兰州地区急性呼吸道感染住院患儿病原学分析

Etiological analysis of children with acute respiratory infections in Lanzhou area

目的了解兰州地区急性呼吸道感染住院患儿病原体检出情况,分析呼吸道感染病原体流行病学特征,为预防和诊治提供依据。方法在兰州大学第一医院590例呼吸道感染住院患儿中541例在急性期采血检测呼吸道合胞病毒(RSV)、副流感病毒(PIV)、埃可病毒(ECHOV)、柯萨奇病毒(Cox V)、腺病毒(ADV)、EB病毒(EBV)及肺炎支原体(MP) Ig M抗体。475例患儿进行痰/咽拭子细菌培养。结果各病毒Ig M抗体阳性检出率从高到低依次是RSV(23. 84%)、ADV(18. 30%)、ECHOV(17. 74%)、Cox V(11. 46%)、EBV(9. 98%)、PIV(3. 33%),MP阳性检出率为12. 94%。痰/咽拭子细菌培养阳性率为19. 79%,其中肺炎链球菌、肺炎克雷伯杆菌、金黄色葡萄球菌阳性率居前三位。结论兰州地区儿童急性呼吸道感染病原主要为RSV、ADV、MP以及肺炎链球菌、肺炎克雷伯菌。年龄越小细菌感染概率越大,而幼儿及学龄前儿童以病毒感染更多见。

Objective To evaluate the etiology of acute respiratory infections in children in Lanzhou area, and to analyze the epidemiological characteristics of acute respiratory infections for prevention and treatment. Methods IgM antibodies of RSV, PIV, ECHOV, CoxV, ADV, EBV and MP in blood samples were detected in 541 of 590 hospitalized children during their acute period in the First Affiliated Hospital of Lanzhou University, among whom 475 cases underwent bacterial culture. Results The positive rates of IgM antibodies were as following： RSV（23.84%）, ADV（18.30%）, ECHOV（17.74%）, CoxV（11.46%）, EBV（9.98%）, PIV（3.33%） and MP（12.94%）. The positive rate for sputum/ pharyngeal swab bacterial culture was 19.79%. The top three were streptococcus pneumoniae, klebsiella pneumoniae, and staphylococcus aureus. Conclusion The main pathogens leading to acute respiratory infections in Lanzhou area are RSV, ADV, MP, and streptococcus pneumoniae and klebsiella pneumoniae. The younger the children are, the more likely they are to be infected with bacteria. Viral infections are more common in infants and preschool children.