肺炎患儿支气管肺泡灌洗液的病原学研究

目的回顾分析我院肺炎患儿支气管肺泡灌洗液中常见病毒、细菌及真菌的分布情况,为小儿肺炎经验性用药提供病原学依据。 方法纳入2019年1月至2019年12月期间在广东省妇幼保健院住院诊疗的肺炎患儿,分析患儿支气管肺泡灌洗液中常见病毒、细菌及真菌的检出率在不同年龄组、重症和非重症肺炎之间分布是否存在差异。 结果共纳入782例患儿,其中重症组190例,非重症组592例。所有患儿中检测出一种及一种以上病原体的病例有628人(80.3%),共检出1044株病原体,其中病毒678株(64.9%),肺炎支原体238株(22.8%),细菌118株(11.3%),真菌10株(1.0%)。检出率最高的病原体为巨细胞病毒(Human Cytomegalovirus, HCMV) (30.8%)、其次为肺炎支原体(Mycoplasma Pneumoniae, MP)(30.4%)、EB病毒(Epstein-Barr Virus, EBV)(19.1%)、呼吸道合胞病毒(Respiratory Syncytial Virus, RSV)(18.3%)、鼻病毒(Rhinovirus, RV)(11.9%)、人博卡病毒(Human Boca Virus, HBoV)(6.3%)。细菌中检出率最高是肺炎链球菌(20株,2.6%)、大肠埃希菌(18株,2.3%)和金黄色葡萄球菌(18株,2.3%)。 结论小儿肺炎主要由病毒引起,HCMV和RSV是婴儿期肺炎的主要病毒病原,肺炎链球菌为首要细菌病原,MP在不同年龄段出现阶梯式增长,学龄组检出率最高。HCMV、RSV和肺炎克雷伯杆菌是重症肺炎重要病原体。

Etiology of bronchoalveolar lavage fluid in children with pneumonia

ObjectiveTo retrospectively analyze the distribution of common viruses, bacteria and fungi in bronchoalveolar lavage fluid of children with pneumonia in our hospital, providing etiological basis for empirical treatment of children with pneumonia. MethodsChildren with pneumonia hospitalized in Guangdong Women and Children Hospital from January 2019 to December 2019 were involved, and the differences in the distribution of common viruses, bacteria and fungi in bronchoalveolar lavage fluid among different age groups, severe and non-severe pneumonia were analyzed. ResultsTotal 782 cases were included, including 190 cases in severe group and 592 cases in non-severe group. Among all the children, 628 patients (80.3%) had one or more pathogens detected, and a total of 1044 strains of pathogens were detected, including 678 (64.9%) strains of virus, 238 (22.8%) strains of mycoplasma pneumoniae, 118 (11.3%) strains of bacteria and 10 (1.0%) strains of fungi. The pathogen with the highest detection rate was HCMV (30.8%), followed by mycoplasma pneumoniae (30.4%), EBV (19.1%), RSV (18.3%), RV (11.9%) and HBoV (6.3%). The highest detection rates in isolated bacterial pathogen were streptococcus pneumoniae (20 strains, 2.6%), Escherichia coli (18 strains, 2.3%) and Staphylococcus aureus (18 strains, 2.3%). ConclusionsPediatric pneumonia is mainly caused by virus, and HCMV and RSV are the main viral pathogens of infantile pneumonia. Streptococcus pneumoniae is the primary bacterial pathogens. MP increases in different age groups step by step, and the detection rate is the highest in the school-age group. HCMV, RSV and Klebsiella pneumoniae are important pathogens of severe pneumonia.