福州地区儿童呼吸道感染非典型病原体检测分析

Analysis of Atypical Pathogens in Children with Respiratory Tract Infection in Fuzhou Region

目的分析一年来福州地区儿童呼吸道感染9种常见非典型病原体及流行病学情况、分布特征。方法分学龄前后、季节,方便选取2016年10月—2017年9月来该院就诊(包括门诊、住院)被诊断为呼吸道感染的患儿6010例呼吸道疾病的儿童应用间接荧光方法进行9种非典型病原体(肺炎支原体(MP)、Q热立克次氏体(COX)、肺炎衣原体(CP)、腺病毒(ADV)、呼吸道合胞病毒(RSV)、甲型流感病毒(INFA)、乙型流感病毒(INFB)、副流感病毒(PIV)、嗜肺军团菌(LP))血清IgM抗体联合检测。结果检测6010例患儿标本,9种非典型病原体IgM抗体阳性数1747例,总阳性率29.1%,其中MP的阳性率最高为19.95%,其次为INFB、PIV、RSV,阳性率较低依次为COX、CP、LP。合并感染193例(3.2%),主要以MP合并其它病原体感染,占总合并感染85.0%。>3岁组患儿总阳性率为18.4%,夏季阳性率最高为24.3%,该组MP阳性率为13.0%。0~3岁组患儿总阳性率为58.5%,秋季阳性率最高为73.3%,该组MP阳性率为39.4%,RSV阳性率为8.0%。两组间差异有统计学意义(P<0.05)。结论福州地区儿童呼吸道感染非典型病原体主要是MP,依次为RSV、INFB、PIV;合并感染以MP合并其他病原体为主;0~3岁组患儿感染阳性率较高,同一种病原体在不同季节检测阳性率有所差异,呈明显季节性。

Objective To analyze the epidemiological situation and distribution characteristics of nine common atypical pathogens of respiratory tract infection in children in fuzhou area in one year.Methods Points before and after the school age,season,October 2016-September 2017 to the hospital(including outpatient,hospital)were convenient selected and diagnosed with 6010 children with respiratory diseases of respiratory tract infection of children with indirect fluorescent method for nine kinds of atypical pathogens(mycoplasma pneumoniae(MP)),Q fever rickettsia(COX),chlamydia pneumonia(CP),adenovirus(ADV)and respiratory syncytial virus(RSV),influenza a virus(INFA),b(INFB),parainfluenza virus(PIV),eosinophilic lung legionella bacteria(LP)serum IgM antibody detection.Results Among the 6010 cases of pediatric specimens,there were 1747 cases with positive IgM antibody of nine atypical pathogens,with a total positive rate of 29.1%.Among them,the highest positive rate of MP was 19.95%,followed by INFB,PIV and RSV,and the lower positive rate was COX,CP and LP.193 cases(3.2%)were co-infected,mainly with MP co-infected with other pathogens,accounting for 85.0%of the total co-infected.The total positive rate of>3-year old group was 18.4%,the highest positive rate in summer was 24.3%,and the MP positive rate in this group was 13.0%.The total positive rate of children aged 0-3 years was 58.5%,the highest positive rate was 73.3%in autumn,the MP positive rate was 39.4%,and the RSV positive rate was 8.0%in this group.The difference between the two groups was statistically significant(P<0.05).Conclusion The atypical pathogens of respiratory tract infection in children in fuzhou were MP,RSV,INFB and PIV.MP was mainly associated with other pathogens.The positive rate of infection in the 0-3 year old group was higher,and the positive rate of the same pathogen detected in different seasons was different,showing obvious seasonality.