846例儿童急性呼吸道感染的病原学分析

目的了解镇江地区儿童急性呼吸道感染9种病原体流行情况及与喘息的关系,以及上、下呼吸道不同部位感染病原学的分布特点。方法选取2012年3月~2013年2月在江苏大学附属医院儿科住院院的846例急性呼吸道感染患儿,采用间接免疫荧光法检测腺病毒、呼吸道合胞病毒、甲型流感病毒、乙型流感病毒、副流感病毒及肺炎支原体等非典型病原体的IgM抗体。结果肺炎支原体阳性率最高,夏秋季为高峰,多见于1~6岁儿童,0~5月最低。病毒总阳性率13.1%,其中乙型流感病毒秋季最高、春季最低,年龄组中1~2岁和3~6岁组阳性率最高,0~5月组和6~12月组阳性率最低。甲型流感病毒夏季阳性率最高,秋季最低。除甲型流感组外,余病原体上、下呼吸道感染差异无统计学意义。155例喘息患儿中,肺炎支原体检出70例,包括肺炎支原体与病毒混合感染16例;病毒阳性者23例,包括两种病毒混合感染1例。结论2012年3月至2013年2月,肺炎支原体是镇江地区包括喘息患儿在内的儿童急性呼吸道感染的最常见病原体,病毒亦为重要病原体,各有其季节年龄等分布特点,且较多出现肺炎支原体和病毒的混合感染。

Etiologic features of 846 hospitalized children with acute respiratory tract infection

Objective To investigate the pathogen distribution characteristics of children with acute respiratory tract infections（ARI） and explore the association between the prevalence of etiological agent of ARI and the development of wheeze among children. Methods The 846 children who were hospitalized with ARI in the pediatric ward of affiliated hospital of Jiangsu university from March 2012 to February 2013 were enrolled. Serum specimens were collected and tested by indirect immunofluorescence for adenovirus（ADV）, respiratory syncytial virus（RSV）, influenza A virus（IAV）, influenza B virus（IBV）, parainfluenza virus（PIV）, Mycoplasma pneumoniae（MP）, Chlamych＇a pneumoniae（CP）, Q rickettsia（Rickettsia burned, Coxiella burnetl） and Legionella pneumophilia （LP）. Results Among the nine pathogens, the predominant pathogen was MP with outbreak peak of summer and autumn, and the age group with the highest positive rate was 1-6 years, lowest was 0-5 months. The total positive rate of the five viruses was 13.1%.The season with the highest positive rate of IBV was autumn,lowest in spring, the age group of 1-2 and 3-6 years has the highest positive rate and 0-5 months and 6-12 month has lowest. And for IAV, the season with the highest positive rate of was summer and lowest in autumn. There was no positive rate difference between acute upper respiratory tract infection （AURI） and acute lower respiratory tract infection （ALRI） except for IAV. Seventy MP cases were detected from 155 children including 16 cases with mixed infection were found, 23 positive cases including one case infected with two virus were detected. Conclusions MP from March 2012 to February 2013 was the main pathogen in children （including children with wheeze） with ARI in Zhenjiang area. Distribution difference in age and season was found Mixed infections of MP and virues were frequently detected.