单中心儿童塑型性支气管炎病原学特点及变迁

Etiological characteristics and changes of plastic bronchitis in children in single center

目的探讨深圳市儿童医院2010至2019年儿童塑型性支气管炎(PB)病原学特点及变迁的情况,提高对PB病原学的认识。方法回顾性分析深圳市儿童医院2010年1月至2019年12月确诊为感染相关PB患儿的临床资料,对其病原学特点及变迁进行总结。结果266例感染相关PB患儿病原学分布情况:肺炎支原体94例,流感病毒38例,腺病毒41例,混合感染16例,细菌11例,病原学不明57例。各年龄组PB分布情况:婴儿15例,幼儿和学龄前儿童分别为63例和112例,学龄期儿童76例。婴、幼儿PB病原学以腺病毒为主(60.0%、28.6%),学龄前及学龄期儿童PB病原体以肺炎支原体(34.8%、60.5%)和流感病毒(13.4%、22.4%)为主,差异有统计学意义(P<0.001)。2010至2019年每年病原体阳性检出率分别为62.5%、60.0%、66.7%、74.1%、64.0%、50.0%、93.3%、57.1%、75.0%、84.7%。每年均有肺炎支原体感染引起PB,2016至2019年,肺炎支原体感染引起PB逐年增多,腺病毒感染引起PB呈隔年增多。结论PB病原体以肺炎支原体最常见,其次是腺病毒和流感病毒,细菌、真菌和其他病毒相对少见。PB在婴、幼儿以腺病毒感染为主,在学龄前及学龄期儿童以肺炎支原体和流感病毒感染为主。

Objective To investigate the etiological characteristics and changes of plastic bronchitis(PB)in children from 2010 to 2019 at Shenzhen Children′s Hospital,and provide reference basis for improving the understanding of PB etiology.Methods The clinical data of children diagnosed with infectious-associated PB at Shenzhen Children′s Hospital from Jan 2010 to Dec 2019 were retrospectively analyzed,and the etiological characteristics and changes were summarized.Results There were 94 cases of mycoplasma pneumoniae,38 cases of influenza virus,41 cases of adenovirus,16 cases of mixed infection,11 cases of bacteria,and 57 cases of unclear etiology in 266 infectious-associated PB children.The distribution of PB in each age group:15 cases were infants,63 cases were toddlers,112 cases were preschoolers,and 76 cases were school-age children.Adenovirus was the main pathogen of PB in infants and toddlers(60.0%,28.6%),and mycoplasma pneumoniae(34.8%,60.5%)as well as influenza virus(13.4%,22.4%)were the main pathogen in preschool and school-age children,with statistically significant difference(P<0.001).From 2010 to 2019,the annual positive rates of pathogens were 62.5%,60.0%,66.7%,74.1%,64.0%,50.0%,93.3%,57.1%,75.0%,and 84.7%,respectively.PB was caused by mycoplasma pneumoniae infection every year.From 2016 to 2019,PB caused by mycoplasma pneumoniae infection increased year by year,while PB caused by adenovirus infection increased every other year.Conclusion Mycoplasma pneumoniae was the most common pathogen of PB,followed by adenoviruses and influenza viruses,while bacteria,fungi and other viruses were relatively rare.In the infant group,adenovirus infection was predominant,while in preschool and school-age children group,mycoplasma pneumoniae and influenza virus infection were predominant.