儿童急性呼吸道感染肺炎衣原体感染状况的研究

目的了解急性呼吸道感染儿童肺炎衣原体(CPn)感染状况及特点.方法采用敏感性较好的培养方法对83例各年龄组呼吸道感染住院儿童进行了鼻咽拭子和咽拭子的培养分离.结果共发现CPn阳性21例,总感染率25.3%.其中49例肺炎中,CPn阳性13例(26.5%),10例毛细支气管炎中CPn阳性2例(20%),6例喘息性支气管炎中CPn阳性1例(16.7%),12例上呼吸道感染中有CPn阳性5例(41.7%),6例支气管炎中未分离到CPn.结论CPn是我国儿童急性呼吸道感染的重要病原,其在儿童急性上呼吸道感染中占有主要地位,在毛细支气管炎、喘息性支气管炎中的作用值得重视.     

儿童肺炎衣原体呼吸道感染29例

我们采用微量免疫荧光法检测血清肺炎衣原体ＭＰ特异性抗体、ＰＣＲ法检测咽拭子ＭＰＤＮＡ,对１４９例急性呼吸道感染进行研究,发现２９例具有近期感染依据。急性感染诊断标准：ＩｇＭ≥１∶３２,ＩｇＧ≥１∶５１２［１］,咽拭子ＰＣＲ阳性。现总结如下。临床资料一、一般资料　１９９７年６月至１９９８年１０月我科住院患儿２９例为观察组,其中男２１例,女８例;年龄４０ｄ～１５ａ,入院前病程≤１ｗｋ１６例,～２ｗｋ１２例,～４ｗｋ１例。急性上呼吸道感染１例,急性支气管炎９例（包括哮喘性支气管炎）,支气管哮喘急性发作…     

儿童呼吸道肺炎衣原体感染的初步研究

我们对１３９例急性呼吸道感染患儿血清肺炎衣原体特异性抗体ＩｇＧ、ＩｇＭ进行了测定。报告如下。对象：１９９７年６月～１９９８年１０月在我科住院的急性呼吸道感染患儿１３９例,其中肺炎５０例,支气管炎４２例,支气管哮喘急性发作合并感染２３例,上呼吸道感染（包括感冒样疾病、咽炎、扁桃体炎）２４例;男９１例,女４８例;年龄９－５月～１５－０岁,平均年龄４－２岁。方法：入院次日采集患儿静脉血１～２ｍｌ,分离血清后－２０℃保存待检。用倪安平［１］和Ｇｒａｙｓｔｏｎ描述的微量荧光法检测１３９例患儿血清的肺炎衣原…     

肺炎衣原体呼吸道感染的临床探讨

本文采用ＰＣＲ方法对１９９５年６￣９月的７４例住院患儿进行肺炎衣原体（ＴＷＡＲ）检测，结果显示ＴＷＡＲ阳性１０例，阳性率１３．５１％，其中９例为肺炎患儿，１例为Ｓｔｉｌｌ病合并上呼吸道感染。１０例临床均有发热、咳嗽。９例患儿均用红霉素治疗，１例安美汀治疗，预后佳，而同期对照组３７例正常儿童ＴＷＡＲ检测均显示阴性。提示：ＴＷＡＲ是儿童呼吸道感染的重要病原体之一。     

儿童呼吸道肺炎衣原体感染流行病学与临床

肺炎衣原体(CP)广泛存在于世界范围内,人类是其唯一的宿主,仅1个血清型。实验室检测方法有分离培养、血清学检测、核酸扩增技术等,目前临床主要使用血清学检测方法。CP是呼吸道感染主要病原之一,人与人之间的传播方式最有可能通过呼吸道飞沫。CP感染与小儿肺炎、哮喘及慢性咳嗽等呼吸道疾病密切相关。目前治疗是使用透过细胞膜而影响网状体代谢活动、抑制其复制和繁殖的抗生素,如四环素、大环内酯类、喹诺酮类等。     

