南京地区急性呼吸道感染儿童支原体、衣原体和常见呼吸道病毒病原学分析

Detection of Mycoplasma pneumoniae, Chlamydia trachomatis and common respiratory viruses in children with acute respiratory infection in Nanjing

摘要:

目的：了解南京地区急性呼吸道感染（acute respiratory infection, ARI）儿童除细菌外的其他病原微生物感染情况，指导临床诊断和治疗。方法应用荧光定量PCR法检测肺炎支原体（MP）和沙眼衣原体（CT），直接免疫荧光法检测呼吸道合胞病毒（RSV）、腺病毒（ADV）、甲型和乙型流感病毒（IVA和IVB）、副流感病毒1、2、3型（PIV-1、2、3）、人偏肺病毒（hMPV）。结果1 592例标本中，MP和CT阳性率分别为25.7%、2.4%；总呼吸道病毒阳性率为40.9%，其中RSV最常见，占阳性病毒株的61.3%，其次为PIV-3、hMPV，分别为6.7%、4.9%。病原体的混合感染率为6.7%，混合感染主要发生在1岁以内婴儿，有68例，占混合感染的63.6%。结论病毒感染是南京地区婴幼儿ARI的主要原因，RSV是首要病毒病原，MP也是常见的ARI病原体，1岁以内婴儿混合感染率高。［中国当代儿科杂志，2010，12（6）：450-454］

Abstract:

OBJECTIVE: To investigate the nonbacterial pathogens in children with acute respiratory infection (ARI) in Nanjing. METHODS: The presence of Mycoplasma pneumoniae (MP) and Chlamydia trachomatis (CT) was determined by quantitative PCR in the nasopharyngeal samples from 1 592 hospitalized children with ARI. Common respiratory viruses, including respiratory syncytial virus (RSV), adenovirus (ADV), influenza virus types A and B (IVA and IVB), parainfluenza virus types 1, 2, 3(PIV-1, 2, 3) and human metapneumovirus (hMPV), were detected using direct immunofluorescence assay. RESULTS: MP and CT were detected in 25.7% and 2.4% of the 1 592 samples respectively. The overall positive rate of respiratory viruses was 40.9%. Among the viruses, the top detected virus was RSV (61.3%), followed by PIV-3 (6.7%) and hMPV (4.9%). Mixed infection among MP, CT and viruses was observed in 107 cases (6.7%). The infants under 1 year old were susceptible to mix-infection (68/107, 63.6%). CONCLUSIONS: Respiratory virus is the main pathogen responsible for ARI in children from Nanjing. RSV is the most commonly identified virus. MP is also the frequently identified pathogen for ARI in children. Mixed infection is common in infants under 1 year old.［Chin J Contemp Pediatr, 2010, 12 (6):450-454］