????????????8172????????????????

目的分析急性呼吸道感染住院患儿的病原学特点。方法对2005年10月至2009年9月苏州大学附属儿童医院呼吸科8172例急性呼吸道感染住院患儿,采用无菌负压吸引法采集其新鲜痰液,分别用直接免疫荧光法、RT-PCR检测7种常见病毒抗原和人类偏肺病毒基因(6599例),细菌培养检测细菌(6404例),ELISA法检测血清肺炎支原体(7842例),检出的阳性病例入选,分析其病例资料。结果 8172例标本中检出1种或1种以上病原4756例(58.2%),6404例细菌检测标本中阳性1883例(29.4%),6599例病毒检测标本中阳性1886例(28.2%),7842例肺炎支原体检测标本中阳性2630例(33.5%)。细菌病原中肺炎链球菌(10.8%)最多见。病毒中以呼吸道合胞病毒(15.8%)最常见。病原混合感染率为16.9%,以细菌及病毒混合感染为最常见。呼吸道合胞病毒冬季检出率最高,人类偏肺病毒冬春季、副流感病毒3夏季检出率较高,流感病毒A夏季检出率较低,肺炎支原体检出率夏秋季较高,冬春季较低;副流感病毒1,2季节差异不明显。结论肺炎支原体是本地区儿童急性呼吸道感染最常见的病原,病毒次之,细菌是混合感染的常见病原。细菌和病毒感染多见于1岁以下婴儿,而支原体感染多见于3岁以上儿童。各病原的流行季节各异。

Etiologic analysis of 8172 cases of acute respiratory cract infection in hospitalized children

??Abstract??Objective To investigate etiology of acute respiratory infection in hospitalized children. Methods From Oct 2005 to Sep 2009?? 8172 hospitalized children with ARI were chosen?? of which 6599 cases were detected seven common viruses’ antigen and hMPV gene using direct immunofluorescence and RT-PCR?? 6404 specimens were cultured for bacteria??7842 cases were detected the antibodies against MP by ELISA. Then analyze and study the positive cases. Results The positive specimens of one or more pathogens detected were 4756??58.2%?? of 8172 cases.Bacterial infections were 1883??29.4%?? in 6404 cases. Viral infections were 1886??28.2%?? in 6599 cases. Mycoplasma pneumoniae were 2630??33.5%?? in 7842 cases. The top four of bacterial detection rate were SP??10.8%???? HI??4.8%????SA??4.7%?? and MC??3.4%????the top four of virus detection rate were RSV??15.8%????hMPV??8.3%????PIV-3??2.1%?? and IVA ??2.0%??. Pathogen mixed infection rate was 16.9%?? virus mixed with bacteria infection was the most common?? detection rate of ????1y group were highest for the SP?? HI?? SA??RSV and PIV-3?? higher detection rate in 3??5y for hMPV?? higher in 3??5y and ??5y for MP. In terms of seasonal distribution?? detection rate of bacteria was lowest in autumn?? no difference between the other three seasons??detection rate of RSV was higher in winter and spring?? hMPV higher in winter and spring?? PIV-3 higher in summer?? IVA lower in summer??detection rate of MP was higher in summer and autumn. Conclusion MP is the most common important pathogen of children ARI in local area?? followed by viruses?? bacteria was the most common in mixed infections. The most common pathogens of bacteria and virus are SP?? HI?? SA?? MC and RSV?? hMPV?? PIV-3?? respectively. Virus and bacteria infection is more common in infants less than 1 year. Mycoplasma pneumoniae infection is more common in children older than 3 years.