989例儿童肺炎支原体感染的临床特征分析

Clinical Characteristics of 989 Cases of Mycoplasma Pneumoniae in Children with Lower Respiratory Tract Infections

目的探讨儿童肺炎支原体(mycoplasma pneumoniae,MP)感染的临床特征。方法从2018年1月至2020年1月在银川市妇幼保健院因下呼吸道感染首次住院治疗的989例患儿中筛选出198例MP感染的患儿,采集患儿静脉血,用被动凝集法检测支原体的感染情况。从季节、年龄、性别及临床症状和实验室指标等多方面对MP感染的患儿进行分析。结果989例标本中MP占198例,检出率为20.0%;198例MP阳性标本中,MP混合病毒的感染率最高(66.2%)。秋、冬季MP感染的检出率高于其他季节(P<0.01)。MP感染多见于6岁以上的患儿。在与MP混合感染的病原体中以人呼吸道合胞病毒(RSV)、人鼻病毒(HRV)、副流感病毒3型(PIV3)、肺炎克雷伯杆菌、肺炎链球菌、金黄色葡萄球菌多见。与非MP感染组比,MP单独感染组患儿中性粒细胞百分比升高,血清降钙素原含量降低(P均<0.05)。结论MP是儿童下呼吸道感染的主要病原体之一,MP感染多发生于秋、冬季和6岁以上患儿,与病毒混合感染最多见,中性粒细胞百分比、血清降钙素原、C-反应蛋白可以作为MP感染的辅助指标。

Objective To investigate the epidemiological and clinical characteristics of mycoplasma pneumoniae(MP)infections in children.Methods From 989 children who were first hospitalized for lower respiratory tract infection in Yinchuan Maternal and Child Health Hospital from January 2018 to January 2020,198 children with MP infection were screened,and their venous blood was collected and tested for mycoplasma pneumoniae infection by passive agglutination method.Children with MP infection were analyzed in terms of season,age,gender,and clinical symptoms and laboratory indices.Results MP accounted for 198 out of 989 specimens,with a detection rate of 20.0%;among the 198 MP-positive specimens,the infection rate of MP mixed virus was the highest(66.2%).The detection rate of MP infection was higher in autumn and winter than in other seasons(P<0.01).MP infection was mostly seen in children over 6 years of age.Among the pathogens that were mixed with MP,human respiratory syncytial virus(RSV),human rhinovirus(HRV),parainfluenza virus type 3(PIV3),Klebsiella pneumoniae,Streptococcus pneumoniae and Staphylococcus aureus were the most common pathogens.Compared with the non-MP-infected group,the MP alone group had a higher percentage of neutrophils and a lower serum calcitoninogen level(P all<0.05).Conclusion MP is one of the main pathogens of lower respiratory tract infections in children.MP infections occur mostly in autumn and winter and in children over 6 years of age,and mixed infections with viruses are most common.Neutrophil percentage,serum calcitoninogen,and C-reactive protein can be used as auxiliary indicators of MP infections.