2559例儿童呼吸道感染病原体分布及流行病学特征调查

Investigation of Pathogen Distribution and Epidemiological Characteristics of Respiratory Tract Infections in 2,559 Children

目的:研究儿童呼吸道感染病原体分布及流行病学特征。方法:选取2023年于河南中医药大学第一附属医院因呼吸道感染住院治疗的患儿2559例,检测病原体类型,分析其分布情况、流行病学特征情况。结果:共收集标本2559例,男性多于女性,年龄0~14(5.74±3.57)岁,阳性检出率为96.83%。共检出病原体5639株,革兰阳性菌958株(16.99%);革兰阴性菌1308株(23.20%);病毒1998株(35.43%);真菌114株(2.02%);支原体、衣原体、立克次体1182株(20.96%),最常见的病原体为肺炎支原体(MP)、流感嗜血杆菌(Hi)、肺炎链球菌(SP)、鼻病毒(RV)、呼吸道合胞病毒(RSV)。2559份标本中检出MP 1182株,不同性别儿童MP检出率比较差异无统计学意义,6~14岁儿童MP检出率最高(P<0.05),在10-12月期间检出率最高(P<0.05)。MP基因23S rRNA区域耐药突变位点主要为A2063G,耐药率达89.85%。结论:儿童呼吸道感染病原体以MP、Hi、SP、RV、RSV为主,不同性别、年龄、发病月份有特异性分布,其中MP耐药基因突变率达到89.85%。呼吸道感染在临床上须尽早诊断,早明确,合理用药,以便控制病情、改善预后。

Objective:To study the distribution and epidemiological characteristics of pathogens in children with respiratory tract infection.Methods:A total of 2,559 children hospitalized for respiratory tract infection in the First Affiliated Hospital of Henan University of Chinese Medicine in 2023 were selected to detect pathogen types and analyze the distribution and epidemiological characteristics.Results:A total of 2,559 specimens were collected,with more males than females,and age of 0 to 14(5.74±3.57)years.The positive detection rate was 96.83%.A total of 5,639 pathogens were detected,including 958 Gram-positive strains(16.99%),1,308 strains(23.20%)of Gram-negative bacteria,1,998 strains of virus(35.43%),114 strains of fungi(2.02%).There were 1,182 strains(20.96%)of Mycoplasma,Chlamydia and Rickettsia.The most common pathogens were Mycoplasma pneumoniae(MP),Haemophilus influenzae(Hi),Streptococcus pneumoniae(SP),rhinovirus(RV),and respiratory syncytial virus(RSV).Totally 1,182 strains of MP was detected in 2,559 specimens,and there was no significant difference in the detection rate of MP among different genders.The detection rate of MP was the highest in children aged from 6 to 14 years(P<0.05),and the highest detection rate was from Oct.to Dec.(P<0.05).The site of drug resistance mutation in the 23S rRNA region of MP gene was mainly A2063G,and the drug resistance rate reached 89.85%.Conclusion:The main pathogens of respiratory tract infections in children are mainly MP,Hi,SP,RV,and RSV,and the specific distribution is different in gender,age and month of onset,with the mutation rate of MP resistance gene reached 89.85%.Respiratory tract infection should be diagnosed as soon as possible,early clarification and rational use of drugs are necessary for controlling the disease and improving the prognosis.