小儿肺炎衣原体感染

肺炎衣原体ＴＷＡＲ株（简称ＴＷＡＲ）是继沙眼衣原体和鹦鹉热衣原体之后，近年来新发现的第３个衣原体生物种。ＴＷＡＲ主要引起肺炎，支气管炎和其它呼吸道感染。它是迄今已知的４种或５种最常见的肺炎病原体之一。本文介绍了肺炎衣原体ＴＷＡＲ株的微生物特性，实验室诊断，流行病学以及小儿ＴＷＡＲ感染的临床表现和治疗。     

小儿下呼吸道衣原体感染的研究

于１９９２年１１月～１９９７年８月对住院的１３０例下呼吸道感染患儿进行咽拭子衣原体培养分离或聚合酶链反应（ＰＣＲ）检测，血清衣原体特异性ＩｇＭ、ＩｇＧ抗体或ＰＣＲ检测，以证实沙眼衣原体（ＣＴ）和肺炎衣原体（ＣＰｎ）是小儿下呼吸道感染的病原体之一，并对...     

聚合酶链反应早期诊断小儿肺炎衣原体呼吸道感染

肺炎衣原体(Chlamydia Pneumoniae,TWAR)是近年来发现的一种人类呼吸道感染的重要病原。我们自1995年11月至1996年11月用PCR技术检测小儿呼吸道感染483例,达到早期诊断肺炎衣     

儿童肺炎衣原体感染16例临床分析

肺炎衣原体（chlamydia pneumoniae，Cpn）是小儿呼吸道感染的常见致病菌。肺炎衣原体感染在儿童中发病率呈逐年上升趋势。据报道，呼吸道感染的Cpn-IgM阳性率推测达到30％以上，易致咳嗽迁延，部分患儿出现喘息。现就我院儿科自2006年4月～2007年4月收治的16例肺炎支原体感染病例分析如下。     

肺炎患儿肺炎衣原体感染情况的研究

随着人们认识的深入 ,肺炎衣原体已被公认为人类急性呼吸道感染的重要病原。为了解长春地区儿童肺炎衣原体感染状况 ,探讨协助临床诊断的方法 ,我们采用细胞培养及微量免疫荧光试验两种方法 ,对肺炎患儿进行肺炎衣原体的检测 ,现将结果报告如下。对象和方法1 病例选择 :1997年 2月～ 1997年 8月 ,在我科住院的1个月～ 14岁患儿共 87例 ,诊断均符合肺炎的诊断标准[1] 。其中 3岁以上患儿 46例 ,3岁及以下患儿 41例 ;男 35例 ,女5 2例。同期采集儿外科 2周内无呼吸道感染病史患儿 (1个月～ 14岁 ) 2 3例作为正常对照。2 标本的处理 :(1)鼻咽…     

Chlamydia pneumoniae in children with acute respiratory tract infections

Children seeking medical attention for acute respiratory tract infections were investigated for evidence of Chlamydia pneumoniae infection. Blood samples were obtained from 367 children. Nasopharyngeal or throat swabs for PCR analysis (polymerase chain reaction) were taken from 360 children. Serology was found to be useful for diagnosis of infection only in children aged 5 y. Using PCR, a prevalence of 8 and 10% of C pneumoniae was found in male and female children aged < 2 y; 17 and 19%, respectively, in the age group 2-4 y and 32 and 21%, respectively, in the age group 5–16 y. We conclude that Chlamydia pneumoniae is a common finding in young children with respiratory tract infections. Younger children were more often found to have a moderate disease, but may have been ill for a long period.     

儿童急性下呼吸道感染肺炎链球菌抗体检测的研究

目的探讨肺炎链球菌在儿童急性下呼吸道感染(ALRI)中的地位,并比较多种抗体检测方法在诊断肺炎链球菌感染中的作用。方法通过配对血清及循环免疫复合物使用EIA方法对101例ALRI患儿进行肺炎链球菌抗体检测。结果101例ALRI患儿中,肺炎链球菌感染17例(16．8％),其中从血清中检测抗体,9例(8．9％)阳性,从循环免疫复合物中检测抗体12例(11．9％)阳性。结论肺炎链球菌是儿童ALRI的常见病原。从循环免疫复合物中检测肺炎链球菌抗体的敏感性优于从血清检测抗体,由于两者存在无重叠部分,应联合使用,互相补充。     

