749例社区获得性肺炎儿童的病原体分布特点

Pathogenic distribution with 749 hospitalized children with community acquired pneumonia

目的探讨南充地区儿童社区获得性肺炎(CAP)的病原学分布特点。方法选取2017年1月～12月于南充市中心医院儿科病房住院的749例CAP患儿,根据年龄分为婴儿组(319例)、幼儿组(217例)、学龄前组(154例)、学龄组(59例),回顾性分析患儿咽深部呼吸道分泌物的细菌培养和呼吸道11种病原体IgM抗体血清学检测结果。结果 749例患儿中,310例检出细菌阳性,阳性率41.39%,其中肺炎链球菌82株(26.45%),大肠埃希菌63株(20.32%),流感嗜血杆菌39株(12.58%); 220例检出病毒阳性,阳性率为29.37%,其中IVB208株(65.00%),IVA41株(12.81%),PIV39株(12.19%);102例检出非典型肺炎病原阳性,阳性率13.62%,其中MP74株(62.18%),CP30株(25.21%),LP15株(12.60%);混合病原体检出阳性者有177例,阳性率15.62%,其中细菌、病毒混合感染60例(33.90%),细菌、非典型肺炎病原体混合感染56例(31.64%),病毒混合感染30例(16.95%)。结论肺炎链球菌是南充地区CAP住院患儿的首要细菌病原,IVB是首要病毒病原,MP是首要非典型肺炎病原,混合感染以细菌、病毒混合感染为主。

Objective To investigate the distribution of pathogens of children with community acquired pneumonia (CAP) in Nanchong area.Methods Pathogens results of 749 children with CAP in Nanchong central hospital were retrospectively analyzed.These results include bacterial culture obtained from patients' lower respiratory tract secretions and the IgM antibodies' results of 11 kinds of respiratory pathogen.Results The overall positive rate of bacteria was 41.39%(310cases),including Streptococcus pneumonia (82 strains,26.45%),Escherichia coli (63 strains,20.32%) and Haemophilus influenza (39 strains,12.58%).The viral positive rate was 29.37%(220 cases),including 208 IVB strains (65.00%),41 IVA strains (12.81%),39 PIV strains (12.19%) and 29 RSV strains (9.06%).The all of atypical pathogens positive rate was 13.62%(102 cases),including 73 MP strains (62.18%),30 CP strains (25.21%) and 15 LP strains (12.60%).The mixed infection rate was 15.62%(177 cases).The mixed infections of bacteria and viruses were 60 cases (33.90%).Bacteria and atypical pathogen were 56 cases (31.64%),viral and viral were 30 cases(16.95%).Conclusion Streptococcus pneumonia was the primary pathogen in CAP bacterial infection.IVB was the primary pathogen for CAP viral infection.MP was the primary pathogen for CAP atypical pathogens infection.The compounded infection of bacteria and viruses was prevalent.