检验医学 ›› 2013, Vol. 28 ›› Issue (7): 599-601.DOI: 10.3969/j.issn.1673-8640.2013.07.009

• 临床应用研究.论著 • 上一篇    下一篇

常州地区儿童急性呼吸道感染病原体的流行病学研究

季 云, 王玉月, 史伟峰, 沈 丽   

  1. 苏州大学附属第三人民医院检验科,江苏 常州 213000
  • 收稿日期:2013-07-29 修回日期:2013-07-29 出版日期:2013-07-25 发布日期:2013-07-29
  • 作者简介:季 云,男,1977年生,学士,主管技师,主要从事免疫学与微生物学研究。

An epidemiological study of pathogens in children with acute respiratory infection of Changzhou region

JI Yun, WANG Yuyue, SHI Weifeng,SHEN Li   

  1. Department of Clinical Laboratory, the Third Affiliated Hospital of Soochow University, Jiangsu Changzhou 213000, China
  • Received:2013-07-29 Revised:2013-07-29 Online:2013-07-25 Published:2013-07-29

摘要: 目的 探讨常州地区儿童急性呼吸道感染(ARI)的病原体种类和流行病学特征。方法 应用间接免疫荧光技术检测2 259例ARI患儿血清中9种病原微生物IgM型抗体,包括嗜肺军团菌1型(LP-1)、肺炎支原体(MP)、Q热立克次体(QFR)、肺炎衣原体(CP)、腺病毒(ADV)、呼吸道合胞病毒(RSV)、甲型流感病毒(FluA)、乙型流感病毒(FluB)和副流感病毒(PIV),并进行统计分析。结果 2 259例患儿IgM型抗体阳性例数达856例,检出率为37.9%。单一感染601例,占70.2%(601/856),其中以MP为主,阳性率达43.6%;而FluB、RSV 、PIV阳性率分别为11.4%、6.3%和5.3%。混合感染占29.8%(255/856),主要以MP合并FluB感染为主,占8.4%;而MP合并PIV、MP合并RSV、MP合并LP-1、MP合并PIV和RSV感染分别为5.8%、2.9%、2.4%和1.4%。856例阳性病例中,MP在<1岁组、1~4岁组、5~8岁组、>8岁组中所占比例分别为34.4%、64.0%、51.5%和54.6%,1~4岁组高于其他组(χ2=18.127,P<0.01)。RSV、FluB和PIV阳性构成情况相似(P>0.05)。儿童ARI检出率在秋、冬季节最高,分别为11.8%和13.6%。结论 常州地区儿童ARI中以MP为主要病原体,并合并病毒感染。1~4岁儿童为易感人群,好发于秋、冬季节,大环内酯类抗菌药物联合病毒唑治疗效果明显。

关键词: 流行病学, 急性呼吸道感染, 儿童, 间接免疫荧光技术

Abstract: Objective To investigate the pathogens in children with acute respiratory infection (ARI) and epidemiological characteristics in Changzhou region. Methods The sera were collected from 2 259 children with ARI, and IgM antibodies against 9 kinds of pathogenic microorganisms, including Iegionella pneumophila type 1 (LP-1), mycoplasma pneumonia (MP), Q fever rickettsia (QFR), chlamydia pneumonia (CP), adenovirus (ADV), respiratory syncytial virus (RSV), influenza A virus (FluA), influenza B virus (FluB) and parainfluenza virus (PIV), were detected by indirect immuno-fluorescence assay. The results were analyzed statistically. Results Among 2 259 children with ARI , 856 cases were detected positively, which accounted for 37.9% . Of the 856 cases, there were 601 cases of infection with unique microorganism (70.2%). MP infection was predominant, and the positive rate was 43.6%. The positive rates of FluB, RSV and PIV were 11.4%, 6.3% and 5.3%, respectively. There were 29.8% (255/856) mixed infection, and the main mixed infection was MP+FluB (8.4%), followed by MP+PIV (5.8%), MP+RSV (2.9%), MP+LP-1 (2.4%) and MP+PIV+RSV (1.4%). Among the 856 positive cases, the percentages of MP were 34.4%, 64.0%, 51.5% and 54.6% respectively in <1 year old, 1- 4 years old, 5-8 years old and > 8 years old groups.The highest positive rate was noted in the 1-4 years old group (χ2=18.127, P<0.01). The positive rates of RSV, FluB and PIV had no significant difference in every age group (P>0.05). The rate of children infected with ARI was higher in autumn and winter, which accounted for 11.8% and 13.6%, respectively. Conclusions MP are major pathogens among children with ARI and complicated with virus infection in Changzhou region. The 1- 4 years old children as susceptible populations occur in the autumn and winter, and the therapy of macrolide antibiotics in combination with ribavirin is effective.

Key words: Epidemiology, Acute respiratory infection, Child, Indirect immuno-fluorescence assay

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