苏州地区14994例儿童呼吸道感染细菌病原学特点

Bacterial pathogenic characteristics of respiratory tract infection in children in Suzhou, China: an analysis of 14 994 cases

摘要:

目的 了解儿童呼吸道感染的细菌病原学特点。方法 收集2005 年11 月至2014 年10 月连续9 年因呼吸道感染入住苏州大学附属儿童医院的14 994 例儿童的病例资料进行回顾性分析。结果 14 994 份呼吸道感染患儿的痰标本中,细菌培养阳性3 947 份,总阳性检出率为26.32%。第1 位细菌病原为肺炎链球菌(12.79%),其次为流感嗜血杆菌(5.02%)、卡他莫拉菌(2.91%)。在不同年份、不同季节、不同年龄段儿童细菌检出率差异有统计学意义(P<0.01)。入院前未使用过抗菌药物的患儿痰细菌培养阳性率高于使用过抗菌药物的患儿(P<0.01)。院外病程<1 个月组、1~3 个月组及>3 个月组患儿痰培养细菌检出率差异有统计学意义(P<0.05)。肺炎链球菌、卡他莫拉菌、鲍曼不动杆菌的阳性检出率随病程的延长呈上升趋势(P<0.05)。结论 肺炎链球菌是引起儿童呼吸道感染的最常见细菌病原,其次为流感嗜血杆菌和卡他莫拉菌。各种细菌在不同的年份、不同的季节、不同的年龄阳性检出率有差异。疾病病程与院外抗菌药物使用对细菌的阳性检出率有影响。

Abstract:

Objective To investigate the bacterial pathogenic characteristics of respiratory tract infection in children. Methods The medical data from 14 994 children with respiratory tract infection who were hospitalized in Children's Hospital Affiliated to Soochow University between November 2005 and October 2014 were retrospectively reviewed. Results Among the 14 994 sputum samples from the children with respiratory tract infection, 3 947 (26.32%) had a positive bacterial culture. The most common bacterial pathogen was Streptococcus pneumonia (12.79%), followed by Haemophilus influenzae (5.02%) and Moraxella catarrhalis (2.91%). The bacterial detection rates differed significantly in different years and seasons and children of different ages (P<0.01). The children who had not taken antibacterial agents before admission had a significantly higher positive bacterial culture rate than those who had taken antibacterial agents (P<0.01). There were significant differences in the bacterial detection rate among the children with different course of disease (<1 month, 1-3 months and >3 months) (P<0.05). The detection rates of Streptococcus pneumonia, Moraxella catarrhalis and Acinetobacter baumannii showed an increased trend with a prolonged disease course (P<0.05). Conclusions Streptococcus pneumonia is the most common bacterial pathogen causing respiratory tract infection in children, followed by Haemophilus influenzae and Moraxella catarrhalis. The detection rate of bacterial pathogens varies in different years and seasons and children of different ages. The course of the disease and application of antibacterial agents outside hospital can affect the detection rate of bacterial pathogens in children with respiratory tract infection.