摘要
目的:探讨上海地区儿童急性肺炎的病原学和临床流行病学特征。方法:724例急性肺炎患儿经鼻深插气管吸痰,采用系列呼吸道病毒单克隆抗体桥联酶标法、培养和聚合酶链反应方法检测呼吸道病原。结果:724例标本中明确病原阳性441例(60.9％),其中病毒感染160例(36.3％),细菌感染125例(28.3％),肺炎支原体感染81例(18.4％),肺炎衣原体感染25例(57％),混合感染50例(11.3％)。724例急性肺炎患儿中检出的主要病原为:呼吸道合胞病毒129例(17.8％)、腺病毒19例(26％)、副流感病毒1、3型13例(1.8％)、副流感病毒2型2例(0.3％)、流感病毒A型7例(1.0％)、肺炎克雷伯菌24例(3.3％)、肺炎链球菌23例(3.2％)、卡他莫拉菌23例(3.2％)、流感嗜血杆菌 22例(3.0％)、金黄色葡萄球菌19例(2.6％)、副流感嗜血杆菌18例(2.5％)、凝固酶阴性葡萄球菌8例(1.1％)、大肠埃希菌4例(0.6％)、肺炎支原体103例(14.2％)及肺炎衣原体27例(3.7％)。结论:病毒感染是儿童急性肺炎最常见的病原体,其次是细菌感染、肺炎支原体感染、肺炎衣原体感染。其中呼吸道台胞病毒占首位,腺病毒感染有所下降,流感病毒和副流感病毒感染无流行迹象。肺炎链球菌和流感嗜血杆菌是主要的细菌病原,但是肺炎克雷伯菌和卡他莫拉菌感染有明显增多。细菌感染全年散发。
Objective: To investigate the etiology and the characteristics of clinical epidemiology of acute pneumonia in children. Methods; Sputum specimens were collected from 724 children with acute pneumonia by nasotracheal aspiration and detection of pathogens by monoclonal antibody bridge linked enzyme assay, sputum culture and polymerase chain reaction (PCR) technique. Results; Microbial etiology were confirmed in 441 (60. 9% ) of 724 patients, among them viral infections were 160 cases (36. 3%), bacterial infections 125 cases (28. 3%), Mycoplasma pneumoniae 81 cases (18. 4%) and Chlamydia pneumoniae 25 cases (5. 7%). Pathogens detected in 724 cases were respiratory syncycial virus 129 (17.8%), adenovirus 19 cases (2.6%), parainfluen-za virus type 1, 3 13 cases (1.8%) and type2 2 cases (0.3%), Klebsiella pneumoniae 24 cases (3. 3%) , Streptococcus pneumoni-ae 23 cases (3.2%), Moraxella catarrhalis 23 cases (3.2%), Haemophilia influenzae 22 cases (3.0%), Staphylococcus aureus 19 cases (2. 6%), Haemophilus parahaemolyticus 18 cases (2. 5%), coagulase-negative Staphlococci 8 cases (1. 1%) and Es-cherichia coli 4 cases (0.6%), Mycoplasma pneumoniae 103 cases (14.2%) and Chlamydia pneumonias 21 cases (3.7%) respectively. Conclusions: Viral infection is the most common cause of acute pneumonia in children, followed by bacteria, Mycoplasma pneumoniae and Chlamydia pneumoniae. Respiratory syncycial virus is the most common pathogen, and the incidence of adenovirus pneumonia is decreasing. There was no evidence of outbreak of influenze and parainfluenzae virus infection. Haemophilus influenza and Streptococcus pneumoniae are the prominent pathogens of bacterial pneumonia, Klebsiella pneumoniae and Moraxella catarrhalis infection are increasing. Viral and Mycoplasma pneumoniae infection are more common in winter and spring while bacterial pneumonia are common in the early summer, however all can be seen in the whole year round. . The average age of patients with Mycoplasma pneumoniae infection become younger and Chlamydia pneumoniae infection is more common in infants.
出处
《中国抗感染化疗杂志》
2003年第3期134-137,共4页
Chinese Journal of Infection and Chemotherapy
