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目的:分析龙华新区儿童社区获得性肺炎(CAP)的病原学分布情况,为临床合理抗感染治疗提供参考。方法:选取2013年6月~2015年12月在深圳龙华新区三大公立医院就诊的450例CAP患儿为研究对象,于入院后6 h内抗感染治疗前用无菌吸痰器采集呼吸道分泌物进行细菌培养、肺炎支原体和沙眼衣原体、鼻咽分泌物病毒检测。结果:450例CAP患儿中的病原学检测阳性393例(87.33%);393例病原学检测阳性CAP患儿细菌感染检出147例(37.4%),其中单一细菌感染中肺炎链球菌感染率显著高于其他类型的细菌感染(P<0.05);393例病原学检测阳性CAP患儿病毒感染检出163例(41.5%),其中呼吸道合胞病毒和腺病毒感染率明显高于其余病毒感染;≤3 CAP岁患儿单一细菌感染、单一病毒感染、细菌+病毒感染、2种病毒感染比率均明显高于>3岁患儿(P<0.05),>3岁CAP患儿单一非典型病原体感染、细菌+非典型病原体感染、2种非典型病原体感染率明显高于≤3岁患儿(P<0.05)。结论:细菌、病毒、非典型病原体是龙华新区儿童CAP的主要病原体,3岁以上CAP儿童病原以非典型病原体为主。
Objective: To analyze the etiological distribution of community-acquired pneumonia (CAP) in children in Longhua New District and provide reference for clinical rational anti-infective treatment. Methods: From June 2013 to December 2015, 450 CAP children treated in three public hospitals in Longhua New District of Shenzhen were enrolled in this study. Before the anti-infective treatment within 6 hours after admission, respiratory secretions were collected with a sterile sputum aspirator Materials for bacterial culture, Mycoplasma pneumoniae and Chlamydia trachomatis, nasopharyngeal secretions virus detection. Results: A total of 393 cases (87.33%) were etiologically detected in 450 cases of CAP. Bacterial infection was found in 393 cases (37.4%) with positive CAP infection. The prevalence of S. pneumoniae in a single bacterial infection (P0.05) .Among 393 cases with positive CAP etiology, 163 (41.5%) were detected with viral infection, of which respiratory syncytial virus and adenovirus infection rates were significantly higher than those of the other virus infections ; ≤3 CAP children with single bacterial infection, single virus infection, bacteria + virus infection, the ratio of two kinds of virus infection were significantly higher than those of children aged> 3 years (P <0.05),> 3 years old with CAP single children with atypical pathogens Infection, bacterial + atypical pathogen infection, two kinds of atypical pathogens infection rate was significantly higher than ≤ 3 years old children (P <0.05). Conclusion: Bacteria, viruses and atypical pathogens are the major causative agents of CAP in children in Longhua New Area. The pathogens of CAP children over 3 years old are mainly atypical pathogens.