珠海市儿童社区获得性肺炎的病原学研究

目的探讨珠海市儿童社区获得性肺炎（CAP）的病原学分布，为合理使用抗生素提供临床依据。方法2012年10月～2013年9月在我院住院确诊的CAP患儿1793例，入院当天取下呼吸道分泌物进行病原菌培养，采用间接免疫荧光法检测人血清中的呼吸道感染主要病原体的IgM抗体，采用被动凝集法测定血清MP特异性IgM。结果1793例CAP患儿中病原学检测阳性者1380例（77．0％）：细菌感染635例（35．4％），病毒感染385例（21．5％），肺炎支原体感染521例（29．0％），肺炎衣原体感染33例（1．8％），混合感染223例（12．4％）。肺炎链球菌位居细菌感染首位，共216例（12．0％），呼吸道合胞病毒病毒感染首位，共183例（10．2％）。≤1岁组肺炎链球菌、流感嗜血杆菌、葡萄球菌、卡他莫拉菌、呼吸道合胞病毒、腺病毒的感染病例数的构成比均高于〉1岁组（P〈0．05），而≤1岁组肺炎支原体的感染病例数构成比低于〉1岁组（P〈0．05）。结论肺炎链球菌、呼吸道合胞病毒、肺炎支原体是儿童CAP的主要病原体。肺炎链球菌及呼吸道合胞病毒在≤1岁组多见。肺炎支原体在〉1岁组多见。

Etiology research of children with community-acquired pneumonia in Zhuhai

Objective To investigate the etiology feature of children with CAP in Zhuhai and provide the clinical evi- dence for using antibiotics reasonably. Methods 1 793 children with CAP were diagnosed in our hospital from Oct 2012 to Sep 2013. Being hospitalized on the first day, the respiratory secretions of every child were taken for bacterial culture,and the serum was taken for detecting the IgM antibody of main pathogens of respiratory tract infection with indirect immunofluorescence and determining the specificity IgM of serum MP with passive agglutination. Results Among the 1 793 children with CAP, the positive etiology detection were 1 380 cases （77.0%） ：the bacterial infection were 635 cases （35.4%）, the virus infection were 385 cases（2L5%）, the mycoplasma pneumonia infection were 521 cases（29.0%）,the pneumonia chlamydia were 33 cases （1.8%） and the mixed infection were 223 cases （12.4%）. The streptococcus pneumonia was at the head of bacterial infection, 216 cases （12.0%）, the respiratory syncytial virus was at the head of viral infection, 183 cases （10.2%）. The constituent ratio of younger than or equal to 1 year old children with streptococcus pneumonia, haemophilus influenza, staphylococcus, mora bacteria, res- piratory syncytial virus or adenovirus were all higher than that of older than 1 year old children（P〈O.05）. The constituent ratio of younger than or equal to 1 year old children with mycoplasma pneumonia infection was lower than that of older than 1 year old children（P〈0.05）. Conclusion The streptococcus pneumonia, respiratory syncytial virus and mycoplasma pneumonia are the major pathogens of children CAP. The streptococcus pneumonia and respiratory syncytial virus often occur on the younger than or equal to 1 year old children. But the mycoplasma pneumonia often occurs on the older than 1 year old children.