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目的了解本院儿童社区获得性肺炎(CAP)病原微生物分布情况。方法选择本院儿科住院的875例年龄28 d～8岁的CAP患儿,于入院4 h内分别采集呼吸道分泌物和静脉血,呼吸道分泌物行细菌和真菌培养,实时(RT)-PCR检测肺炎支原体和沙眼衣原体;静脉血用ELISA法检测呼吸道合胞病毒和腺病毒,并行血培养。结果 875例CAP患儿中,呼吸道分泌物培养出致病菌233株。其中革兰阳性菌124株(占53.2%),革兰阴性菌107株(占45.9%),真菌2株(占0.9%)。排名前6位细菌分别为肺炎链球菌(34.8%),大肠埃希菌(11.6%),金黄色葡萄球菌(8.6%),肺炎克雷伯菌(6.4%),卡他莫拉菌(5.6%),不活泼型大肠埃希菌(4.7%)。前6位细菌中产酶菌株占检出全部细菌的20.6%。非细菌病原体检出率为24.5%(214/875例),其中呼吸道合胞病毒的感染率为19.3%(169/875例)。呼吸道合胞病毒与肺炎链球菌混合感染率最常见(3.3%)。多数病原微生物以≤1岁患儿中感染率高。结论肺炎链球菌与呼吸道合胞病毒为本院儿童CAP的主要病原体;多数病原微生物在≤1岁患儿中的感染率高。
Objective To understand the distribution of pathogenic microorganisms in children with community-acquired pneumonia (CAP) in our hospital. Methods A total of 875 children aged 28-8 years old with CAP admitted to our hospital were enrolled in this study. Respiratory secretions and venous blood were collected within 4 hours after admission. Bacterial and fungal cultures were collected for respiratory secretions. Real-time RT-PCR Mycoplasma pneumoniae and Chlamydia trachomatis; venous blood was detected by ELISA respiratory syncytial virus and adenovirus, parallel blood culture. Results Among 875 CAP patients, 233 strains of pathogens were cultured in respiratory secretions. There were 124 Gram-positive bacteria (53.2%), 107 Gram-negative bacteria (45.9%) and 2 fungi (0.9%). The top six bacteria were Streptococcus pneumoniae (34.8%), Escherichia coli (11.6%), Staphylococcus aureus (8.6%), Klebsiella pneumoniae (6.4%) and Moraxella catarrhalis %), Inactive Escherichia coli (4.7%). The first 6 bacteria producing enzymes accounted for 20.6% of all bacteria detected. The detection rate of non-bacterial pathogens was 24.5% (214/875 cases), of which respiratory syncytial virus infection rate was 19.3% (169/875 cases). The most common mixed infection rate of respiratory syncytial virus and S. pneumoniae (3.3%). Most pathogenic microorganisms in children ≤ 1 year old infection rate. Conclusions Streptococcus pneumoniae and respiratory syncytial virus are the main pathogens of CAP in our hospital. Most of the pathogenic microorganisms have a high infection rate in children ≤ 1 year old.