Prevalence of specific antibodies to Chlamydia pneumoniae in children with acute respiratory infections

We investigated 56 boys and 30 girls between the ages of 1 month and 15 years with acute respiratory infections for antibodies to Chlamydia pneumoniae and Mycoplasma pneumoniae. Antibodies were only occasionally found in children less than 10 years of age (4% of boys (1/23) and 5% of girls (1/19). In the age group 10–12 years, antibodies were detected in 55% of boys (4/9) but not in the 2 girls investigated. In the age group 13–15 years, antibodies were detected in 58% of boys (14/24) and in 33% of girls (3/9). Infection caused by M. pneumoniae was found in 13% of boys in the oldest age group.□     

儿童急性下呼吸道感染病毒病原学分析

目的了解儿童急性下呼吸道感染病毒病原学特点。方法采用直接免疫荧光法(DIF),对2007年9月—2009年9月住院的5480例0～12岁下呼吸道感染患儿鼻咽分泌物进行8种病毒检测。结果5480例患儿中,2710例检出至少1种病毒,总检出率49.5%。呼吸道合胞病毒(RSV)检出最多,为1386例,占51.1%,其余,依次是偏肺病毒(hMPV)513例(18.9%),副流感病毒Ⅲ(PIVⅢ)338例(12.5%),腺病毒(ADV)192例(7.1%);流感病毒A(IFA)128例(4.7%),流感病毒B(IFB)79例(2.9%),副流感病毒Ⅰ(PIVⅠ)41例(1.5%),副流感病毒Ⅱ(PIVⅡ)33例(1.2%)。6个月以下年龄组阳性率最高,为43.5%。RSV、hMPV季节性较明显,主要集中在冬春季节(11月至次年4月)。肺炎、毛细支气管炎、支气管炎(伴喘息)、支气管炎(不伴喘息)和哮喘患儿病毒阳性率分别为47.4%、63.6%、50.5%、30.1%和43.5%。结论病毒是儿童急性下呼吸道感染的主要病原。发病年龄主要在婴幼儿,其中RSV和hMPV最常见。     

北京地区儿童急性下呼吸道感染的病原学研究

目的 探讨儿童急性下呼吸道感染（ＡＬＲＩ）的病原学。方法 采用血培养及常用的抗原、抗体检测方法检测１０２例ＡＬＲＩ患儿常见的致病原。结果 ⑴１０２例儿童ＡＬＲＩ中,明确病原诊断的有６０例（５８．８％）。⑵在检出病原的６０例中,单纯细胞菌感染１５例（２５％）,单纯病毒感染１９例（３２％）,单纯支原体感染８例（１３％）,单纯衣原体感染１例（２％）,混合感染１７例（２８％）。⑶检出的主要病原：１０２例Ａ     

The role of Chlamydia pneumoniae in acute respiratory tract infections in young children in The Gambia, West Africa

BACKGROUND: Little is known about the role of Chlamydia pneumoniae in the aetiology of acute respiratory tract infections (ARI) in children in developing countries. AIMS: To obtain better information, we studied the presence of C. pneumoniae and its association with clinical signs and symptoms of ARI in children under 5 years of age in The Gambia. METHODS: C. pneumoniae was sought by polymerase chain reaction in nasopharyngeal secretions and/or lung puncture aspirates from 324 infants under 3 months of age and 325 children between 3 months and 5 years of age with malnutrition, with or without pneumonia, and in control children. Clinical signs and symptoms for ARI and the spectrum of other viral and bacterial organisms were compared between those positive for C. pneumoniae and those negative. RESULTS: Of 324 young infants, ten (3.1%) showed the presence of C. pneumoniae whereas in the older children 50 of 325 (15%) were positive for C. pneumoniae. There was no significant association between clinical signs and symptoms of ARI and C. pneumoniae positivity in the young infants. Among older infants and children, there was a trend to more frequent lobar alveolar changes in those positive for C. pneumoniae. No bacterial pathogens were found to be significantly associated with C. pneumoniae infection. However, there was an association with measles in the malnutrition group and with RSV in the young infants group. CONCLUSIONS: In this study, C. pneumoniae was not associated with any particular clinical syndrome. We found no evidence that the organism plays a major role in ARI in young children in developing countries such as The Gambia.     

