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目的了解阜阳地区发热呼吸道症候群住院患者的细菌病原谱构成,为临床医生的经验性用药提供理论依据。方法对阜阳市第二人民医院自2014年10月—2015年9月符合发热呼吸道症候群定义的120例住院患者行痰培养、血培养、聚合酶链式反应(PCR)、尿抗原检测进行病原学检测,检测病原菌包括肺炎链球菌(SP)、金黄色葡萄球菌(SA)、肺炎克雷伯菌(KP)、流感嗜血杆菌(HI)、铜绿假单胞菌(PA)、A组乙型链球菌(β-HA)、肺炎支原体(MP)、肺炎衣原体(CT)、嗜肺军团菌(LP)。结果 120份病例的阳性率为43.3%,其中各病原菌比例SP为15.8%(19/120)、SA为0.8%(1/120)、KP为5.0%(6/120)、HI为9.2%(11/120)、PA为7.5%(9/120)、MP为9.2%(11/120)、未检测到β-HA、CT、LP,混合感染率为4.2%(5/120)。120例患者均诊断为社区获得性肺炎,其中单纯社区获得性肺炎75例,病原菌感染的阳性率为38.7%(29/75),混合感染2例,混合感染率为2.7%。有基础肺病慢性阻塞性肺病病史的病例45例,病原菌感染的阳性率为48.9%(23/45),混合感染3例,混合感染率为6.7%。结论阜阳市发热呼吸道症候群住院患者的前3位致病菌为肺炎链球菌、流感嗜血杆菌和肺炎支原体,混合感染较常见。发热呼吸道症候群的主要疾病为社区获得性肺炎。单纯社区获得性肺炎患者和有慢性阻塞性肺病病史的社区获得性肺炎患者的细菌病原谱存在差异。
Objective To understand the composition of the bacterial pathogenic spectrum in the inpatients with febrile respiratory syndrome in Fuyang area and to provide theoretical basis for the empirical medication of clinicians. Methods The sputum culture, blood culture, polymerase chain reaction (PCR) and urinary antigen test were performed in 120 hospitalized patients in Fuyang Second People’s Hospital from October 2014 to September 2015 who met the definition of Fever respiratory syndrome. The detection and detection of pathogenic bacteria include Streptococcus pneumoniae (SP), Staphylococcus aureus (SA), Klebsiella pneumonia (KP), Haemophilus influenzae (HI), Pseudomonas aeruginosa (PA) Streptococcus (β-HA), Mycoplasma pneumoniae (MP), Chlamydia pneumoniae (CT), Legionella pneumophila (LP). Results The positive rate of 120 cases was 43.3%. The proportion of each pathogen was 15.8% (19/120), SA was 0.8% (1/120), KP was 5.0% (6/120), HI was 9.2% 11/120). PA was 7.5% (9/120) and MP was 9.2% (11/120). No β-HA, CT, or LP was detected with a mixed infection rate of 4.2% (5/120). 120 patients were diagnosed as community-acquired pneumonia, 75 cases of community-acquired pneumonia alone, the positive rate of pathogen infection was 38.7% (29/75), mixed infection in 2 cases, the mixed infection rate was 2.7%. Forty-five patients had a history of chronic lung disease with pulmonary disease, the positive rate of pathogen infection was 48.9% (23/45), and 3 were mixed infections with a mixed infection rate of 6.7%. Conclusion The first three pathogens of fever respiratory syndrome in Fuyang are Streptococcus pneumoniae, Haemophilus influenzae and Mycoplasma pneumoniae. The mixed infection is more common. The leading cause of fever respiratory syndrome is community-acquired pneumonia. There was a difference in the bacterial etiology between patients with community-acquired pneumonia and those with a history of chronic obstructive pulmonary disease.