龙华新区儿童社区获得性肺炎的病原学调查

Study of etiology of children's community-acquired pneumonia in Longhua new district

目的:分析龙华新区儿童社区获得性肺炎(CAP)的病原学分布情况,为临床合理抗感染治疗提供参考。方法:选取2013年6月~2015年12月在深圳龙华新区三大公立医院就诊的450例CAP患儿为研究对象,于入院后6 h内抗感染治疗前用无菌吸痰器采集呼吸道分泌物进行细菌培养、肺炎支原体和沙眼衣原体、鼻咽分泌物病毒检测。结果:450例CAP患儿中的病原学检测阳性393例(87.33%);393例病原学检测阳性CAP患儿细菌感染检出147例(37.4%),其中单一细菌感染中肺炎链球菌感染率显著高于其他类型的细菌感染(P<0.05);393例病原学检测阳性CAP患儿病毒感染检出163例(41.5%),其中呼吸道合胞病毒和腺病毒感染率明显高于其余病毒感染;≤3 CAP岁患儿单一细菌感染、单一病毒感染、细菌+病毒感染、2种病毒感染比率均明显高于>3岁患儿(P<0.05),>3岁CAP患儿单一非典型病原体感染、细菌+非典型病原体感染、2种非典型病原体感染率明显高于≤3岁患儿(P<0.05)。结论:细菌、病毒、非典型病原体是龙华新区儿童CAP的主要病原体,3岁以上CAP儿童病原以非典型病原体为主。

Objective： To analyze the etiology of community acquired pneumonia in Longhua new district,and to provide reference for rational clinical anti-infection treatment. Methods： 450 cases children with CAP in three public hospitals in shenzhen longhua new district from June 2013 to December 2015 were studied. 6 h after admission and prio anti-infection treatment, respiratory secretions were collected and cultured, mycoplasma pneumoniae,chlamydia trachomatis,nasopharyngeal secretions virus were detected. Results： 393 cases were detected to have positive pathogens in 450 cases of children with CAP（ 87. 33%）; 147 cases of bacterial infection among 393 cases（ 37. 4%） had single pathogenic bacterial infection,Streptococcus pneumoniae infection rate was significantly higher than that of other types（ P〈0. 05）; 163 case（ 41. 5%） had respiratory syncytial virus and adenovirus infection,the rates were significantly higher than those of other viral infections. Those younger than 3 years old with single bacterial infection,a single virus infection,bacteria and virus infection,2 virus infection were more frequently seen among those older than 3 years（ P〈0. 05）; those older than 3 years with single atypical pathogens,bacteria plus atypical pathogens,2 atypical pathogens infection were found more frequently than those younger than 3 years old children（ P〈0. 05）. Conclusion： Bacteria,viruses and atypical pathogens were the main pathogens for CAP children in longhua new district. CAP children older than 3 years primarily have atypical pathogens.