1934例呼吸道感染患者9种呼吸道病原体特征分析

Analysis of 9 Respiratory Pathogens in 1934 Patients with Respiratory Tract Infection

目的了解呼吸道非典型病原体的感染特点,为临床合理用药提供理论依据。方法收集2016-01/2017-12月在作者医院就诊的疑似呼吸道感染1934例患者血清,采用间接免疫荧光技术对9种呼吸道病原体进行测定。结果 951例(49.17%)阳性血清被检出。感染模式主要以单一病原体感染为主,阳性率为36.09%(698/1934),以肺炎支原体(M. pneumoniae,MP)感染居多,阳性率为39.76%(769/1934),其他混合感染的阳性率为13.09%(253/1934)。MP在1～18岁儿童及青少年中阳性率高于19～59岁成年人患者(P<0.05)。19～59岁成年人患者中以嗜肺军团菌血清1型(legionella pneumophila serogroup 1,LP1)感染为主,其阳性率为3.53%(19/539),与1～18岁年龄段患者和≥60岁老年患者相比,差异均有统计学意义(P均<0.05)。MP、呼吸道合胞病毒(respiratory syncytial virus,RSV)、乙型流感病毒(influenza virus type B,IVB)在夏季中的阳性率分别为47.36%、4.09%、15.87%,Q热立克次体(Q fever Rickettsia,COX)、肺炎衣原体(chlamydia pneumoniae,CP)和RSV秋季的阳性率分别为6.57%、2.08%、3.21%,均高于其他季节(P均<0.05)。副流感病毒1、2、3型(parainfluenza virus type 1, 2 and 3,PIV-1、2、3)好发于秋季,而LP1好发于冬季。结论通过对呼吸道病原体九联检检测,发现该地呼吸道感染病原体以MP,PIV-1、2、3和IVB为主。

Objective To understand the infection characteristics of atypical pathogens in the respiratory tract,and provide a theoretical basis for clinical rational drug use.Methods The serum samples from 1934 patients with suspected respiratory infections in author’s hospital from January 2016 to December 2017 were collected,and 9 respiratory pathogens were measured by indirect immunofluorescence.Results A total of 951(49.17%) serum samples were found to be positive.The infection pattern was mainly caused by single pathogen infection, the positive rate was 36.09%(698/1934),the infection was mostly caused by M. pneumoniae(MP),the positive rate was 39.76%(769/1934), and the positive rate of other mixed infections was 13.09%(253/1934).The positive rate of MP in children and adolescents aged 1-18 years was higher than that of adults aged 19-59 years(P<0.05). Adults aged 19-59 years were mainly infected with legionella pneumophila serogroup 1(LP1),with a positive rate of 3.53%(19/539),which was significantly different compared with patients aged 1-18 years and older patients aged ≥60 years(all P<0.05).The positive rates of MP, respiratory syncytial virus(RSV) and influenza virus type B(IVB) in summer were 47.36%, 4.09% and 15.87%,respectively,the positive rates of Q fever Rickettsia(COX),chlamydia pneumoniae(CP) and RSV in autumn were 6.57%,2.08% and 3.21%, respectively, which were higher than those in other seasons(all P<0.05). Parainfluenza virus type 1, 2 and 3(PIV-1, 2, 3) were more common in autumn, while LP1 was more common in winter.Conclusion Through the joint detection of 9 respiratory pathogens,it is found that MP, PIV-1, 2, 3 and IVB are the mainly pathogens of respiratory tract infections in this area.