【摘要】 目的探讨急性下呼吸道感染患者非典型病原体与病毒感染情况。方法采集71例社区获得性肺炎和21例急性气管-支气管炎患者支气管肺泡灌洗液(BALF),采用多重PCR技术与Luminex xMAP多重分析技术平台相结合,以荧光微球为载体检测非典型病原体与多种病毒。结果10种(14个亚型)病原体阳性检出率为50.00%,其中病毒阳性检出率为33.69%,以流感病毒A为主,其占病毒阳性检出的67.74%;非典型病原体阳性检出率为16.30%,以肺炎支原体(MP)为多,其占非典型病原体阳性检出的73.33%;MP、病毒和细菌混合感染率为13.04%。结论多重荧光微球检测技术具有高通量、敏感性高、特异性强、检测速度快、价格便宜的优点,可实用于临床病原微生物的快速检测;流感病毒A和肺炎支原体是本地区社区获得性肺炎和急性气管-支气管炎重要的病原体,并有相互混合感染或与细菌混合感染,临床应予重视。更多还原

【Abstract】 OBJECTIVE To investigate the infection rate of atypical organism and virus in patients with community-acquired acute lower respiratory tract infection.METHODS Seventy one community-acquired pneumonia and 21 acute tracheobronchitis patients were included in this study.Bronchoalveolar lavage fluids were sampled for detection.Specific multiplexed fluorescent microspheres,multiplex PCR technology and Luminex xMAP(flexible Multi-Analyte Profiling) were combined to be used to detect the DNA or RNA of 10 species(14 subtypes) respiratory pathogens including adenovirus(ADV),influenza virus A(FluA)and influenza virus B(FluB),respiratory syncytial virus(RSV),parainfluenza virus types 1,2,3,4(PIV1,PIV2,PIV3,PIV4),rhinovirus(RhiV),severe acute respiratory syndrome coronavirus(SARS-Cov),human metapneumovirus(hMPV),Mycoplasma pneumoniae(MP),Chlamydia pneumoniae(CP) and Legionella pneumophilia(LP).RESULTS Forty-six of 92(50%) were found to be positive for virus or MP or CP.The positive rates were 33.69%(31/92) for viruses and 16.30%(15/92) for atypical organisms.67.74%(21/31) of the viruses were FluA,73.33%(11/15) of the atypical organisms were MP.The mixed infection rate of MP,viruses and bacteria was 13.04%(12/92).CONCLUSIONS Multiplexed fluorescent microspheres,and multiplex PCR technology as specific assays for detecting multiple respiratory pathogens in clinical specimens are highly sensitive.The FluA and MP are the important pathogens in patients with community-acquired pneumonia and acute tracheobronchitis in our community.The pathogens could mixed with each other or with bacteria to cause infection.The mixed infection of MP,viruses and bacteria should not be ignored.更多还原