基于病原体学的急性呼吸道感染住院患儿非细菌性病原学混合感染特点研究

The characteristics of hospitalized children with non mixed infection of bacterial pathogens of acute respiratory tract infection pathogen based

目的通过回顾性分析本院儿科急性呼吸道感染住院患儿的非细菌性病原学混合感染的特点。方法研究2014年5月至2015年3月我院儿内科住院治疗的急性呼吸道感染患儿，于入院24h内取静脉血2ml应用间接免疫荧光检测9种常见呼吸道病原早期特异性抗体IgM。对所得病原学检测结果及临床资料进行统计分析。结果患儿中总阳性率51．2％（147／287）；各病原检出率以流感病毒A占首位30．0％（86／287），其次是流感病毒B为28．2％（81／287）。3～6岁年龄组病原检出率56．3％（54／96）及病原混合感染率40．6％（39／96）均最高，其中以流感病毒B合并流感病毒A的双重感染最常见（48．5％；16／33）。按月份分布，8月份病原检出率最高，占80．0％（12／15）。根据病原检测结果分组，三组间临床特征发热、咳嗽、病种（上、下呼吸道感染）、住院天数及白细胞计数差异均无统计学意义。流感病毒A、流感病毒B及副流感病毒1在混合感染中阳性率较单一感染高（P〈0．05）。结论本地区儿童急性呼吸道感染病原混合感染率占有一定比例，以流感病毒A检出率占首位，流感病毒B次之。双重感染多见。多发生于3～6岁儿童，8月份为混合感染的发病高峰期。

Objective To explore the frequency, clinical presentations and impact of coinfections of respiratory agents on hospitalized children. Methods Patients from May 2014 to 2015 March in my courtyard department of Pediatrics inpatient treatment of acute respiratory tract infections in children were taking venous blood 2 ml by indirect immune fluorescence detection 9 kinds of common respiratory pathogens early specific antibody IgM within 24 hours of admission. Statistical analysis on the detection results and clinical data of the pathogens. Results The total positive rate was 51.20/oo （147/287）. The detection rate of each pathogen was the first 30% （86/287） of influenza virus A, followed by influenza virus Bwas 28.2% （81/287）. The pathogen detection rate of 3-6 age group was 56.3% （54/96） and pathogen mixed infection rate was 40.6 % （39/96）, among which the double infection of influenza virus A combined with influenza virus B was the most common （48.5%;16/33）. According to the month distribution, in August, the highest incidence rate of pathogens, accounting for 80 % （12/15）. According to the pathogen detection results, there were no significant differences between the three groups in clinical characteristics of fever, cough, disease （upper and lower respiratory tract infections）, hospital days and white blood cell count. The positive rate of influenza virus A, influenza virus B and influenza virus 1 in mixed infection was higher than that of single infection （ P ~ 0.05）. Conclusions There is a higher occurrence of infections with two or more respiratory pathogens in children admitted with acute respiratory infections, and influenza A virus is the most common virus detected in coinfections. While infections with two or more respiratory pathogens donrt cause more-severe clinical illness than infections with a single respiratory agent.