肺炎支原体感染与儿童社区获得性肺炎的相关性分析

The role of Mycoplasma pneumoniae in children with community-acquired pneumonia

目的:探讨肺炎支原体感染与儿童社区获得性肺炎的相关性。方法:回顾性分析苏州大学附属儿童医院2017年1月至2018年12月收治的2367例毛细支气管炎、支气管肺炎、大叶性肺炎和间质性肺炎患儿的病原学检测资料。检测的病原包括肺炎支原体(MP),呼吸道合胞病毒(RSV),腺病毒(Adv),甲型和乙型流感病毒,副流感病毒(PIV)1、2和3,人偏肺病毒(hMPV),博卡病毒(HBoV)和细菌。结果:毛细支气管炎最常见的病原体是RSV(34.9%,249/713),其次是MP(15.8%,113/713)和HBoV(11.9%,85/713)。支气管肺炎的最常见病原体是肺炎链球菌(Sp,14.8%,180/1220),其次是RSV(13.1%,160/1220)和MP(10.2%,124/1220)。大叶性肺炎的最常见病原体是MP(47.8%,141/295),其次是Sp(12.9%,38/295)。间质性肺炎的最常见病原体是MP(35.3%,49/139),其次是RSV(23.0%,32/139)和Adv(6.5%,9/139)。与非MP感染相比,MP感染患儿年龄较大,发热较多,呼吸急促较少,调整后OR(95%CI)值分别为2.4(1.1~3.5)、5.1(3.2~10.4)和0.2(0.0~0.4)。结论:MP是大叶性肺炎和间质性肺炎的最常见病原体,也是毛细支气管炎的第二大常见病因。MP感染通常与年龄、发热呈正相关,和呼吸急促呈负相关。

Objective To explore the role of Mycoplasma pneumoniae(MP)in hospitalized children with community-acquired pneumonia(CAP)in Suzhou.Methods Pathogen data of 2367 patients with bronchiolitis,bronchopneumonia,lobar pneumonia,and interstitial pneumonia were retrospectively analyzed from January 2017 to December 2018 in Children′s Hospital of Soochow University.The detected pathogens were MP,respiratory syncytial virus(RSV),adenovirus(Adv),influenza A,B,parainfluenza virus(PIV)1,2 and 3,human metapneumovirus(hMPV),boca virus(HBoV)and bacteria.Results The most common pathogen of bronchiolitis was RSV(34.9%,249/713),followed by MP(15.8%,113/713)and hMPV(11.4%,85/713).The most common pathogen of bronchial pneumonia was Streptococcus pneumoniae(Sp,14.8%,180/1220),followed by RSV(13.1%,160/1220)and MP(10.2%,124/1220).The most common pathogen of lobar pneumonia was MP(47.8%,141/295),followed by Sp(12.9%,38/295).The most common pathogen of interstitial pneumonia was MP(35.3%,49/139),followed by RSV(23.0%,32/139)and Adv(6.5%,9/139).Compared with non-MP infections,children with MP infections were older,and had higher percentage of fever and less shortness of breath.The adjusted OR(95%CI)was 2.4(1.1-3.5),5.1(3.2-10.4)and 0.2(0.0-0.4),respectively.Conclusions MP is the most common pathogen of lobar pneumonia and interstitial pneumonia and the second most common cause of bronchiolitis.MP infections are usually associated with older age,higher percentage of fever and less shortness of breath.