肺炎支原体肺炎患儿混合感染分析

目的了解肺炎支原体患儿混合感染的病原微生物组成情况。方法选取2009年1月至2012年1月在深圳市宝安区妇幼保健院就诊的300例肺炎支原体患儿作为研究对象,所有研究对象均行血清肺炎支原体抗体检测、痰细菌培养、呼吸道病毒抗原检测及胸片检测,对于有支气管镜检查指征的患儿同时做支气管镜下肺泡灌洗及对肺泡灌洗液做培养。结果在300例肺炎支原体患儿中有156例患儿混合其他病原微生物感染(52.67%),其中混合肺炎衣原体感染者80例,占51.28%(80/156),混合病毒感染者46例,占29.49%(46/156),混合细菌感染者30例,占19.23%(30/156),年幼患儿(≤3岁)以混合病毒感染为主,年长患儿(>3岁)以混合肺炎衣原体感染为主。与肺炎支原体肺炎非混合感染组比较,肺炎支原体混合感染组的热程显著长于肺炎支原体非混合感染组,且发生胸腔积液的概率也显著增加(P<0.05)。影像学方面,肺炎支原体混合感染组较肺炎支原体肺炎非混合感染组更容易出现大片状阴影(P<0.05)。结论肺炎支原体患儿混合感染较为常见,混合感染率占半数以上,肺炎衣原体混合感染率最高,其次为病毒混合感染率,细菌混合感染率最低。年幼儿童以病毒混合感染为主,而年长儿童则以肺炎衣原体混合感染为主。

Analysis on Mixed Infections in Children with Mycoplasma Pneumoniae Pneumonia

Objective To study thepathogenic microorganisms composition of mixed infections in children with mycoplasma pneumoniae(M.pneumoniae) pneumonia.Methods A total of 300 cases diagnosed as M.pneumoniae pneumonia from Shenzhen Bao'an Maternal and Children Health Care Centers from Jan.2009 to Jan.2012 were enrolled into this study.All the subjects were received serum Chlamydia pneumoniae antibody test,sputum bacterial culture,and respiratory virus antigen examination.bronchoalveolar lavage and lavage bacterial culture were also done for those with the indications for bronchoscopy.Results The incidence rate of mixed infections in children with M.pneumoniae pneumonia was 52.67%(156 /300).The most frequent co-infected pathogen was Chlamydia pneumoniae(80 /156,51.28%),followed by viruses(46 /156,29.49%),and bacteria(30 /156,19.23%).Younger children(≤3 years) were mainly virus co-infected,and older children(> 3 years) were mainly Chlamydia pneumonia co-infected.Compared with non-mixed infections,those with mixed infections had larger area of shadow in chest imaging(P < 0.05).Conclusion More than half of cases with M.pneumoniae pneumonia had mixed infections,most frequently caused by Chlamydia pneumonia followed by viruses.The incidence rate of mixed infections with bacteria was the lowest.For younger children,mixed infections with virus were more common;while for older children,mixed infection with Chlamydia pneumoniae was more common.