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目的了解儿童急性下呼吸道感染(ALRTI)的病原学特征及病原微生物分布规律。方法对入选的200例年龄在1月至6岁之间的ALRTI患儿,分别采集呼吸道分泌物和静脉血进行多病原联合监测。对采集到的痰液进行细菌培养,呼吸道病毒抗原利用ELISA法检测。结果在200例ALRTI患儿中,呼吸道分泌物培养细菌165株,其中革兰阳性菌49株(29.7%),革兰阴性菌103株(62.4%),真菌13株。致病病原微生物以大肠埃希菌、肺炎克雷伯菌、肺炎链球菌和金黄色葡萄球菌为主要菌株。其他病原体感染检出136株,较高的4种分别为合胞病毒(27.2%)、鼻病毒(22.1%)、副流感病毒(18.4%)和肺炎支原体(14.7%)。结论不同年龄段儿童下呼吸道感染病原分布各有差异,革兰阳性菌多分布于3岁及以下患儿,革兰阴性菌在各个年龄段均衡分布,合胞病毒和肺炎支原体在1岁及以下患儿中分布率稍高。对儿童急性下呼吸道感染的治疗可以根据致病病原菌在不同年龄段的分布特征进行针对性用药和治疗。
Objective To understand the etiological characteristics and distribution of pathogenic microorganisms in children with acute lower respiratory tract infection (ALRTI). Methods A total of 200 ALRTI children between the ages of 1 and 6 were enrolled in this study. Respiratory secretions and venous blood were collected for pathogenicity surveillance. The collected sputum bacterial culture, respiratory virus antigens using ELISA assay. Results Among 200 children with ALRTI, 165 bacteria were cultured in respiratory secretions, of which 49 were gram-positive bacteria (29.7%), 103 (62.4%) were gram-negative bacteria and 13 were fungi. Pathogenic microorganisms Escherichia coli, Klebsiella pneumoniae, Streptococcus pneumoniae and Staphylococcus aureus as the main strain. 136 strains were detected in other pathogens, the highest ones were syncytial virus (27.2%), rhinovirus (22.1%), parainfluenza virus (18.4%) and mycoplasma pneumoniae (14.7%) respectively. Conclusions There are differences in the distribution of lower respiratory tract infection in children of different ages. Gram-positive bacteria are mostly distributed in children aged 3 years and younger. Gram-negative bacteria are evenly distributed in all age groups. The syncytial virus and Mycoplasma pneumoniae are below 1 year old and below Distribution rate in children slightly higher. The treatment of acute lower respiratory tract infection in children according to the distribution of pathogenic bacteria in different age groups targeted medication and treatment.