急性肺炎多病原混合感染的检测及分析

Determination and analysis of multi- bacteria coinfection of acute pneumonia

目的 了解急性肺炎时肺炎链球菌 (SP)、流感嗜血杆菌 (Hi)、卡他布兰汉菌 (BC)、肺炎支原体 (MP)及肺炎衣原体 (CP)等多病原混合感染的发病情况。方法 采用酶免疫分析法 ,对 5 3例住院急性肺炎患儿的双份血清进行不定型Hi抗体、B型Hi荚膜多糖抗体和全菌抗体进行检测 ,SP溶血素抗体和C 多糖抗体 ,循环免疫复合物中SP溶血素抗体、表面蛋白A抗体和C 多糖抗体 ,CB全菌抗体及MP抗体的检测 ;采用免疫荧光法检测患儿双份血清中CP抗体 ;并同时进行血液普通细菌培养。结果 5 3例肺炎患儿中 32例 (占 6 0 .4 % )病原学检测阳性。其中单一病原体感染 2 1例 ,2种和 3种病原体混合感染分别为 8例和 3例。在各种病原体中 ,SP和CP感染最常见 (各占 2 0 .8% ,11/ 5 3) ,其次为MP感染 (占 16 .7% ,7/ 4 2 )和Hi感染 (占 13.2 % ,7/ 5 3)。结论 急性肺炎时SP、CP、MP和Hi等是常见的病原 ,在小儿肺炎经验治疗时 ,多病原体混合感染情况应予以重视。

Objective To investigate the proportion of streptococus pneumonia(SP), haemophilus influenzae (Hi),branhamella catarrhalis (BC), chlamydia pneumonia (CP) and mycoplasma pneumonia (MP) in children with acute pneumonia.Methods Fifty-three hospital-treated children with acute pneumofmonia were included in a prospective study. The enzyme immunoassay was used to detect antibodies in paired sera against non-capsulated Hi, Hi type-B capsular polysaccharide and whole cell, antibodies against pneumococcal pneumolysin, C-polysaccharide and pneumococcal pneumolysin, C-polysaccharide, surface protein A in circulating immune complexes and antibodies against BC and MP. Antibodies against CP by immunofluorescence in paired sera as well as blood cultures were detected in these cases.Results The evidence of bacteria infection was demonstrated in 32 cases (60.4 %) among children with acute pneumonia, of which 11 cases had 2 or 3 organisms coinfection. In these causative agents,SP and CP were the most common organisms (11/53 cases respectively,20.8 %), followed by MP (7/42,16.7 %),Hi(7/53,13.2 %).Conclusion SP,Hi,CP and MP are common causative agents of children with acute pneumonia and multi-agents coinfection isn′t ingnored in our empiric antibiotic therapy for the disease.