石家庄地区儿童社区获得性肺炎临床症状、病原学和流行病学分析

Clinical symptoms, etiology and epidemiological analysis of community-acquired pneumonia in children in Shijiazhuang

目的探讨石家庄地区儿童社区获得性肺炎临床症状,病原菌分布和流行病学,为本地区合理使用抗感染治疗提供依据。方法选择1047例确诊为CAP患儿作为研究对象,收集病例信息,取呼吸道分泌物做细菌培养,采用酶联免疫法检测呼吸道病原菌,整理不同病原体感染患儿临床特点,应用SPSS 19.0软件对病原学和流行病学综合分析。结果1047例CAP患儿主要临床症状以中、高热、咳嗽、干咳为主,构成比分别为62.18%、47.18%、37.15%;共检测出641例患儿的病原学类型,统计分析得出:CAP患儿性别间的感染类型分布差异不明显,无统计学意义(P>0.05);支(衣)原体、混合感染性2~5岁、秋季最多,病毒性、细菌性<1岁、冬季最多,年龄、季节间感染类型分布均有统计学意义(P>0.05);不同感染类型CAP患儿构成情况:支(衣)原体、病毒性、细菌性、混合感染性,分别为359、95、77、110例,其中支(衣)原体最多,占比56.01%,细菌感染中肺炎链球菌最多,占比32.47%,细菌感染患儿年龄中1岁以下儿童细菌感染最多59.75%;患儿人群分布:不同感染类型CAP以散居儿童为主,远高于幼托儿童、学生及其他儿童。结论石家庄地区儿童社区获得性肺炎的感染病原学呈多样化,CAP患儿病原菌中,肺炎支原体为常见,细菌培养以肺炎链球菌最为常见,为临床针对性治疗及减少抗菌药物的不合理使用提供依据。

Objective To explore the clinical symptoms,pathogen distribution and epidemiology of children with community-acquired pneumonia in Shijiazhuang,and to provide evidence for rational use of anti-infective treatment in the region.Methods 1047 children with CAP were selected as the research objects.Case information was collected,respiratory secretions were cultured,respiratory pathogens were detected by ELISA,clinical characteristics of children infected with different pathogens were sorted out,and comprehensive analysis of etiology and epidemiology was made by SPSS19.0 software.Results The main clinical symptoms of 1047 children with CAP were moderate to high fever,cough and dry cough,with the constituent ratios of 62.18%,47.18%and 37.15%respectively.A total of 641 children with CAP were detected as etiological types.Statistical analysis showed that there was no significant difference in the distribution of infection types between the sexes of children with CAP(P>0.05).There were significant difference in chlamydia,mixed infectious 2~5 years old,autumn most,viral,bacterial 1-year-old,winter most,age,and seasonal distribution of infection types(P<0.05).The composition of CAP children with different types of infection included chlamydia mycoplasma,viral,bacterial,mixed infectious(359,95,77 respectively).Among 110 cases,chlamydia was the most,accounting for 56.01%.Streptococcus pneumoniae accounted for 32.47%of the bacterial infections.Among the children with bacterial infections,59.75%of the children under the age of 1 were infected with bacteria.Distribution of children with different types of CAP was mainly scattered children,which was much higher than that of children in kindergartens,students and other children.Conclusion The etiology of community acquired pneumonia in children in Shijiazhuang area is diversified.Mycoplasma pneumoniae and Streptococcus are the most common pathogens in CAP children,which can provide basis for clinical targeted treatment and reducing the irrational use of antibiotics.