昆明地区小儿社区获得性下呼吸道感染病原菌分析
Etiological Analysis of Community-acquired Lower Respiratory Tract Infection in Children in Kunming
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摘要: 目的 分析昆明市 (海拔1860 m) 小儿社区获得性下呼吸道感染病原菌流行病学特征.方法 对2011年01月至2015年12月因社区获得性下呼吸道感染入住昆明医科大学第二附属医院及昆明市妇幼保健院9 793例患儿痰标本培养结果进行回顾性分析.结果 9 793例社区获得性下呼吸道感染患儿痰标本中, 合格痰标本为8 433份, 合格率为86.10%, 细菌培养阳性2 918份, 细菌检出率为34.60%, 共检出菌株3 123株, 其中革兰氏阴性菌 (1 839株;58.9%) , 革兰氏阳性菌 (1284株;41.4%) , 革兰氏阴性检出率逐年增加;其中流感嗜血杆菌 (768株;24.60%) 最多见, 其次是肺炎链球菌 (665株;21.3%) 、大肠埃希菌 (315株;10.1%) 、金黄色葡萄球菌 (9.9%) ;卡他莫拉菌272株 (8.7%) ;肺炎克雷伯杆菌224株 (7.2%) .6种常见细菌在不同季节检出率差异有统计学意义 (P<0.05) .除卡他莫拉菌外5种常见细菌在不同年龄段检出率差异有统计学意义 (P<0.05) .结论 昆明地区小儿社区获得性下呼吸道感染病原菌以革兰氏阴性菌为主, 最常见的是流感嗜血杆菌;痰培养细菌检出率以冬季最高;近5 a婴幼儿下呼吸道感染最常见的致病菌是流感嗜血杆菌, 学龄前期、学龄期儿童是肺炎链球菌.昆明小儿社区下呼吸道感染致病菌与平原地区不同.
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关键词:
- 社区获得性下呼吸道感染 /
- 病原菌 /
- 小儿
Abstract: Objective To investigate epidemiological characteristics of pathogenic bacteria of community-acquired lower respiratory tract infection in children in Kunming (with an altitude of 1860 m) .Me thods The results of bacterial culture of 9793 patients with community-acquired lower respiratory tract infection in the Second Affiliated Hospital of Kunming Medical University and Kunming Maternal and Child Health Hospital from Jan 2011 to Nov 2015 were reviewed.Re s ults Among the 9793 phlegm samples from the children patients with community-acquired lower respiratory tract infection, 8433 (86.10%) phlegm samples were qualified, 2918 (34.6%) had a positive bacterial culture.The pathogenic bacteria mainly were gram-negative bacteria (1 839 strains, 58.9%) , and gram-positive bacteria (1 284 strains, 41.4%) . The detection rate of gram-negative bacteria was increasing, among which Haemophilus was in a leading position (768 strains, 24.60%) , followed by Streptococcus pneumonia (665 strains, 21.3%) , E. coli (315 strains, 10.10%) , Staphylococcus aureus (310 strains, 9.9%) , Moraxella catarrhalis (272 strains, 8.7%) , and Klebsiella pneumoniae bacillus (224 strains, 7.2%) . The detection rates of six common bacteria in different seasons were significantly different (P<0.05) . The detection rates of six common bacteria except Moraxella catarrhalis in different age groups were significantly different (P<0.05) . Conclus ions Gram-negative bacterium was the main pathogenic bacteria for those children who got community-acquired lower respiratory tract infections. Haemophilus influenza was the most common pathogenic bacteria and the detection rate of pathogenic bacteria in winter was high. The most common pathogenic bacteria in infants and toddler were Haemophilus influenza. The most common pathogen in preschool and school-age children was Streptococcus pneumonia.The pathogenic bacteria of lower respiratory tract infection in the children community of Kunming are different from those in the plain area. -
[1] [1] CHOCHUA S, D'ACREMONT V, HANKE C, et al.Increased nasopharyngeal density and concurrent carriage of streptococcus pneumoniae, haemophilus influenzae, and moraxella catarrhalis are associated with pneumonia in febrile children[J].PLOS ONE, 2016, 11 (12) :e0167725. [2]王卫平.儿科学.第8版.北京:人民卫生出版社, 2013:278-287. [3] [3] ALES TICHOPAD, CRAIG ROBERTS, IGOR GEMBULAet, al.Clinical and economic burden of community-acquired pneumonia among adults in the Czech Republic, Hungary, Poland and Slovakia[J].PLOS ONE, 2013, 8 (8) :71-79. [4]杨晓华, 谭南, 林爱心, 等.儿童下呼吸道感染病原菌检测结果影响因素的探讨[J].国际检验医学杂志, 2017, 38 (10) :1327-1328. [5]郭宽鹏, 李先斌, 宋春荣, 等.儿童下呼吸道感染病原学特点及耐药性分析:一项来自省级儿童医院2年的痰标本结果[J].实用检验医师杂志, 2017, 9 (1) :8-12. [6]包庆洋, 李昌崇, 张冰, 等.2011-2015年小儿下呼吸道感染病原学分布及药敏分析[J].中国妇幼保健, 2016, 31 (16) :3282-3285. [7]袁翊, 陈文碧, 刘靳波, 等.儿童下呼吸道临床分离菌的分布及耐药性[J].中国感染与化疗杂志, 2017, 17 (5) :552-557. [8]侯俏珍, 曾华松, 何丽雅, 等.反复呼吸道感染儿童CD19、Ig E、Ig G亚类检测的意义[J].实用医学杂志, 2015, 31 (9) :1524-1526. [9]陶琪, 李永祥.学龄前儿童流感嗜血杆菌感染的流行病学特征与耐药性研究[J].中国卫生检验杂志, 2016, 26 (14) :2114-2117. [10]孙秋风, 严永东, 陈正荣, 等.下呼吸道感染性疾病7794例病原分布研究[J].中国实用儿科杂志, 2014, 29 (3) :214-217. [11]曹丽云, 赵琳.小儿下呼吸道感染的常见病原体及发病机制[J].中国微生态学杂志, 2016, 28 (2) :246-249. [12]叶慧芬, 曾俊韶, 覃文周.儿童感染社区获得性耐甲氧西林金黄色葡萄球菌的研究进展[J].临床儿科杂志, 2013, 31 (8) :779-783. [13]王小娟, 陈俊华, 王惠姣.肺炎链球菌致学龄前儿童下呼吸道感染的临床特征与耐药性分析[J].中国消毒学杂志, 2016, 33 (2) :187-189. [14] [14] BEZERRA P G, BRITTO M C, CORREIA J B, et al.Viral and atypical bacterial detection in acute respiratory infection in children under five years[J].Plos one, 2011, 6 (4) :e18928. [15]陆权.小儿社区获得性呼吸道感染和抗菌药物的合理使用[J].上海医药, 2009, 30 (6) :245-247.
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