血液培养联合血液微生物抗体检测在社区获得性肺炎住院儿童诊断中的应用分析

Application of blood culture combined with blood microbial antibody detection in diagnosis of hospitalized children with community-acquired pneumonia

目的研究血液培养联合血液微生物抗体检测在社区获得性肺炎住院儿童诊断中的应用。方法选择2017年1月-2017年12月在本院儿科治疗的确诊为社区获得性肺炎(community-acquired pneumonia,CAP)的患儿298例。采用自行设计的调查表研究患者基本资料,血液培养联合血液微生物抗体检测患儿血液中致病微生物分布情况。结果 200例CAP患儿检出阳性结果,其中呼吸道微生物IgM抗体检测阳性145例,血培养细菌检测阳性55例。呼吸道微生物IgM抗体检测阳性结果中,支原体(19.46%)是最常见的病原体,其次为乙型流感病毒(16.44%),再次是副流感病毒(6.38%)、腺病毒(5.70%)、甲型流感病毒(0.67%),未检出衣原体。血培养阳性结果中,流感嗜血杆菌(5.36%)是最常见的病原体,其次为肺炎链球菌(5.03%),再次是克雷伯杆菌(3.02%)、大肠埃希菌(1.68%)、鲍曼不动杆菌(1.01%)。不同年龄组患儿病原微生物检出情况显示29天~1岁患儿支原体、乙型流感病毒、副流感病毒、腺病毒检出率明显大于1~3岁、4~6岁、7~14岁患儿,1~3岁患儿支原体、乙型流感病毒检出率明显大于4~6岁、7~14岁患儿。结论本地区CAP患儿的最常见病原体是支原体,检出率为19.46%,而且病毒和支原体感染率呈现低龄化趋势。

Objective To discuss the application of blood culture combined with blood microbial antibody detection in the diagnosis of hospitalized children with community-acquired pneumonia.Methods Two hundred and ninety-eight children with pediatric CAP diagnosed during pediatric treatment in our hospital from January 2017 to December 2017 were enrolled.A self-designed questionnaire was used to collect the basic data of patients.Blood culture combined with blood microbial antibodies was used to detect the distribution of pathogenic microorganisms in the blood of the children.Results Positive results were seen in 200 children with CAP,of which 145 were positive for respiratory IgM antibodies and 55 were positive for blood cultures.Among the positive results of respiratory bacterium IgM antibody detection,mycoplasma（19.46%）was the most common pathogen detected,followed by influenza B virus（16.44%）,then parainfluenza virus（6.38%）,adenovirus（5.70%）and influenza A virus（0.67%）;chlamydia was not found.Among the positive blood culture results,Haemophilus influenzae（5.36%）was the most common pathogen detected,followed by S.pneumoniae（5.03%）,Klebsiella spp.（3.02%）,E.coli（1.68%）and Acinetobacter baumannii（1.01%）.The detection rates of mycoplasma,influenza B virus,parainfluenza virus and adenovirus in patients at age of 29 days to 1 year old were significantly higher than in those at age of 1 to 3 years old,4 to 6 years old,and 7 to 14 years old,respectively.The detection rates of mycoplasma and influenza B in children at age of 1 to 3 years old were significantly higher than in those at of 4 to 6 years old and 7 to 14 years old,respectively.Conclusion The most common pathogen in children with CAP in this region is mycoplasma,with a detection rate of 19.46%,and the incidence rate of virus and Mycoplasma infections show a low-age trend.