社区获得性肺炎非典型病原体分布及其流行特征

目的 了解社区获得性肺炎(CAP)非典型病原体感染的分布情况及其流行特征.方法 收集确诊为社区获得性肺炎患者278例,间接免疫荧光法(IFA)检测人血清中呼吸道9种主要的非典型性病原体的IgM抗体.结果 病原体检测阳性者150例,总阳性率54.O％.单一病原体感染中,肺炎支原体(MP) 125例(45.0％)、呼吸道合胞病毒( RSV) 27例(9.7％)、腺病毒22例(7.9％)、副流感病毒1、2和3型19例(6.8％)、乙型流感病毒16例(5.8％)、嗜肺军团菌血清1型13例(4.7％)、肺炎衣原体2例(0.7％)和甲型流感病毒1例(0.4％).混合感染共63例(22.7％),其中61例(21.9％)为MP与其他病原体的混合感染,病毒感染以RSV最常见,共27例(9.7％).CAP患者患有基础疾病共139例(50％),其余为无基础疾病者.基础疾病中以循环疾病和呼吸疾病最常见,各占总CAP患者的15,1％和13.0％.所有受检者MP阳性率最高,达45％,其中未成年组3～18岁中MP阳性率高达60.2％,而成人组18 ～50岁中MP阳性率高达81.8％.CAP春季病原体阳性检出率为46.9％,冬季病原体阳性检出率为63.8％(x2=7.752,P＜0.05).结论 非典型性病原体(特别是MP)感染在CAP患者中比例较大,其流行与分布跟病原体种类、基础疾病、年龄、季节等有一定的关系.

The epidemiologic and clinical features of atypical pathogens in patients with community-acquired pneumonia

Objective To investigate the epidemiologic and clinical features of atypical pathogens caused community-acquired pneumonia.Methods 278 patients diagnosed as community-acquired pneumonia were included.The IgMs of 9 respiratory infection pathogens were tested by indirect immunofluoreseent assay.Results There were 150 patients(54%) with positive results.The pathogens included Mycoplasma pneumonia(125,45%),respiratory syncytial virus(27,9.7%),Adenovirus(22,7.9%),paramyxovirus serotypes 1,2 and 3(19,6.8%),Influenza B virus(16,5.8%),Legionella pneumophila serotype 1(13,4.7%),Chlamydia pneumoniae(2,0.7%) and Influenza A virus(1,0.4%).63 cases(22.7%) were mixed infection,most of which(61 cases,21.9%) were infected with MP and other pathogens.RSV(27,9.7%) was the predominant pathogen of virus infections.There were 139 cases(278,50%) with basic diseases,such as circulatory system diseases and respiratory system diseases,which accounted for 15.1% and 13.0% respectively.The positive rate of MP was the highest,up to 45%.In the group of age 3 to 18,the MP positive rate was 60.2%,while in the group of age 18 to 50,it was 81.8%.The positive pathogen detection rate of CAP was 46.9% in spring and 63.8% in winter(χ2=7.752,P<0.05).Conclusion Atypical pathogen infections(especially Mycoplasma pneumoniae) account for a large proportion of community-acquired pneumonia and its prevalence and distribution has a certain relationship with underlying diseases,age,and season.