北京市西城区1247例重症肺炎病例呼吸道病原谱分析

Pathogenic spectrum of 1 247 severe pneumonia patients in Xicheng District of Beijing

摘要:

目的 了解北京市西城区重症肺炎病例呼吸道传染病病原的分布状况及变化规律，为制定相关防治策略提供依据。方法 在北京市西城区三家哨点医院，采集住院重症肺炎病例的呼吸道标本，用实时荧光PCR方法进行嗜麦芽窄食单胞菌、化脓性链球菌、金黄色葡萄球菌、肺炎克雷伯菌、流感嗜血杆菌、嗜肺军团菌、结核分枝杆菌、鲍曼不动杆菌、卡他莫拉菌、大肠杆菌、肺炎链球菌、铜绿假单胞菌、肺囊虫、副流感病毒、博卡病毒、鼻病毒、冠状病毒、流感病毒、人偏肺病毒、腺病毒、呼吸道合胞病毒、肠道病毒、肺炎支原体、肺炎衣原体24种呼吸道病原的检测。结果 2014-2020年，共调查并检测1247例重症肺炎病例，总阳性率44.91%。细菌检测阳性率20.21%，病毒检测阳性率29.91%。病毒有明显的秋冬季高峰流行特征，不同年度检测阳性率不同，2020年阳性率最高；细菌检测阳性率无明显时间特征。低年龄组重症肺炎病例以病毒感染较多；高年龄组则以细菌感染为主。结论 北京市西城区重症肺炎病例病原种类复杂多样。不同病原流行特征不同。呼吸道病原菌与病毒在不同年龄组病原分布特征不同。应持续进行必要的病原学检测及研究，以用于临床诊断、治疗与进一步明确呼吸道病原的长期流行趋势。

Abstract:

Objective To investigate the pathology, epidemiology of severe pneumonia in Xicheng District of Beijing. Methods From 2014 to 2020, in 3 sentinel hospitals, collected and detected the respiratory tract specimens of the severe pneumonia patients. Multiple pathogens including Stenotrophomonas maltophilia, Streptococcus pyogenes, Staphylococcus aureus, Klebsiella Pneumoniae, Haemophilus influenzae, Legionella pneumophila, Mycobacterium tuberculosis, Acinetobacter baumannii, Moraxella catarrhalis, Escherichia coli, Streptococcus pneumoniae, Pseudomonas aeruginosa, Pneumocystis,Parainfluenza virus, Bocavirus, Rhinovirus, Coronavirus, Influenza, Human metapneumovirus, Adenovirus, Respiratory syncytial virus, Enterovirus, Mycoplasma pneumoniae, Chlamydia pneumoniae were detected with PT-PCR. Analyze epidemic characteristics of the cases. Results Of the 1 247 respiratory samples cultured during the period from 2014 to 2020, 560(44.91%) are positive. The positive rates of virus(29.91%) is higher than Bacteria(20.21%). The top five pathogens were Acinetobacter baumannii(9.22%), Pseudomonas aeruginosa(8.26%), Stenotrophomonas maltophilia(7.78%), Klebsiella Pneumoniae（6.74%） and Parainfluenza virus（6.58%）. Conclusion There was a variety of pathogen in the severe pneumonia patients. Acinetobacter baumannii, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Klebsiella Pneumoniae and Parainfluenza virus were the main pathogens of respiratory infections in Xicheng district of Beijing. It is necessary to strengthen the surveillance of the disease.