Analysis on distribution and epidemic characteristics of common pathogens of pneumonia among hospitalized children, Suzhou, 2011-2018
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摘要:
目的 了解苏州市住院儿童肺炎的病原分布特点及流行特征。 方法 以2011年4月-2018年3月入住苏州大学附属儿童医院呼吸科的临床肺炎住院儿童为对象, 采集鼻咽分泌物, 对儿童肺炎常见的细菌和病毒病原进行检测。 结果 4 765名临床肺炎病例中, 病原检出阳性3 602例(75.6%), 细菌检出阳性2 736例(57.4%), 阳性率最高的为肺炎链球菌(Streptococcus pneumoniae, SP)(20.3%), 其次为流感嗜血杆菌(Haemophilus influenzae, H.i)(15.5%); 病毒检出阳性2 101例(44.1%), 阳性率最高的为呼吸道合胞病毒(respiratory syncytial virus, RSV)(16.4%), 其次为博卡病毒(bocavirus, BoV)(13.6%)。细菌和病毒混合感染1 235例(25.9%), 最主要类型为呼吸道合胞病毒和肺炎链球菌、博卡病毒和草绿色链球菌(Streptococcus viride, SV)。 结论 SP、H.i、RSV、BoV是临床肺炎最主要的病原, 病原分布在月龄、季节上存在统计学差异, 细菌和病毒混合感染率较高。 Abstract:Objective To understand the distribution and epidemic characteristics of common pathogens of pneumonia among hospitalized children in Suzhou. Methods Nasopharyngeal secretions were collected from hospitalized children with clinical pneumonia admitted to the respiratory department of Children's Hospital Affiliated to Suzhou University from April 2011 to March 2018 to detect common viral and bacterial pathogens of children's pneumonia. Results The total positive rate of pathogens was 75.6% in the 4 765 clinical pneumonia cases. The positive rate of bacterial pathogens was 57.4%. Streptococcus pneumoniae(SP) was the highest, followed by Haemophilus influenzae(H.i); The positive rate of viral pathogens was 44.1%. Respiratory syncytial virus(RSV) was the highest, followed by Bocavirus(BoV). The mixed infection rate of bacteria and virus was 25.9%, and the most common types were RSV and SP, BoV and Streptococcus viride(SV). Conclusions SP, H.i, RSV and BoV are the main pathogens of clinical pneumonia in children. There are statistical differences in different age groups and seasons of hospitalized children's pneumonia in Suzhou. The mixed infection rate of bacteria and virus is high. -
Key words:
- Hospitalized children /
- Clinical pneumonia /
- Pathogenic distribution
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表 1 研究对象与排除对象的基本特征分析[n (%)]
Table 1. Basic characteristics of research objects and exclusion objects [n (%)]
特征 纳入对象(n=4 765) 排除对象(n=1 062) χ2/Z值 P值 性别 1.79 1.181 男 2 941(61.7) 632(59.5) 女 1 824(38.3) 430(40.5) 年龄(月) -1.55 0.122 ≤6 1197(25.1) 265(25.0) 7~ 934(19.6) 172(16.2) 13~ 2 549(53.5) 605(57.0) > 60 85(1.8) 20(1.9) 季节 7.78 0.051 春季 1 287(27.0) 267(25.1) 夏季 995(20.9) 246(23.2) 秋季 1 075(22.6) 265(25.0) 冬季 1 408(29.5) 284(26.7) 表 2 儿童肺炎主要病原的月龄特点[n (%)]
