论文部分内容阅读
目的:了解北京市某医院引起成人社区获得性肺炎（CAP）的病原体分布情况，以期为临床诊治和感染防控提供依据。方法:收集2016年6月至2020年1月在北京市某医院就诊的326例成人CAP患者的下呼吸道样本，采用多重实时荧光定量PCR检测方法对多种呼吸道病原体进行检测，分析呼吸道病原体在不同年龄和不同季节的检出情况。结果:326例CAP患者中212例至少检出1种病原体，检出率为65.03%，其中不同病原体混合感染67例（20.55%）。病原体分布为细菌感染139例（42.64%），病毒感染99例（30.37%），肺炎支原体感染40例（12.27%），检出前三位病原体分别为肺炎链球菌（68例，20.86%）、支原体（40例，12.27%）、甲型流感病毒（40例，12.27%）。18~59岁组肺炎链球菌、支原体的阳性率较高（28.68%，25.00%），≥60岁组肺炎链球菌、甲型流感病毒的阳性率较高（15.26%，13.68%）。甲型流感病毒的阳性率在冬季最高（30.77%，28/91），肺炎支原体的阳性率在秋季较高（18.07%，15/83）。结论:北京市某医院的CAP呼吸道感染病原体以肺炎链球菌、肺炎支原体、甲型流感病毒为主。呼吸道病原体的感染分布与年龄、季节有关，临床应重视混合病原体的感染。“,”Objective:To investigate the pathogen distribution of adult patients with community acquired pneumonia (CAP) in a general hospital in Beijing, so as to provide evidence for clinical diagnosis, treatment and infection control.Methods:Lower respiratory tract specimens were obtained from 326 adult CAP patients in Beijing Jiangong Hospital during June 2016 and January 2020, and various kinds of respiratory pathogens were detected by multiple real-time fluorescent quantitative PCR. The detection of respiratory pathogens in different age groups and seasons were analyzed.Results:At least one pathogen was detected in 212 of 326 CAP patients with the detection rate of 65.03%. Among them, 67 cases were mixed infected with different pathogens (20.55%) . Pathogen distribution showed bacterial infection in 139 cases (42.64%) , viral infection in 99 cases (30.37%) , and n Mycoplasma pneumoniae infection in 40 cases (12.27%) . The top three respiratory pathogens in CAP cases were n Streptococcus pneumoniae (68 cases, 20.86%) , n Mycoplasma pneumoniae (40 cases, 12.27%) and influenza A virus (40 cases, 12.27%) . The positive rates of n Streptococcus pneumoniae and n Mycoplasma pneumoniae were high in 18-59 years old group (28.68% and 25.00%) , and the positive rates of n Streptococcus pneumoniae and influenza A virus were high in ≥60 years old group (15.26% and 13.68%) . The positive rate of influenza A virus was the highest in winter (30.77%, 28/91) , while the positive rate of n Mycoplasma pneumoniae was the highest in autumn (18.07%, 15/83) .n Conclusions:Streptococcus pneumoniae, n Mycoplasma pneumoniae and influenza A virus are the most common pathogens of CAP in a general hospital in Beijing. The infection distribution of respiratory pathogens is related to the age and season, and clinical attention should be paid to mixed infection.n