winter （P 〈 0, 01 ）. Conclusion The acute respiratory tract infection in children in Luzhou region is closely correlated with atypical infection pathogens. The main respiratory pathogens include MP, IBV, LP, PIVs and coinfection. The positive detection rate is different in children of different age groups. The detection rate is the highest in children aged between 4 years and 6 years, during spring and summer.