银川市某医院不同年龄段儿童下呼吸道感染病原检测及分析

Detection and analysis on pathogens of lower respiratory tract infection in children of different ages in Yinchuan

目的分别应用恒温扩增芯片法和痰培养法对银川市儿童细菌性下呼吸道感染病原进行检测,分析比较不同年龄段患儿感染病原差异。方法纳入儿童下呼吸道感染病例515例,按照年龄分为2组,≤3岁为A组,>3岁为B组,于24 h内收集其痰液(含吸取痰)或肺泡灌洗液作为样本,同时采用恒温扩增芯片法和痰培养法进行病原学检测,统计芯片法与培养法的病原体检出情况。结果515例下呼吸道感染病例中,A组阳性193例(56.6%),B组阳性148例(43.4%),A组总阳性检出率高于B组(P<0.05)。A组阳性检出率前5位病原体依次是流感嗜血杆菌、金黄色葡萄球菌、耐甲氧西林葡萄球菌、大肠埃希氏菌及肺炎支原体。B组阳性检出率前5位病原体依次是肺炎链球菌、流感嗜血杆菌、肺炎支原体、金黄色葡萄球菌及耐甲氧西林葡萄球菌,其中A组大肠埃希氏菌阳性检出率高于B组(P<0.05),流感嗜血杆菌、肺炎链球菌和肺炎支原体的阳性检出率则低于B组(P<0.05),A组混合感染阳性检出率低于B组(P<0.05)。结论银川市不同年龄呼吸道感染患儿对细菌易感性及病原谱差异较大。将芯片法与不同年龄段儿童下呼吸道感染病原谱特点相结合,有助于临床快速判断患儿下呼吸道感染病原,有针对性地进行治疗。

Objective To detect the pathogens of bacterial lower respiratory tract infection in children in Yinchuan by constant temperature amplification chip method and sputum culture method respectively,and to analyze and compare the differences in the pathogens of the infections in children of different age groups.Methods 515 cases of lower respiratory tract infection in children in were included and children were divided into two groups according to age,≤3 years old for group A and>3 years old for group B.Their sputum(including suction sputum)or alveolar lavage fluid was collected as samples within 24 hours,and the isothermal amplification chip method and sputum culture method were used for pathogen detection,and the pathogen detection of microchip method and traditional method was counted.Results Among the 515 cases of lower respiratory tract infection,193 cases(56.6%)were in group A and 148 cases(43.4%)in group B,and the overall positive detection rate of group A was significantly higher than that in group B(P<0.05).The top 5 pathogens in the positive detection rate of group A were Haemophilus influenzae,Staphylococcus aureus,methicil lin-res istant Staphylococcus,Escherichia coli and Mycoplasma pneumoniae,and the top five pathogens in group B positive detection rate were Streptococcus pneumoniae,Haemophilus influenzae,Mycoplasma pneumoniae,Staphylococcus aureus and methicillin-resistant Staphylococcus,among which the positive detection rate of Escherichia coli in group A was significantly higher than that in group B(P<0.05),while the positive detection rates of Haemophilus influenzae,Streptococcus pneumoniae and Mycoplasma pneumoniae were significantly lower than those in group B(P<0.05).The positive detection rate of coinfection in group A was significantly lower than that in group B(P<0.05).Conclusion The susceptibility and pathogenic spectrum of children with lower respiratory tract infection of different ages in Yinchuan is varied greatly.The combination of the microchip method with the pathogenic spectrum characteristics of lower respiratory tract infection in children of different ages is helpful for clinical rapid clinical judgment of the pathogens of lower respiratory tract infection in children and targeted treatment.