赣州地区儿童下呼吸道感染病原体分布分析

Distribution Analysis of Pathogens of Lower Respiratory Tract Infections in Children in Ganzhou

目的 了解赣州地区0~14岁儿童下呼吸道感染病原学及流行病学特征。方法 回顾性分析2021年10月至2023年10月广东省人民医院赣州医院儿科收治的383例下呼吸道感染患儿,采用间接荧光免疫法检测患儿血清中呼吸道合胞病毒(RSV)、腺病毒(HAdV)、流感病毒A型(FluA)、流感病毒B型(FluB)、副流感病毒(HPIV)、肺炎支原体(MP)、肺炎衣原体(CP)、嗜肺军团菌(LP)、柯萨奇病毒A型(CoxA)、柯萨奇病毒B型(CoxB)、埃可病毒(ECHO)的IgM抗体,并对检测结果汇总分析。结果 383例下呼吸道感染患儿中阳性检出病例231例,阳性率60.3%,其中主要感染病原体为肺炎支原体;男性患儿和女性患儿比较,各病原检测阳性率差异无统计学意义(P>0.05);各季节中MP阳性检出率均排于首位,但差异无统计学意义(P>0.05),冬季FluA阳性检出率显著高于其他季节(P<0.05),夏冬季LP、FluB阳性检测率显著高于春、秋季(P<0.05)。不同年龄组呼吸道病原总阳性检出率有显著差异(P<0.05),其中学龄前组、学龄组中FluB阳性检出率显著高于婴幼儿组(P<0.05),学龄前组LP阳性检出率显著高于婴幼儿组(P<0.05)。结论 赣州地区下呼吸道感染患儿非典型病原菌MP、LP、CP感染率较高,主要为MP感染,全年易感,而流感病毒具有明显季节、年龄差异,学龄前、学龄儿童较婴幼儿流感病毒易感性高,冬季为高发季节。

Objective To investigate the pathogenetic and epidemiologic characteristics of lower respiratory tract infections in children aged 0-14 years in Ganzhou.Methods 382 children with lower respiratory tract infections admitted to the Department of Pediatrics of our hospital from October 2021 to October 2023 were retrospectively analyzed;indirect fluorescence immunoassay was used to detect respiratory syncytial virus(RSV),adenovirus(HAdV),influenza virus type A(FluA),influenza virus type B(FluB),parainfluenza virus(HPIV),mycoplasma pneumoniae(MP),chlamydia pneumoniae(CP),legionella pneumophila(LP),Coxsackievirus A(CoxA),Coxsackievirus B(CoxB),and Echovirus(ECHO)IgM antibodies;the results of the tests were summarized and analyzed.Results Among the 383 children with lower respiratory tract infections,231 cases(60.3%)were reported positive,in which the main infectious agent was mycoplasma pneumoniae;the difference in the positivity rate of the detection of the various pathogens was not statistically significant when comparing male children and female children(P>0.05);the positive detection rate of MP ranked first in all seasons,but the difference was not statistically significant(P>0.05);the positive detection rate of FluA was significantly higher in winter than in other seasons(P<0.05);the positive detection rate of LP and FluB was significantly higher in summer and winter than in spring and fall(P<0.05).There was a significant difference in the total positive detection rate of respiratory pathogens in different age groups(P<0.05),with the positive detection rate of FluB in the preschool and school-age groups being significantly higher than that of the infant and toddler groups(P<0.05),and the positive detection rate of LP in the preschool group being significantly higher than that of the infant and toddler group(P<0.05).ConclusionThe findings suggest that children with lower respiratory tract infections in Ganzhouhave high rates of infection with atypical pathogens MP,LP,and CP,mainly MP infections,which are susceptible throughout the year,while influenza viruses have obvious seasonal and age differences,with preschool and school-age children having higher susceptibility to influenza viruses than infants and young children,and winter being the high season.