揭阳市近6年儿童病毒性肺炎混合感染的病原学分析

Etiological Analysis of Viral Pneumonia Mixed Infection in Child near Six Years inJieyang City

目的:总结揭阳市近6年儿童病毒性肺炎(VP)的呼吸道病毒流行病学特征及混合感染的发生率、主要类型和病原体构成,为临床诊治病毒性肺炎提供一定的指导方向。方法:回顾性分析揭阳市人民医院2017年3月-2022年3月病毒性肺炎患儿的7种常见呼吸道病毒即呼吸道合胞病毒(RSV)、腺病毒(ADV)、流感A病毒(INF-A)、流感B病毒(INF-B)、副流感1型病毒(PIV-1)、副流感2型病毒(PIV-2)和副流感3型病毒(PIV-3)的抗原检测结果,检测方法为直接免疫荧光法检测鼻咽拭子标本。检索患儿肺炎支原体(MP)、肺炎衣原体(CP)核酸检测结果和呼吸道标本的细菌培养结果。结果:2736例病毒性肺炎主要由RSV、PIV-3感染引起。单一病毒感染占66.5%,混合感染占33.5%。两组性别、好发年龄段均无明显差异(P均>0.05),而发病季节分布有明显差异(P<0.05),单一感染组发病主要集中于4-12月(82.35%),混合感染组发病主要集中于1-9月(82.23%)。混合感染的主要类型是病毒-细菌的双重感染,以RSV合并肺炎链球菌、流感嗜血杆菌为主。结论:揭阳地区的儿童病毒性肺炎主要是由RSV和PIV-3感染引起,混合感染约占三分之一,在临床诊疗过程中要合理联合用药,以提高疗效。

Objective:To summarize the epidemiological characteristics of respiratory viruses,the incidence of mixed infection,the main type and the pathogen composition of mixed infection in children with viral pneumonia near Six years in Jieyang City,and to provide certain guidance for the clinical diagnosis and treatment of viral pneumonia.Meth⁃ods:The antigen detection results of the seven common respiratory virus,included respiratory syncytial virus(RSV),ade⁃novirus(ADV),influenza A virus(INF⁃A),influenza B virus(INF⁃B),parainfluenza virus type 1(PIV⁃1),parainfluen⁃za virus type 2(PIV⁃2)and parainfluenza virus type 3(PIV⁃3)were analyzed retrospectively from Mar 2017 to Mar 2022 in Jieyang Peoples Hospital in children with viral pneumonia.Nasopharyngeal swab specimens were detected used direct immunofluorescence.Then retrieve the nucleic acid test results of Mycoplasma pneumoniae(MP),Chlamydia pneumoniae(CP)and the bacterial clutured result of respiratory specimen.Results:2736 cases of viral pneumonia were mainly caused by RSV and PIV⁃3 infection.There was no difference in mixed infection rates between different viruses.The children with single virus infection accounted for 66.5%,while the mixed infection accounted for 33.5%.There were no significant dif⁃ference in gender and age of common infection between the two groups(P>0.05),but there were significant difference in seasonal distribution between the two groups(P<0.05).The incidence of the single infection group was maily concenttract⁃ed from Apr to Dec(82.35%),while the incidence of the mixed infecction group was maily concentrated from Jan to Sep(82.23%).The main type of mixed infection was viral and bacterial double infection,mainly respiratory syncytial virus combined with Streptococcus pneumoniae or Haemophilus influenzae.Conclusion:The viral pneumonia in Jieyang region is mainly caused by RSV and PIV⁃3 infection,and mixed infection accounted for one⁃third of the total.Therefore,it should pay attention to the combined usage of drugs to improve the curative effect.