清远市儿童社区获得性肺炎病原体分布及临床特点分析

Distribution and clinical characteristics of pathogens in children with community acquired pneumonia in Qingyuan city

目的探讨清远市儿童社区获得性肺炎(CAP)的病原体分布并分析其临床特点。方法选取2017年8月~2018年8月我院收治的清远市1000例CAP患儿作为研究对象。根据患儿年龄结构组成,将所有入选患儿分为婴儿组(770例)、幼儿组(140例)、学龄前期组(68例)、学龄期组(22例)。采集所有患儿气道深部痰液及咽峡部脱落细胞,并且收集不同季节的样本。分析检测所有的样本,比较不同年龄组及不同季节的样本情况。结果所有患儿检出80.2%为阳性病原体,检出病原体共1244株。婴儿组的病毒、细菌、真菌、CT感染率显著高于其他各组,差异有统计学意义(P<0.05)。学龄前期组的肺炎支原体感染率明显高于其他各组,差异有统计学意义(P<0.05)。冬季的病毒、沙眼衣原体感染率显著高于其他季节,差异有统计学意义(P<0.05)。结论清远市CAP患儿检出数量最多的是革兰阴性菌等细菌,病毒多是呼吸道合胞病毒,且肺炎支原体感染有向低年龄段发展的趋势。

Objective To investigate the pathogen distribution and clinical characteristics of children with community-acquired pneumonia (CAP) in Qingyuan. Methods A total of 1000 cases of children with CAP in Qingyuan City from August 2017 to August 2018 were selected as the study subjects. All the children were divided into infant group (770 cases),infant group (140 cases),pre-school group (68 cases),school age group (22 cases) according to the age structure of the children. Sputum and exfoliated cells from the isthmus of the pharynx were collected from the deep airway of all children,and samples from different seasons were also collected. All samples were analyzed and tested,and the samples of different age groups and different seasons were compared. Results All the children were found to be 80.2% of positive pathogens,and 1244 strains were detected. The infection rates of viruses,bacteria,fungi and CT in infant group were significantly higher than those in other groups,the differences were statistically significant (P<0.05). The infection rate of Mycoplasma pneumoniae in pre-school age group was significantly higher than that in each group,the difference was statistically significant (P<0.05). The infection rates of viruses and Chlamydia trachomatis in winter were significantly higher than those in other seasons,the differences were statistically significant (P<0.05). Conclusion Gram-negative bacteria and other bacteria were the most detected in CAP children in Qingyuan City. Respiratory syncytial virus was the most common virus,and mycoplasma pneumoniae infection tended to develop to the younger age group.