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目的了解儿童下呼吸道感染患者非典型病原体的构成和临床流行特征,为有效防治儿童下呼吸道感染提供依据。方法收集杭州市第六人民医院收治的1 375例下呼吸道感染患儿血清标本,采用间接免疫荧光法进行8种常见病原体IgM检测。结果 1 375例标本总阳性率为43.20%,各年龄段阳性率差异有统计学意义,在3～6岁年龄段达到高峰(66.67%)。2种以上病原体检出率随着年龄段增加有升高趋势,差异有统计学意义(P<0.05)。阳性率秋季最高(50.23%),冬季最低(40.34%)。肺炎支原体是儿童下呼吸道感染患者的主要非典型病原体,呼吸道合胞病毒、嗜肺军团菌和流感病毒流行具有典型季节性。结论肺炎支原体为儿童急性下呼吸道感染最常见的非典型病原体,不同病原体具有不同的临床流行特征。
Objective To understand the composition and clinical features of atypical pathogens in children with lower respiratory tract infections and provide evidence for effective prevention and treatment of lower respiratory tract infections in children. Methods A total of 1 375 serum samples of children with lower respiratory tract infection were collected from the Sixth People ’s Hospital of Hangzhou. IgM was detected by indirect immunofluorescence in 8 kinds of common pathogens. Results The total positive rate of 1 375 specimens was 43.20%. There was a significant difference in the positive rate among all age groups, reaching a peak (66.67%) at the age of 3 to 6 years. The detection rate of two or more pathogens increased with age, the difference was statistically significant (P <0.05). The highest positive rate was in autumn (50.23%) and lowest in winter (40.34%). Mycoplasma pneumoniae is a major atypical causative agent of children with lower respiratory tract infections, and the seasonal epidemic of respiratory syncytial virus, Legionella pneumophila, and influenza viruses is typical. Conclusions Mycoplasma pneumoniae is the most common atypical pneumonia in children with acute lower respiratory tract infection. Different pathogens have different clinical epidemiological features.