闽南地区5 869例儿童社区获得性肺炎患者 病原学特点分析

目的通过对闽南地区社区获得性肺炎(CAP)患儿病原特点进行分析,为CAP早期预警、预防和早期经验治疗提供指导和依据。方法收集我院2015年1月至2017年5月5 869例CAP患儿静脉血、呼吸道分泌物及痰标本分别进行肺炎支原体(MP)、呼吸道病毒检测以及细菌培养和鉴定。结果 5 869例CAP患儿中明确病原体感染4 931例,其中单纯细菌感染3 054例,单纯病毒感染966例,单纯MP感染620例,混合感染291例,未检出病原体938例。细菌性病原主要以肺炎链球菌、流感嗜血杆菌和卡他莫拉菌为主,在各季节检出率不同且男性多于女性,主要在低龄儿童中检出。病毒感染者主要分布于低龄儿童,夏季检出率最高,病原以呼吸道合胞病毒(RSV)为主,占68.22%。该类患者在性别上比较差异无统计学意义。MP感染者中女性多于男性,主要分布于大龄儿童,冬季检出率最高。结论本地区CAP患儿病原检出率由高到低分别为细菌、病毒和MP。细菌和MP检出率在患儿中具有性别差异,各种病原在不同年龄段儿童及季节中检出率不同。

Etiological characteristics of 5,869 cases of community-acquired pneumonia in children in southern Fujian

Abstract: Objective To explore the characteristics of the pathogens in children with CAP in southern Fujian and provide theoretical guidance and scientific evidence for early warning, prevention and empirical treatment of CAP. Methods The specimens of venous blood, respiratory secretions and sputa of patients in our hospital from January 1, 2015 to May 30, 2017 were collected for detection of Mycoplasma pneumonia (MP) and respiratory viruses, and for bacterial culturing and identification. Results There were 4,931 pathogen-positive CAP cases among the 5,869 ones, including 3,054 cases of bacterial infections, 966 cases of viral infections, 620 cases of MP infection, and 291 cases of mixed infections. Streptococcus pneumonia was the most common bacterial pathogen, followed by Haemophilus influenza and Moraxella catarrhalis, the detection rates of which were different between seasons and higher in male than in female patients. Bacterial infections occurred more often in younger children. There was no difference in the incidence of viral infections between genders. Viral infections mainly occurred in younger children and the detection rate of pathogens were highest in summer with RSV being predominant, accounting for 68.22%. The incidence of MP infection was higher in female than in male children. MP infection mainly occurred in elder children and the detection rate of pathogens were highest in winter. Conclusion The most common pathogens detected in CAP children in southern Fujian were bacteria, followed by viruses and MP. There were differences in the detection rates of bacteria and MP between genders. The detection rates of pathogens varied in different age groups and seasons.