发热门诊呼吸道感染患者中的肺炎衣原体感染调查

目的 了解发热门诊呼吸道感染患者中的肺炎衣原体感染状况,为临床诊断和治疗提供依据。方法 采集2010年11月15日至12月15日在北京友谊医院发热门诊就诊,诊断为呼吸道感染患者的咽拭子标本92例,采用国际肺炎衣原体参考菌株TW-183作为阳性对照和优化PCR条件。用肺炎衣原体种特异性引物对其16S rRNA基因进行PCR检测,阳性产物进行基因测序,结果采用SPSS 10.0软件进行数据统计分析,计数资料比较用(²检验,P≤0.05为差异有统计学意义。结果 CpnA-CpnB PCR可检测到5 ×10^-1 IFU 的肺炎衣原体。92例呼吸道感染患者的咽拭子标本中PCR阳性者为30例,阳性率为32.6%。男性和女性、不同年龄组、以及上呼吸道和下呼吸道感染病例的阳性率间差异均无统计学意义(P>0.05)。结论 在发热门诊有呼吸道症状的病例中,肺炎衣原体感染率较高。临床医生应对肺炎衣原体感染加以重视。CpnA-CpnB PCR法是一灵敏快速的肺炎衣原体筛查方法。

Chlamydia pneumoniae infection of the patients with respiratory tract infection diagnosed clinically at a Fever clinic

Previous studies got different C. pneumoniae infection rate in patients with respiratory infection in different cohorts. Still, it is not quite clear that how many patients with respiratory infection are infected by C. pneumoniae in China. The study was designed to investigate Chlamydia pneumoniae (C. pneumoniae) infection in patients with respiratory tract infection diagnosed clinically at a fever clinic by means of CpnA-CpnB PCR and provide information for the clinical diagnosis and treatment. The international reference strain TW-183 was used as a positive control for optimizing the PCR conditions and determining the sensitivity of CpnA-CpnB PCR (Polymerase Chain Reaction). The PCR products were sequenced. SPSS software and χ² tests were used to analyze the results. CpnA-CpnB PCR could detect 5 x 10^-1 IFU C. pneumoniae organisms. C. pneumoniae was detected in 92 patients' throat swab samples by CpnA-CpnB PCR. 30 were positive and the positive rate was 32.6%. No significant difference was observed in positive rates between male and female patients, among different age groups, and between different clinical symptoms, P>0.05, respectively. There was higher C. pneumoniae infection rate in the patients with respiratory tract infection at the fever clinic, at least contributed to a mixed infection with other pathogens. Clinicians should pay full attention to the infection of C. pneumoniae. CpnA-CpnB PCR is a direct, rapid, sensitive assay to detect C. pneumoniae.