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目的:分析上海崇明地区急性下呼吸道感染(acute lower respiratory infections,ALRIs)患儿所感染病原体的流行病学特点及临床特征。方法:采集523例ALRIs患儿的血清,用间接免疫荧光法检测9类病原体[嗜肺军团菌1型、肺炎支原体、Q热立克次体、肺炎衣原体、腺病毒、呼吸道合胞病毒(respiratory syncytial virus,RSV)、甲型流感病毒、乙型流感病毒及副流感病毒]的Ig M抗体;同时采集其深部鼻咽分泌物,用直接免疫荧光法检测人偏肺病毒抗原,并进行统计学分析。结果:523例ALRIs患儿的病原体总阳性检出率为69.2%,其中混合感染者占2.9%。感染率排前5位的病原体分别为RSV(20.1%)、肺炎支原体(13.4%)、副流感病毒(9.9%)、人偏肺病毒(8.0%)和腺病毒(6.9%)。病原体的总检出率在不同性别患儿间的差异无统计学意义,而在不同年龄组间及不同季节分布间差异有统计学意义;不同ALRIs疾病间的病原体检出率不同,以毛细支气管炎最高。结论:本地区ALRIs患儿感染的病原体以RSV为主,其次为肺炎支原体、副流感病毒感染,其中又以婴儿易感,且冬、春季多发。
Objective: To analyze the epidemiological characteristics and clinical features of pathogens in children with acute lower respiratory infection (ALRIs) in Chongming area, Shanghai. Methods: Serum samples were collected from 523 children with ALRIs. Nine kinds of pathogens (Legionella pneumophila, Mycoplasma pneumoniae, Chlamydia pneumoniae, Chlamydia pneumoniae, adenovirus, respiratory syncytial virus (respiratory syncytial virus) syncytial virus (RSV), influenza A (A), influenza B (B) and parainfluenza virus (IgM). Meanwhile, the deep nasopharyngeal secretions were collected and the antigens of human metapneumovirus were detected by direct immunofluorescence analysis. Results: The total positive detection rate of pathogens in 523 children with ALRIs was 69.2%, of which 2.9% were mixed infection. The top 5 infection rates were RSV (20.1%), Mycoplasma pneumoniae (13.4%), Parainfluenza virus (9.9%), Human metapneumovirus (8.0%) and Adenovirus (6.9%). There was no significant difference in the total detection rate of pathogens between children with different genders, but there were significant differences among different age groups and among different seasons. The detection rates of pathogens in different ALRIs were different, with capillary bronchus The highest inflammation. CONCLUSION: The main pathogens of ALRIs in this area are RSV, followed by Mycoplasma pneumoniae and Parainfluenza virus, which are susceptible to infants and have multiple infections in winter and spring.