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目的分析石家庄市儿童呼吸道感染病原体的流行特点,为临床预防和治疗呼吸道感染提供病原学依据。方法纳入就诊于儿科的呼吸道感染患儿936例,运用间接免疫荧光法检测儿童血清的八种呼吸道病原体的IgM型抗体。根据不同季节、不同年龄和不同性别分组,分析其病原体阳性率和感染类型。结果 936例患儿血清标本中,检出病原体IgM抗体共424例,阳性率为45.30%。其中肺炎支原体阳性率(28.63%)最高,其次依次为流感病毒B型、呼吸道合胞病毒、流感病毒A型、肺炎衣原体、腺病毒、副流感病毒,未检出嗜肺军团菌。不同季节病原体的阳性率有差异,冬季的病原体阳性率(50.33%)显著高于夏、秋季的阳性率(33.71%和41.46%),差异均有统计学意义;不同年龄组中,婴儿组病原体阳性率(16.05%)显著低于其他3个年龄组,差异均有统计学意义;检出病原体的424例阳性患儿中,单一病原体感染类型者为290例(30.98%),混合感染者134例(14.32%);全部936例患儿中,男童病原体阳性率(42.33%)显著低于女童阳性率(52.29%);病原体混合感染类型中以肺炎支原体和流感病毒B型混合感染最常见,其中婴儿组混合感染病原体检出率均显著低于幼儿组、学龄前组和学龄组。结论肺炎支原体全年在儿童呼吸道感染中占主要地位。年龄和性别是石家庄市儿童呼吸道病原体感染的特异性因素,冬季为呼吸道病原体感染高峰期。
Objective To analyze the epidemiological characteristics of pathogens in children with respiratory tract infection in Shijiazhuang and to provide etiological evidence for clinical prevention and treatment of respiratory tract infections. Methods Nine hundred and sixty-six pediatric patients with respiratory tract infection were enrolled in this study. IgM antibodies against eight respiratory pathogens were detected by indirect immunofluorescence. According to different seasons, different ages and different gender groups, analysis of the positive rate of pathogens and infection types. Results A total of 424 pathogen IgM antibodies were detected in 936 children with the positive rate of 45.30%. The positive rate of Mycoplasma pneumoniae (28.63%) was the highest, followed by influenza B virus, respiratory syncytial virus, influenza A virus, Chlamydia pneumoniae, adenovirus and parainfluenza virus. Legionella pneumophila was not detected. The positive rate of pathogens in different seasons was different. The positive rate of pathogens in winter (50.33%) was significantly higher than that in summer and autumn (33.71% and 41.46%), the differences were statistically significant. In different age groups, The positive rate (16.05%) was significantly lower than the other three age groups, the difference was statistically significant; of the 424 positive children with pathogen detection, the single pathogen infection type was 290 (30.98%), mixed infection 134 (14.32%). Among all the 936 children, the positive rate of boy pathogens (42.33%) was significantly lower than that of girls (52.29%). The most common type of mixed infection among pathogens was Mycoplasma pneumoniae and influenza B , Of which the detection rate of mixed infectious pathogens in infants was significantly lower than those in young children, preschool children and school-age children. Conclusion Mycoplasma pneumoniae plays a major role in childhood respiratory infection. Age and sex are the specific factors of respiratory tract pathogens in children in Shijiazhuang, and the peak of respiratory tract infection in winter.