【摘要】 目的:分析198例小儿重症肺炎患儿的病原学特点。方法:采集100例小儿重症肺炎患儿痰、血清标本,98例小儿重症肺炎患儿痰、肺泡灌洗液及血清标本,采用病原菌培养、免疫荧光法检测7种呼吸道病毒,采用实时定量PCR(q PCR)法检测支原体和衣原体并分析其病原菌分布特点。结果:198例患儿中,病原检测阳性者169例,前3位的依次为单纯细菌感染、混合感染及单纯病毒感染;革兰阴性杆菌以肺炎克雷伯菌和大肠埃希菌为主,革兰阳性球菌以肺炎链球菌和金黄色葡萄球菌为主,病毒感染以呼吸道合胞病毒为主,混合感染以细菌合并支原体和细菌合并病毒感染为主;婴幼儿多发生单纯细菌或病毒感染,婴儿以肺炎克雷伯菌和大肠埃希菌感染为主,病毒以呼吸道合胞病毒和腺病毒感染最常见,其年龄分布差异有统计学意义(P <0. 05); 3～7岁儿童单纯支原体感染和细菌合并支原体混合感染多见;冬、春季患儿对呼吸道合胞病毒和腺病毒易感,其季节分布差异有统计学意义(P <0. 05)。结论:小儿重症肺炎多发生于婴幼儿,主要以细菌和病毒感染为主;病毒感染冬和春季易发,肺炎支原体感染在学龄前儿童中多见;混合感染不容忽视。更多还原

【Abstract】 Objective: To analyze the etiology characteristics of 198 children with severe pneumonia.Methods: Sputum and serum samples were collected from 100 children with severe pneumonia,and sputum,alveolar lavage fluid,and serum samples from 98 children with severe pneumonia. These samples were cultured using bacterial culturing technique to form colonies. Seven types of respiratory viruses were detected in purified colonies by immunofluorescence. Mycoplasma and chlamydia were detected by q PCR. The distribution characteristics of pathogenic bacteria were analyzed. Results: Of the 198 children,169 were pathogen positive. The top three infections were simple bacterial infection,mixed infection and simple viral infection. Identified Gram-negative bacilli were mainly Klebsiella pneumoniae and Escherichia coli,while Gram-positive cocci are mainly Streptococcus pneumoniae and Staphylococcus aureus. Identified viral infections are mainly respiratory syncytial virus. Mixed infections are mainly bacterial combined with mycoplasma or viral infection. Infants and young children were prone to bacterial and viral infections. Among the infants under 1 year old,K. pneumoniae and Escherichia coli were the most common bacterial infections,while respiratory syncytial virus and adenovirus were the most common viral infections. The age distribution was statistically significant( P< 0. 05). Mycoplasma infection and mixed bacterial plus mycoplasma infection were common in children aged 3 ～ 7 years old. Children were susceptible to respiratory syncytial virus and adenovirus in winter and spring,and the seasonal distribution was statistically significant( P < 0. 05). Conclusion:Bacterial and viral infections are the main causes of severe pneumonia in infants and young children.Children are easily infected with viruses in winter and spring. Mycoplasma pneumoniae infection is more common in preschool children. Mixed infections cannot be ignored.更多还原