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目的 了解急性肺炎时肺炎链球菌 (SP)、流感嗜血杆菌 (Hi)、卡他布兰汉菌 (BC)、肺炎支原体 (MP)及肺炎衣原体 (CP)等多病原混合感染的发病情况。方法 采用酶免疫分析法 ,对 5 3例住院急性肺炎患儿的双份血清进行不定型Hi抗体、B型Hi荚膜多糖抗体和全菌抗体进行检测 ,SP溶血素抗体和C 多糖抗体 ,循环免疫复合物中SP溶血素抗体、表面蛋白A抗体和C 多糖抗体 ,CB全菌抗体及MP抗体的检测 ;采用免疫荧光法检测患儿双份血清中CP抗体 ;并同时进行血液普通细菌培养。结果 5 3例肺炎患儿中 32例 (占 6 0 .4 % )病原学检测阳性。其中单一病原体感染 2 1例 ,2种和 3种病原体混合感染分别为 8例和 3例。在各种病原体中 ,SP和CP感染最常见 (各占 2 0 .8% ,11/ 5 3) ,其次为MP感染 (占 16 .7% ,7/ 4 2 )和Hi感染 (占 13.2 % ,7/ 5 3)。结论 急性肺炎时SP、CP、MP和Hi等是常见的病原 ,在小儿肺炎经验治疗时 ,多病原体混合感染情况应予以重视。
Objective To investigate the incidence of multiple pathogenic mixed infections in patients with acute pneumonia such as Streptococcus pneumoniae, Hi, BC, MP and CP. Methods Enzyme immunoassay was used to detect the type II Hi antibody, type B Hi capsular polysaccharide antibody and whole bacteria antibody in two sera from 53 inpatients with acute pneumonia. The serum levels of SP hemolysin and C polysaccharide were measured. Immune complexes in the SP hemolysin antibody, surface protein A antibody and C polysaccharide antibodies, CB whole bacteria antibodies and MP antibody detection; immunofluorescence assay in children with two copies of serum CP antibody; and at the same time ordinary blood culture of bacteria. Results 32 out of 53 children with pneumonia (60.0%) had positive etiological tests. Among them, 21 cases were infected with a single pathogen, and 8 and 3 cases were infected with 2 and 3 pathogens respectively. Among the various pathogens, SP and CP infections were most common (20.8% and 11/53% respectively), followed by MP infection (16.7% and 7/42) and Hi infection (13.2% , 7/5 3). Conclusions SP, CP, MP and Hi are common pathogens in acute pneumonia. In the experience of pediatric pneumonia, mixed infection of multiple pathogens should be paid more attention.