Table 2. Age characteristics of main pathogens of pneumonia in children[n (%)]
≤6月龄 7~月龄 13~月龄 > 60月龄 χ2值 P值 (n=1 197) (n=934) (n=2 549) (n=85) 细菌性病原 81.79 < 0.001 SP 149(12.4) 204(21.8) 597(23.4) 16(18.8) 62.51 < 0.001 H.i 197(16.5) 180(19.3) 355(13.9) 5(5.9) 21.84 < 0.001 SV 159(13.3) 142(15.2) 331(13.0) 10(11.8) 31.17 0.366 MC 63(5.3) 60(6.4) 166(6.5) 0(0.0) 7.95 0.047 SA 131(10.9) 21(2.2) 38(1.5) 3(3.5) 197.21 < 0.001 E.coli 18(1.5) 5(0.5) 3(0.1) 0(0.0) - < 0.001a PA 9(0.8) 5(0.5) 9(0.4) 0(0.0) - 0.379a K.pn 9(0.8) 3(0.3) 1(0.0) 0(0.0) - 0.001a 病毒性病原 476(39.8) 447(47.9) 1 156(45.4) 22(25.9) 25.43 < 0.001 RSV 304(25.4) 178(19.1) 297(11.7) 1(1.2) 131.96 < 0.001 BoV 48(4.0) 139(14.9) 448(17.6) 12(14.1) 129.47 < 0.001 IFVA 39(3.3) 64(6.9) 191(7.5) 1(1.2) 29.56 < 0.001 IFVB 17(1.4) 29(3.1) 98(3.8) 4(4.7) 16.65 0.001 PIV 51(4.3) 57(6.1) 113(4.4) 1(1.2) 7.42 0.060 HMPV 29(2.4) 20(2.1) 45(1.8) 3(3.5) 2.84 0.418 ADV 5(0.4) 11(1.2) 61(2.4) 0(0.0) 23.02 < 0.001 注:a对E.coli、PA、K.pn的月龄分布特点分析采用确切概率法。 表 3 儿童肺炎主要病原的季节特点[n (%)]
Table 3. Seasonal characteristics of main pathogens of pneumonia in children[n (%)]
春季 夏季 秋季 冬季 χ2值 P值 (n=1 287) (n=995) (n=1 075) (n=1 408) 细菌性病原 43.67 < 0.001 SP 251(19.5) 167(16.8) 253(23.5) 295(21.0) 15.45 0.001 H.i 329(25.6) 118(11.9) 65(6.0) 225(16.0) 183.50 < 0.001 SV 135(10.5) 185(18.6) 221(20.6) 101(7.2) 126.42 < 0.001 MC 68(5.3) 55(5.5) 86(8.0) 80(5.7) 9.31 0.025 SA 58(4.5) 42(4.2) 41(3.8) 52(3.7) 1.38 0.710 E.coli 7(0.5) 6(0.6) 7(0.7) 6(0.4) 65.20 0.885 PA 3(0.2) 6(0.6) 11(1.0) 3(0.2) 10.63 0.014 K.pn 0(0.0) 6(0.6) 3(0.3) 4(0.3) - 0.030a 病毒性病原 505(39.2) 438(44.0) 484(45.0) 674(47.9) 20.83 < 0.001 RSV 147(11.4) 20(2.0) 236(22.0) 377(26.8) 162.58 < 0.001 细菌性病原 791(61.5) 561(56.4) 668(62.1) 716(50.9) 43.67 < 0.001 SP 251(19.5) 167(16.8) 253(23.5) 295(21.0) 15.45 0.001 H.i 329(25.6) 118(11.9) 65(6.0) 225(16.0) 183.50 < 0.001 SV 135(10.5) 185(18.6) 221(20.6) 101(7.2) 126.42 < 0.001 注:a对K.pn的季节分布特点分析采用确切概率法。 表 4 儿童肺炎病原混合感染情况[n (%)]
Table 4. Mixed infection of pneumonia in children[n (%)]
n 合并其他细菌感染 合并其他病毒感染 细菌-病毒混合感染 RSV 780 - 86(11.0) 451(57.8) BoV 647 - 121(18.7) 412(63.7) INF 443 - 91(20.5) 253(57.1) PIV 222 - 26(11.7) 133(59.9) ADV 77 - 6(7.8) 37(48.1) HMPV 97 - 12(12.4) 40(41.2) SP 851 167(19.6) - 430(50.5) H.i 737 182(24.7) - 295(40.0) SV 642 91(14.2) - 324(50.5) MC 289 111(38.4) - 140(48.4) SA 193 61(31.6) - 66(34.2) -
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