摘要
目的探讨河北省儿童医院呼吸道细菌感染病原谱特征及其规律,为临床治疗提供参考。方法收集2016年2月至2017年2月河北省儿童医院门诊及住院332例患儿的痰液,采用恒温扩增芯片法,提取痰液中呼吸道八种临床常见下呼吸道病原菌的核酸,该八种病原菌分别为肺炎链球菌(PRSP),金黄色葡萄球菌(MRSA),耐甲氧西林葡萄球菌(MRS),肺炎克雷伯菌(KPN),铜绿假单胞菌(PAE),鲍曼不动杆菌(PDRA),大肠埃希菌(E.coli),流感嗜血杆菌(HIB)。按年龄段分为婴儿组,幼儿组,学龄前组,学龄组。结果332例标本中有161例中培养出病原菌,其阳性率为48.49%;病原菌检出率,肺炎链球菌占20.48%、耐甲氧西林葡萄球菌占20.48%、流感嗜血杆菌占13.25%、金黄色葡萄球菌占5.12%、大肠埃希菌占2.71%;肺炎链球菌和耐甲氧西林葡萄球菌检出率明显高于其他病原菌(P<0.05);肺炎链球菌和耐甲氧西林葡萄球菌检出率高于流感嗜血杆菌感染(P<0.05);肺炎链球菌,耐甲氧西林葡萄球菌,流感嗜血杆菌检出率明显高于其他病原菌(P<0.05)。感染两种及以上病原菌51例,混合感染阳性率为15.36%。婴儿组耐甲氧西林葡萄球菌和流感嗜血杆菌检出率分别为11.45%和6.02%,明显高于其他年龄组(P<0.05);幼儿组肺炎链球菌感染检出率明显高于其他年龄组(P<0.05)。不同年龄段混合感染发生率差异有统计学意义(P<0.05)。结论通过回顾性分析比较,河北省儿童医院儿童呼吸道细菌感染主要病原菌依次为肺炎链球菌、耐甲氧西林葡萄球菌以及流感嗜血杆菌。婴儿呼吸道主要细菌感染病原体是耐甲氧西林葡萄球菌和流感嗜血杆菌,幼儿呼吸道感染主要细菌病原体为肺炎链球菌。混合感染与年龄段呈反比,年龄段越小越容易混合感染。
Objective To investigate the pathogen spectrum characteristics and its regulation,so as to provide reference for clinical treatment.Methods The sputum specimens of 332 outpatient and inpatient were collected in Hebei Provincial Children’s Hospital from February 2016 to February 2017.The constant temperature amplification chip method was used to extract the nucleic acids in sputum specimens of eight clinically common pathogens at the lower respiratory tract,including streptococcus pneumoniae(PRSP),staphylococ-cus aureus(MRSA),methicillin-resistant staphylococcus(MRS),klebsiella Pneumoniae(KPN),pseudomonas aeruginosa(PAE),acinetobacter baumanniI(PDRA),escherichia coli(E.coli)and haemophilus influenzae(HIB).According to the age of children patients,the experiment was divided into infant group,toddler group,preschool group and school age group.Results Among the 332 sputum specimens,pathogenic bacteria were ioslated from 161 specimens,with the positive rate being 48.49%.In the aspect of detection rate of pathogenic bacteria,PRSP acounted for 20.48%,MRS 20.48%,HIB 13.25%,MRSA 5.12%,E.coli 2.71%.The detection rates of PRSP and MRS were significantly higher than those of the other pathogenic bacteria(P<0.05).The detection rates of PRSP and MRS were significantly higher than those of HIB(P<0.05).The detection rates of PRSP,MRS and HIB were significantly higher than those of of the other pathogenic bacteria(P<0.05).There were 51 cases of two or more pathogenic bacteria,and the positive rate of mixed infection was 15.36%.The detection rates of MRS and HIB in infantg group were 11.45%and 6.02%,respectively,which were significantly higher than those in the other age groups(P<0.05).The detection rate of PRSP in infant group was significantly higher than that in other age groups(P<0.05).Moreover there were significant differences in the incidence rates of mixed infection in differenr age groups(P<0.05).Conclusion Through retrospective analysis and comparison,the main pathogenic bacteria in respiratory tract infection in our hospital are PRSP,MRS and HIB,and the main pathogens of respiratory tract bacterial infection in infants in our hospital are MRS and HIB,and the main bacterial pathogens of respiratory tract infection in toddler are PRSP.Moreover the mixed infection is inversely proportional to patient’s age,and the younger the patients,the higher the mixed infection incidence rate.
作者
王帆
葛胜旺
周亮
WANG Fan;GE Shengwang;ZHOU Liang(Hebei Provincial Children’s Hospital Affiliated to Hebei Medical University,Hebei,Shijiazhuang 050031,China)
出处
《河北医药》
CAS
2019年第22期3491-3494,共4页
Hebei Medical Journal
关键词
儿童
呼吸道感染
细菌
病原谱
children
respiratory tract infection
bacterium
pathogen spectrum
作者简介
通讯作者:周亮,050031石家庄市,河北医科大学附属河北省儿童医院国际部,E-mail:liuzongtai@sina.com。
