北苑地区儿童冬春季社区获得性肺炎非细菌性病原体流行病学分析

An Epidemiological Analysis of Non-bacterial Pathogens of Community-Acquired Pneumonia Among Children from Beiyuan Area in Winter and Spring

目的儿童冬春季社区获得性肺炎是常见病,通过对北京朝阳区北苑地区儿童社区获得性肺炎非细菌性病原体统计研究,为进一步规范诊疗提供参考,提高临床救治率。方法收集北苑地区2018年11月1日至2019年4月30日期间有社区获得性肺炎临床表现(发热、咳嗽)的门、急诊确诊患儿病例,统计分析血常规及咽拭子的检查结果,探讨儿童冬春季非细菌性病原体感染所致社区获得性肺炎流行病特征以及病原与血常规、C反应蛋白的关系,优化儿科感染患儿诊治的规范。结果2018年11月1日至2019年4月30日期间11月、12月为非细菌性病原体感染所致社区获得性肺炎高发期,占总确诊人数的71.68%;≤1岁婴儿感染人数最多,7岁以内学龄前儿童占87.34%;感染人数最多的为肺炎支原体和呼吸道合胞病毒,占比分别为55.16%和32.42%。确诊患儿白细胞升高比例为23.35%,中性粒细胞百分比增高比例为9.57%,C反应蛋白增高比例为23.60%,三项指标同时增高比例为2.98%。结论北京北苑地区儿童冬春季非细菌性病原体感染所致社区获得性肺炎儿童以学龄前儿童居多,病原以肺炎支原体、呼吸道合胞病毒为主,且多数确诊感染患儿血常规白细胞,中性粒细胞、C反应蛋白不升高,应根据流行病学特点重视学龄前社区获得性肺炎儿童的诊疗,尤其应重视血象不高但有临床表现的患儿,同时应考虑混合感染的情况,避免诊疗不全面。

Objective Community acquired pneumonia(CAP)is a common disease in children in winter and spring.To investigate non-bacterial pathogens of community-acquired pneumonia in Beiyuan District,Chaoyang District,Beijing,this paper aims to provide a reference for future standardized diagnosis and treatment and to improve the clinical treatment rate.Methods The objective of the current study is to investigate the epidemiological characteristics of community-acquired pneumonia caused by non-bacterial pathogens in winter and spring,and the relationship between pathogens and blood routine and C-reactive protein,so as to standardize the diagnosis and treatment of pediatric infections.Results From November 1,2018 to April 30,2019,November and December were identifies as the high incidence periods of community-acquired pneumonia caused by non-bacterial pathogens,accounting for 71.68%of the total number of confirmed cases.0-1-year-old infants were the most infected population,accounting for 87.34%of preschool children under 7 years old.Mycoplasma pneumoniae and respiratory syncytial virus were the most infected pathogens,accounting for 55.16%and 32.42%respectively.Among infected children,the individual-increase of blood routine leukocytes,neutrophils or C-reactive protein were 35%,9.57%,and 23.60%,respectively,and all-three-increase was 2.98%.Conclusion The majority of children with community-acquired pneumonia caused by non-bacterial pathogens in winter and spring in Beiyuan District are preschool children.The main pathogens are Mycoplasma pneumoniae and respiratory syncytial virus.Most of the children with confirmed infection do not have elevated blood routine leukocytes,neutrophils and C-reactive proteins.We should pay attention to the prevention and treatment of preschool children with community-acquired pneumonia according to the epidemiological characteristics.In order to avoid potential incomplete diagnosis and treatment,we should pay special attention to the children with low blood count but with clinical manifestations,and consider the situation of mixed infections.