Objective To understand the mixed infection of children with mycoplasma pneumoniae pneumonia(MPP) in Suzhou,in order to provide basis for the diagnosis and treatment of MPP mixed infection.Methods A total of 815 inpatients with MPP were selected from January 2015 to December 2016 in the Department of Respiration in Children′s Hospital of Soochow University. Multiple pathogens were detected in 815 inpatients,and clinical data were analyzed. Results 1) In 815 cases of MPP,350 cases had mixed infection,including 199 cases with virus infection,91 cases with bacterial infection,60 cases with virus and bacterial infection. The common virus pathogens included HRV,HBoV and RSV. The common bacterial pathogens were streptococcus pneumonia(SP) and haemophilus influenza(Hi). 2) Compared with the single infection group,the mixed virus infection group was younger,had a higher proportion of wheezing,dyspnea and gastrointestinal symptoms and was more likely to have severe pneumonia(χ2=27.126,12.093,8.466,5.031,7.267,P<0.05).3)The mixed bacterial infection group was younger,with longer fever duration,and the proportions of dyspnea and WBC>10×109/L in mixed bacterial infection group were significantly higher than those in single infection group(χ2=5.392,4.944,4.155,4.742,P<0.05). 4) The MPP with virus and bacterial infection group was younger,with longer fever duration,and the proportions of wheezing,dyspnea and WBC>10×109/L were significantly higher than those in single infection group(χ2=5.245,5.647,4.161,8.221,6.568, P<0.05). X ray indicated that the proportions of hydrothorax and pulmonary dilatation were significantly higher in MPP with virus and bacterial infection group(χ2=4.946,5.382,P<0.05).5) Logistic regression analysis showed that risk factors for MPP with virus infection included age under 3 years old(OR=2.23,95%CI:1.516—3.279) and gastrointestinal symptoms(OR=1.583,95%CI:1.020—2.455). Risk factors for MPP with bacterial infection were age under 3 years old(OR=1.841,95%CI:1.131—2.999),having fever > 10 days(OR=2.492,95%CI:1.191—5.212)and WBC>10×109/L(OR=1.648,95%CI:1.038—2.616). Age under 3 years old(OR=2.345,95%CI:1.250—4.399),having fever>10 days(OR=3.291,95%CI:1.304—8.307), dyspnea(OR=4.427,95%CI:1.135—17.268) and WBC>10×109/L(OR=2.39,95%CI:1.357—4.212) were found to be the risk factors for MPP with virus and bacterial infection. Conclusions There is a certain proportion of mixed infection among hospitalized children with MPP,and the main mixed pathogen of MPP is virus,followed by bacteria. The clinical manifestations and risk factors of mixed infection are related to the pathogen of mixed infection.
Key words
mycoplasma pneumoniae /
pneumonia /
mixed infection /
pathogen /
children
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References
[1] Liu WK,Liu Q,Chen de H,et al.Epidemiology of acute respiratory infections in children in Guangzhou:a three-year study[J].PLoS One,2014,9(5):e96674.
[2] 曹兰芳.儿童难治性肺炎支原体肺炎的诊治现状和进展[J].临床儿科杂志,2010,28(1):94-97.
[3] 胡亚美,江载芳.诸福棠实用儿科学[M].7版.北京:人民卫生出版社,2003:1204-1205.
[4] Qing SONG,Bao-Ping XU,Kun-Ling SHEN.Effects of bacterial and viral co-infections of mycoplasma pneumoniae pneumonia in children:analysis report from Beijing Children′s Hospital between 2010 and 2014[J].Int J Clin Exp Med,2015,8(9):15666-15674.
[5] 陈玲玲,成云改,陈志敏,等.肺炎支原体肺炎患儿混合感染的研究[J].中华儿科杂志,2012,50(3):211-215.
[6] Okada T,Morozumi M,Sakata H,et al.A practical approach estimating etiologic agents using real-time PCR in pediatric inpatients with community-acquired pneumonia[J].J Infect Chemother,2012,18(6):832-840.
[7] 程力平,孙捷,柳克智.支原体混合感染性患儿肺炎106例临床分析[J]. 中国医药导刊,2013,15(1):6-7.
[8] 张丽娉,王丽燕.青岛地区2013至2014年小儿肺炎支原体肺炎流行情况[J].中国小儿急救医学,2015,22(6):429-432.
[9] Chiu CY,Chen CJ,Wong KS,et al. Impact of bacterial and viral coinfection on mycoplasmal pneumonia in childhood community acquired pneumonia[J].J Microbiol Immunol Infect,2015,48(1):5l-56.
[10] Qing SONG,Bao-Ping XU,Kun-Ling SHEN.Bacterial co-infection in hospitalized children with mycoplasma pneumoniae pneumonia[J].Indian Pediatrics,2016,53(10),879-882.
[11] Chen ZR,Yan YD,Wang YQ,et al.Epidemiology of community-acquired mycoplasma pneumoniae respiratory tract infections among hospitalized Chinese children,including relationships with meteorological factors[J].Hippokratia,2013,17(1):20-26.
[12] Huong PLT,Hien PT,Lan NTP,et al.First report on prevalence and risk factors of severe atypical pneumonia in Vietnamese children aged 1-15 years[J].BMC Public Health,2014,14:1304.