2015~2018年北京市成人流感病毒性肺炎共感染病原调查

Survey on pathogens of co-infection of influenza virus pneumonia among adults in Beijing from 2015 to 2018

目的分析北京地区2015~2018年流感病毒感染性肺炎的共感染情况,为临床抗生素药物与抗病毒药物的选用提供参考依据。方法从北京市23家医院2015年1月~2018年12月收集的流感病毒(Ⅳ)感染肺炎标本中筛选出114份流感病毒PCR检测阳性标本,其中重症肺炎77例。采用荧光定量PCR法检测呼吸道12种病毒和11种细菌的共感染情况。结果114例流感肺炎患者中,仅检出有Ⅳ感染的共22例(19.3%),其中甲型流感病毒(ⅣA)感染18例(15.8%),乙型流感病毒(ⅣB)感染4例(3.5%)。Ⅳ混合其他病原感染共92例(80.7%),其中与1种病原共感染47例(51.1%),与多种病原共感染45例(48.9%)。Ⅳ与1种病原共感染的47例中,ⅣA和ⅣB共感染情况最多(8.5%);与细菌共感染42例(89.4%),其中与耐甲氧西林金黄色葡萄球菌的感染率最高,其次为肺炎链球菌和铜绿假单胞菌。结论流感病毒性重症肺炎≥80%存在流感病毒与细菌共感染现象,2015~2018年北京地区流感病毒与细菌共感染的细菌病原排序为耐甲氧西林金黄色葡萄球菌>肺炎链球菌>铜绿假单胞菌,其中耐甲氧西林金黄色葡萄球菌是北京市近年来与流感病毒共感染最为普遍的细菌。本研究结果为临床治疗用药筛选提供了可靠依据。

Objective To analyze the co-infection of influenza virus infection pneumonia in Beijing from 2015 to 2018,so as to provide reference for the selection of clinical antibiotics and antiviral drugs.Methods The 114 influenza virus positive samples were screened out from the influenza virus infected pneumonia samples collected from 23 hospitals in Beijing from January 2015 to December 2018,of which 77 were severe pneumonia.Co-infection of 12 viruses and 11 bacteria in the respiratory tract was detected by fluorescence quantitative PCR.Results Of the 114 patients with influenza pneumonia,only 22 cases(19.3%)with influenza virus infection were detected,of which 18 cases(15.8%)were infected with influenza A virus and 4 cases(3.5%)were infected with influenza B virus.A total of 92 cases(80.7%)of influenza virus mixed with other pathogens,including 47 cases(51.1%)co-infected with one pathogen,45 cases(48.9%)co-infected with multiple pathogens Among the cases,influenza A virus and influenza B virus co-infected the most(8.5%);42 cases(89.4%)were co-infected with bacteria,of which the highest infection rate was methicillin-resistant Staphylococcus aureus,followed by pneumonia Streptococcus and Pseudomonas aeruginosa.Conclusion More than 80%of patients with severe viral pneumonia of influenza have co-infection of influenza virus and bacteria.The bacterial pathogens co-infected with influenza virus and bacteria in Beijing area from 2015 to 2018 are methicillin-resistant Staphylococcus aureus>Streptococcus pneumoniae>Verdigris Pseudomonas,among which methicillin-resistant Staphylococcus aureus is the most common bacteria co-infected with influenza virus in Beijing in recent years.The results of this study provide a reliable basis for clinical treatment drug screening.