Recurrent lower respiratory tract infections in children

Recurrent lower respiratory tract infections in children are caused by a deficiency in the host defense or an underlying pulmonary disorder which may result from structural or functional alterations. Aspiration syndromes, congenital defects, airway clearance disorders and immune deficiency are the main categories. Careful evaluation with good history and examination provide important leads to limit the radiological and laboratory work up to the most relevant investigations. Some of the structural abnormalities are amenable to cure; however, secondary events need careful management of the underlying lung disorder to give the best quality of life to these children.     

Viral infections in hospitalized children affected by acute lower respiratory tract disease

OBJECTIVE: To evaluate the frequency of the main respiratory viruses in hospitalized children affected by acute lower respiratory tract disease at a university hospital. METHODS: This is a prospective trial that included two cohorts of hospitalized children in the period from April to July 1996. The groups were selected according to the presence of lower respiratory tract disease on admission: Group A- with acute disease (history of less than 7 days) and B- without present or recent respiratory disease. The parameters for defining lower respiratory tract disease included physical and/or radiological pulmonary changes. Clinical and radiological criteria were established for the classification of lower respiratory tract diseases in group A. Nasopharyngeal swab was collected from all children on admission for viral detection by cellular cultures and direct immunofluorescence. RESULTS: 201 cases were selected, 126 in group A and 75 in group B. Viruses were identified in 71 children from groupA(56.4%) and only in 3 from group B (4.0%). The predominant agent in group A was respiratory syncytial virus, identified in 66 cases; adenovirus (4) and influenza (1) were detected in other patients. In group B two patients with respiratory syncytial virus and one with adenovirus were identified. The patients from group A affected by respiratory syncytial virus were younger (median age 3 months versus 13 months) and more wheezy on physical examination (78.7%) than the other patients of the group (33.3%). This virus was associated to most of the bronchiolitis cases (84%) and to half of the pneumonia cases (46.4%). CONCLUSION: The authors found a significant presence of viruses in the majority of children hospitalized with acute lower respiratory tract disease. The respiratory syncytial virus was the predominant agent identified. These results are similar to others previously reported both in developed and some developing countries. The authors emphasize that the present study evaluated only partially the possibility of simultaneous infection by other pathogens and that the present protocol was conducted during the season with the highest incidence of respiratory syncytial virus.     

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??Objective To investigate the clinical relevance of multiple viral infections in children with acute lower respiratory disease. Methods A total of 1722 children with clinical diagnosis of lower respiratory tract infection ??ALRTI?? during the period of October 2007 to September 2011 were involved in our study. One nasopharyngeal aspirate specimen was collected from each patient. ??RT?? PCRs were performed to detect common respiratory tract viruses including respiratory syncytial virus ??RSV?? ?? rhinovirus ??RV?? ?? influenza virus type A and B?? parainfluenza virus ??PIV?? type 1-4?? adenovirus ??enterovirus?? human coronavirus?? human metapneumonia virus and human bocavirus. Results Totally 206 children had single RSV infection?? 124 children had dual infections ??RSV co-infected with an additional virus?? and 40 children had multiple infections along with a RSV infection. Out of the 124 patients?? 68??54.8%?? were co-infected with RV?? 24 with PIV. There was a statistically significant difference between the dual viral infections group and the RSV-infected group in hospital stay??P??0.001??. Compared to patients in the single RSV infected group?? patients in the multiple viral infection group had significantly more frequency in fever ??P??0.017???? duration of fever longer??P??0.015???? hospital stay also longer??P??0.001????and they received more intravenous steroid therapy during hospitalization??P??0.005??. There was no significant difference in oxygen therapy?? respiratory support and use of bronchodilators. Conclusion Multiple viral infections are linked to more frequency in fever?? longer fever days?? longer hospital stay?? and more frequent use of intravenous steroid therapy during hospitalization. Mixed respiratory virus infection may affect the patient's disease severity and prognosis.