ALRTI混合感染及单一感染患儿的病原菌分布及血清PCT、CRP水平分析

Pathogen distribution and serum procalcitonin and C-reactive protein levels in children with acute lower respiratory tract infection of mixed type and single type

目的比较小儿急性下呼吸道感染(ALRTI)混合感染及单一感染的病原菌分布以及降钙素原(PCT)和C反应蛋白(CRP)水平。方法选择佛山市妇幼保健院2019年1~12月收治的516例ALRTI患儿进行研究,根据感染情况不同分为混合感染(A组)220例和单一感染(B组)296例。比较两组患儿的病原菌分布、血清PCT、CRP水平及并发症发生情况。结果两组患儿共分离出细菌427株,A组患儿有细菌283株,B组患儿有细菌144株,其中两组排名前三位的病原菌分别是肺炎链球菌、流感嗜血杆菌、卡他莫拉氏菌,A组患儿的肺炎链球菌、流感嗜血杆菌、卡他莫拉氏菌、金黄色葡萄球菌、肺炎克雷伯杆菌、大肠埃希菌占比略高于B组,但差异无统计学意义(P>0.05);A组患儿的血清PCT、CRP、发热时间和住院时间分别为(1.20±0.33)μg/L、(12.41±2.38)mg/L、(4.28±0.51)d、(15.02±1.25)d,B组分别为(0.75±0.07)μg/L、(7.69±1.20)mg/L、(2.70±0.63)d、(12.59±1.14)d,A组患儿的血清PCT、CRP明显高于B组,发热时间和住院时间明显长于B组,差异均有统计学意义(P<0.05);A组患儿的并发症总发生率为10.00%,明显高于B组的3.38%,差异有统计学意义(P<0.05)。结论ALRTI混合感染及单一感染患儿血清PCT、CRP和病原菌分布存在明显差异,在临床治疗中应根据患儿血清中PCT、CRP水平和病原菌分布特点,合理的选择治疗所需的药物。

Objective To compare the distribution of pathogenic bacteria and the levels of procalcitonin(PCT)and C-reactive protein(CRP)in children with acute lower respiratory tract infection(ALRTI)of mixed type and single type.Methods A total of 516 children with ALRTI admitted to Foshan Women and Children Hospital from January 2019 to December 2019 were selected for the study.According to the infection status,they were divided into mixed infection group(group A,220 cases)and single infection group(group B,296 cases).The distribution of pathogenic bacteria,serum PCT,CRP levels,and the occurrence of complications were compared between the two groups.Results A total of 427 strains of bacteria were isolated from the two groups of children,including 283 strains in group A and 144 strains in group B.The top three pathogenic bacteria in the two groups were Streptococcus pneumoniae,Haemophilus influenza,and Moraxella catarae.The proportion of Streptococcus pneumoniae,Haemophilus influenzae,Moraxella catarae,Staphylococcus aureus,Klebsiella pneumonia,and Escherichia coli in group A was slightly higher than that in group B,but the differences were not statistically significant(P>0.05).The serum PCT,CRP,fever time and hospital stay were(1.20±0.33)μg/L,(12.41±2.38)mg/L,(4.28±0.51)d,(15.02±1.25)d in group A and(0.75±0.07)μg/L,(7.69±1.20)mg/L,(2.70±0.63)d,(12.59±1.14)d in group B;serum PCT and CRP in group A were significantly higher than those in group B,and the fever time and hospital stay were significantly longer than those in group B,with statistically significant difference(P<0.05).The total incidence of complications in group A was 10.00%,which was significantly higher than 3.38%in control group,and the difference was statistically significant(P<0.05).Conclusion There are significant differences in serum PCT,CRP,and pathogen distribution in children with ALRTI of mixed infection and single infection.In clinical treatment,the drugs needed for treatment should be reasonably selected according to the serum PCT and CRP levels in children and the characteristics of pathogen distribution.