支气管异物并下呼吸道感染患儿病原菌多重PCR检测结果分析

MULTIPLE POLYMERASE CHAIN REACTION DETECTION RESULTS OF PATHOGENIC BACTERIA IN CHILDREN WITH BRONCHIAL FOREIGN BODY AND LOWER RESPIRATORY TRACT INFECTION

目的探讨支气管异物并下呼吸道感染患儿病原菌感染特点,以及多重聚合酶链反应(PCR)检测在下呼吸道病原菌感染诊断中的应用价值。方法采用纤维支气管镜获取78例支气管异物并下呼吸道感染患儿的下呼吸道分泌物标本,分别进行分离培养和多重PCR检测患儿病原菌感染情况。结果78例患儿下呼吸道分泌物标本中分离培养检出金黄色葡萄球菌10株,肺炎克雷伯菌6株,成团泛菌3株,病原菌检出率为24.3%;多重PCR检测结果为流感嗜血杆菌39株,肺炎链球菌24株,金黄色葡萄球菌15株,肺炎克雷伯菌7株,其中3例同时检出3种病原菌,2例同时检出2种病原菌,病原菌检出率为96.2%;两种方法病原菌检出率比较差异具有显著性(χ^2=6.218,P<0.05)。结论支气管异物患儿并下呼吸道感染时,流感嗜血杆菌与肺炎链球菌是主要的致病菌,且存在混合感染的现象;支气管异物并下呼吸道感染患儿病原菌检测时,多重PCR检测优于分离培养。

Objective To investigate the characteristics of the infection with pathogenic bacteria in children with bronc-hial foreign body and lower respiratory tract infection,as well as the value of multiple polymerase chain reaction(PCR)in the diagnosis of lower respiratory tract infection.Methods A fiber bronchoscope was used to obtain the samples of lower respiratory tract secretions from 78 children with bronchial foreign body and lower respiratory tract infection,and isolation and culture and multiple PCR were used to observe the infection of pathogenic bacteria in children.Results A total of 10 strains of Staphylococcus aureus,6 strains of Klebsiella pneumoniae,and 3 strains of Pantoea agglomerans were isolated and cultured from the samples of lower respiratory tract secretions of 78 children,with a detection rate of pathogenic bacteria of 24.3%.Multiple PCR found 39 strains of Haemophilus influenzae,24 strains of Streptococcus pneumoniae,15 strains of Staphylococcus aureus,and 7 strains of Klebsiella pneumonia;3 children were found to have 3 pathogenic bacteria at the same time,and 2 children were found to have 2 pathogenic bacteria at the same time,with a detection rate of pathogenic bacteria of 96.2%.There was a significant difference in the detection rate of pathogenic bacteria between these two methods(χ^2=6.218,P<0.05).Conclusion Haemophilus influenzae and Streptococcus pneumoniae are main pathogenic bacteria in children with bronchial foreign body and lower respiratory tract infection,and mixed infection may also exist.Multiple PCR is better than isolation and culture in the detection of pathogenic bacteria in children with bronchial foreign body and lower respiratory tract infection.