广州市南沙区儿童社区获得性肺炎病原调查及临床特点分析

Pathogenic investigation and clinical characteristics of community acquired pneumonia for children in Nansha district of Guangzhou

目的调查广州市南沙区社区获得性肺炎(CAP)患儿的病原体构成情况及临床特点,为临床诊治工作提供参考。方法 207例住院CAP患儿,采用细菌培养、直接免疫荧光法检测7种呼吸道病毒、酶联免疫吸附实验(ELISA)检测血清肺炎支原体和肺炎衣原体,分析患儿的临床特点。结果 207例CAP患儿,病原总检出率为84.1%(174/207)。其中细菌、病毒、肺炎支原体和肺炎衣原体阳性率分别为29.5%(61/207)、20.3%(42/207)、28.5%(59/207)和5.8%(12/207)。病原混合感染24.6%(51/207);呼吸道合胞病毒(RSV)感染57.1%(24/42)。细菌、病毒和肺炎衣原体各年龄段检出率比较差异无统计学意义(P>0.05)。肺炎支原体在4~6岁年龄段检出率高于其他年龄段,差异有统计学意义(χ~2=11.711,P=0.008<0.05)。各病原体在不同季度检出率比较差异无统计学意义(P>0.05)。不同病原体感染病例的临床特点有所不同。结论广州市南沙区CAP患儿病原体主要是金黄色葡萄球菌、RSV和肺炎支原体。病原体的检出与季节和年龄无关;不同病原体感染的患儿,主要的临床特点各有侧重。

Objective To investigate composition and clinical characteristics of pathogens of community acquired pneumonia （CAP） for children in Nansha district of Guangzhou, so as to provide reference for clinical diagnosis. Methods Serum Mycoplasma pneumoniae and Chlamydia pneumoniae in 207 hospitalized CAP children were detected by bacteria culture, direct immunofluorescence testing of 7 kinds of respiratory virus, enzyme-linked immunosorbent assay （ELISA）, and their clinical characteristics were analyzed. Results The total pathogen detection rate was 84.1% （174/207） in 207 CAP children, with positive rates of bacteria, virus, Mycoplasma pneumoniae and Chlamydia pneumoniae respectively as 29.5% （61/207）, 20.3% （42/207）, 28.5% （59/207） and 5.8% （12/207）. Pathogen mixed infection was 24.6% （51/207）, and respiratory syncytial virus （RSV） infection was 57.1% （24/42）. There were no statistically significant difference in detection rate of bacteria, virus and Chlamydia pneumoniae in all age groups （P〉 0.05）. The detection rate of Mycoplasma pneumoniae in 4-6 years old group was higher than that of other age groups, and the difference was statistically significant （X 2= 11.711, P=0.008〈0.05）. There were no significant difference in the detection rates of pathogens in different seasons （P〉0.05）. The clinical characteristics of different pathogens were different. Conclusion The pathogens of CAP in Nansha District of Guangzhou are mainly Staphylococcus aureus, RSV and mycoplasma pneumoniae, and the detection of pathogens has nothing to do with season and age. The main clinical characteristics are focused for different pathogens infected children.