2014-2016年河北省石家庄地区儿童重症社区获得性肺炎的病原学分析
Pathogenic analysis of severe community-acquired pneumonia in children in Shijiazhuang,Hebei province,2014-2016
李飞 1安淑华 2郭佳运 3李奇 1谢正德 1陈祥鹏1
作者信息
- 1. 国家儿童医学中心首都医科大学附属北京儿童医院北京市儿科研究所感染与病毒研究室 中国医学科学院儿童危重感染诊治创新单元国家呼吸系统疾病临床医学研究中心,教育部儿科重大疾病研究重点实验室儿童呼吸道感染性疾病研究北京市重点实验室,北京 100045
- 2. 河北省儿童医院呼吸科,石家庄 050031
- 3. 首都医科大学附属北京儿童医院内分泌科,北京 100045
- 折叠
摘要
目的 了解河北省儿童重症社区获得性肺炎的病原学分布情况.方法 收集2014年1月至2016年1月在河北省儿童医院住院的314例被诊断为重症肺炎的儿童的临床数据,同时采集鼻咽拭子样本进行实验室检查.结果 在314例患儿中,鼻咽拭子病原阳性为298例(94.94％),其中246例(78.34％)同时检测到多种病原,主要为混合病毒和细菌(206例,占65.61％).病原体检出总数为848株,其中病毒为483株(56.96％),以呼吸道合胞病毒最常见(A型97株、B型86株);细菌和非典型病原体(肺炎支原体)为365株(43.04％),以肺炎链球菌(220株)和流感嗜血杆菌(119株)为主.不同年龄组中,1岁以下儿童的病原体检出率更高(x2=21.389,P＜0.001).在不同季节中,病原体检出阳性率没有显著差异,但在秋季、冬季和春季分别检出呼吸道合胞病毒A型、呼吸道合胞病毒B型和肺炎链球菌的比例较高,差异有统计学意义(x2=22.205,P＜0.001;x2=37.874,P＜0.001;x2=11.380,P=0.009).结论 儿童重症肺炎鼻咽拭子样本检测的病原体通常为混合病毒和细菌,并且不同病原体在不同年龄和季节的检出率有差异,鼻咽拭子样本病原检测对临床病原判断具有一定的参考价值.
Abstract
Objective To investigate the etiological distribution of severe community-acquired pneumonia(CAP)in children in Hebei Province.Methods The nasopharyngeal swab samples and clinical data from 314 children with severe pneumonia were retrospectively analyzed between January 2014 and January 2016.Results Among the 314 children,298(94.94％)showed positive result for pathogens in their nasopharyngeal swab samples,with 246 cases(78.34％)of multiple pathogens,predominantly mixed viruses and bacteria(206 cases,65.61％).A total of 848 strains of pathogens were detected,including 483 strains(56.96％)of viruses,predominantly respiratory syncytial virus with 97 strains of subtype A and 86 strains of B.Bacteria and atypical pathogens(Mycoplasma pneumoniae)had 365 strains(43.04％),mainly Streptococcus pneumoniae(220 strains)and Haemophilus influenzae(119 strains).The detection rate of pathogens was higher in children under one year of age(x2=21.389,P＜0.001).There were no significant differences in different seasons,but the detection rates of respiratory syncytial virus A,respiratory syncytial virus B,and Streptococcus pneumoniae were higher in autumn,winter,and spring,respectively,with statistically significant differences(x2=22.205,P＜0.001;x2=37.874,P＜0.001;x2=11.380,P=0.009).Conclusions Nasopharyngeal swab sample testing in children with severe pneumonia typically shows a coexistence of viral and bacterial pathogens,with detection rates varying among different age groups and seasons.Nasopharyngeal swab sample testing for pathogens provides valuable references for the identification of clinical pathogens.
关键词
重症肺炎/鼻咽拭子/病原学/儿童Key words
Severe pneumonia/Nasopharyngeal swab/Etiology/Children引用本文复制引用
基金项目
国家科技重大专项(2017ZX10104001-005-010)
国家科技重大专项(2017ZX10103004-004)
中国医学科学院医学与健康科技创新工程(2019-I2M-5-026)
北京市卫生健康委员会改革与发展项目()
出版年
2024
NETL
NSTL
万方数据