5岁以下呼吸道感染住院患儿痰标本的细菌与病毒病原学

Etiology and Distribution of Respiratory Tract Infections in In-patients of Children Below 5 Years Old

目的 了解 5岁以下呼吸道感染住院患儿疾病种类及其病原学 ,探讨其影响因素。方法 无菌负压吸引法采集 5岁以下呼吸道感染住院患儿新鲜痰液 ,细菌培养检测细菌 ,直接免疫荧光法检测病毒 ,同时相应地对每一位患儿作问卷调查。结果 999例患儿中 83.0 %为肺炎病例 ,其次为上呼吸道感染、哮喘合并感染、支气管炎。不同性别、年龄、家庭背景、季节疾病种类分布不同。 999例痰标本中 ,细菌、病毒总检出率为 39.3% ,其中单纯病毒检出率 16 .5 % ,单纯细菌检出率 18.1% ,细菌病毒合并感染检出率 4 .6 % ,细菌病毒合并感染中病毒以呼吸道合胞病毒为主 (87.0 % ) ,细菌则以嗜血杆菌 (74 .0 )和肺炎链球菌 (15 .2 % )为主。多因素分析表明 ,季节、抗生素应用情况及疾病种类分布对病毒检出率有影响 ,不同季节、地区、年龄的患儿细菌检出率不同。结论 婴幼儿呼吸道感染疾病及其痰标本细菌、病毒病原学分布存在人群、地区和季节的差异 ,应加强对其监测 。

Purpose: To understand the distribution and etiology of respiratory infections and know their influencing factors in children below 5 years old. Methods: Bacteria and virus were tested using sputum culture and direct immunofluoresence respectively. Accordingly, each case was investigated by the same questionnaire. Results: Among 999 cases, pneumoniae was the most common disease (83%), followed by upper respiratory infection, asthma and bronchitis. The distribution of illness in sex, age, living background and season were different. Among 999 samples, evidence of specific microbial etiology was obtained in 392 cases (39.3%). Bacterial infection was foumd in 181 cases (18.1%), viral infection in 165 cases (16.5%), compound infection with virus and bacteria in 46 cases (4.6%). Factors influencing the bacterial and viral infection incidence were season, area, age and previous antibiotic use, season, disease distribution respectively. Conclusions: The distribution and etiology of respiratiory infections were different in demography, geography and season, surveillance should be strengthened.