青海省急性呼吸道感染病原学分析

目的了解青海省急性呼吸道感染常见病原,探讨高原地区发热呼吸道症候群的病原谱构成。方法采集急性呼吸道感染患者的呼吸道分泌物、血液和尿液标本,用多重RT-PCR方法对标本进行9种细菌(支原体、衣原体)和7种病毒核酸检测。结果受检患者329例,细菌(支原体、衣原体)阳性率为5.86%(19/324),病毒阳性率为14.94%(46/308),差异有统计学意义(χ2=14.08,P<0.01)。检出的细菌主要为肺炎链球菌(占47.37%),其次为肺炎克雷伯菌(占31.58%);检出的病毒主要为人腺病毒(占31.25%),其次为人副流感病毒(占27.08%)。男性患者病原体核酸阳性率为21.26%(44/207),女性患者为13.93%(17/122),差异无统计学意义(χ2=2.72,P>0.05)。结论青海高原地区急性呼吸道感染病原主要为人腺病毒、副流感病毒、流感病毒、肺炎链球菌和肺炎克雷伯菌,且病毒性呼吸道疾病所占比例较大,提示高原地区发热呼吸道感染病原以病毒为主。

Etiological analysis of cases of acute respiratory tract infections in Qinghai,China

Objectives To determine the common pathogens responsible for acute respiratory tract infections in Qinghai Province and to determine the pathogenic spectrum of febrile respiratory syndrome. Methods Respiratory tract, blood, and urine specimens were collected from patients with an acute respiratory tract infection, and multiplex RT-PCR was used to detect nine species of bacteria （Mycoplasma and Chlarnydia） and seven species of viruses. Results Specimens were collected from 329 patients. Of the specimens, 5.86% （19/324） tested positive for bacteria while 14. 94% （46/308） tested positive for viruses. Bacteria were detected significantly more often than viruses （ Х^2= 14.08, P= 0. 000）. The bacterium detected most often was Streptococcus pneurnoniae （47.37 % ）, followed by Klebsiella pneumoniae （31.58 %）. The virus detected most often was human adenovirus （31.25 %）, followed by human parainfluenza virus （27.08 %）. Men tested positive for a pathogen at a rate of 21.26% （44/207） while women tested positive at a rate of 13.93% （17/122）. The difference in this rate of detection was not statistically significant （Х^2 = 2.72, P= 0. 099）. Conclusion Human adenovirus, parainfluenza virus, influenza virus, Streptococcus pneumoniae, and Klebsiella pneumoniae were the main pathogens detected in cases of acute respiratory tract infections in the Qinghai plateau region. Acute respiratory tract infections were mostly due to viral infection, indicating that viral infections are mainly responsible for fevers and respiratory tract infections in this plateau region.