小儿急性呼吸道感染9项病原体的感染情况及其分布特点

Infection and distribution features of nine pathogens of acute respiratory tract infection in children

目的了解小儿急性呼吸道感染9项病原体的感染情况及其分布特点。方法纳入临床诊断为急性呼吸道感染的患儿1 308例,采用间接免疫荧光法检测9种常见呼吸道感染病原体[嗜肺军团菌血清1型、肺炎支原体(MP)、Q热立克次体、肺炎衣原体、腺病毒(ADV)、呼吸道合胞病毒、甲型流感病毒(INFA)、乙型流感病毒(INFB)及副流感病毒(PIV)]的Ig M,分析患儿总体检出情况,不同年龄段、性别、季节病原体的Ig M阳性率,以及混合感染情况。结果 (1)1 308例患者中,病原体Ig M总阳性率为37.46%(490/1 308),其中阳性率最高的病原体为MP,其次为PIV。(2)≥1岁患儿病原体Ig M总阳性率高于<1岁患儿(P<0.05),各年龄段患儿均主要以MP和PIV感染为主,≥1岁患儿的MP-Ig M阳性率高于<1岁患儿(P<0.05)。(3)女性患儿病原体Ig M的总阳性率、混合感染率以及MP-Ig M、PIV-Ig M、INFA-Ig M阳性率均高于男性(均P<0.05)。(4)两种及两种以上病原体Ig M阳性的患儿共159例(12.2%),主要为MP合并其他病原体混合感染,以MP+PIV最常见;≥1岁患儿的病原体混合感染率及MP+PIV的感染率均高于<1岁的患儿(均P<0.05)。(5)病原体Ig M总阳性率在夏季最高,在冬季最低(均P<0.05),其中各季节均以MP、PIV感染为主;在各季节中,MP、ADV、INFA、INFB、PIV的Ig M阳性率均以夏季最高(P<0.05)。结论 MP、PIV是小儿急性呼吸道感染中的常见病原体,不同年龄和性别的患儿病原体的感染率及感染模式不同,且9种病原体的感染率与季节可能有一定的相关性。

Objective To investigate the infection condition and distribution features of nine pathogens of acute respiratory tract infection in children. Methods A total of 1308 children clinically diagnosed as acute respiratory tract infection were enrolled.Indirect immunofluorescence assay was used to detect the IgMs of nine common pathogens of acute respiratory tract infection [including Legionella pneumophila serotype 1, Mycoplasma pneumoniae （MP）,Q fever rickettsia, Chlamydia pneumoniae ,adenovirus（ADV）,respiratory syncytial virus,influenza A virus（INFA）,influenza B virus（INFB） and parainfluenza virus（PIV）].The overall detection result,IgM positive rates of different seasons,the children with different ages and gender,and mixed infection were analyzed. Results （1）In 1 308 children,the total IgM positive rate of pathogen was 37.46%（490/1 308）.The highest positive rate was found in MP followed by PIV.（2）The total IgM positive rate of pathogen in the children aged ≥1 year was higher than that in the children aged 〈1 year（ P 〈0.05）.MP and PIV infection were the most common types in each age group.The MP-IgM positive rate of the children aged ≥1 year was higher than that in the children aged 〈1 year（ P 〈0.05）.（3）The girls obtained higher total IgM positive rate of pathogen,mixed infection rate,the rates of MP-IgM,PIV-IgM and INFA-IgM compared to the boys（all P 〈0.05）.（4）The IgM positive rate of two or more than two pathogens were found in 159 cases（12.2%）.The common type was MP infection complicated with the other pathogens infection,and the type of MP＋PIV was the most common.The mixed infection rate and infection rate of MP＋PIV in the children aged≥1 year were higher than those in the children aged 〈1 year（all P 〈0.05）.（5）The highest total IgM positive rate of pathogen was observed in summer and the lowest in winter（all P 〈0.05）.MP and PIV infection were the common types in four seasons.In each season,the highest IgM positive rates of MP,ADV,INFA,INFB and PIV were observed in summer（ P 〈0.05）. Conclusion MP and PIV are the common pathogens causing acute respiratory infection in children.The infection rate and infection pattern of pathogens are different in the children with different ages or genders.The infection rates of nine pathogens are probably related to the season.