仰光儿童医院急性呼吸道感染患儿非典型肺炎感染的分子诊断

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摘要

急性呼吸道感染(ARI)是一种高发病率和死亡率的临床疾病,特别是在婴幼儿中。肺炎是呼吸道感染的常见并发症。非典型肺炎通常由肺炎支原体、肺炎衣原体和嗜肺军团菌引起,常规培养法无法诊断致病菌,临床症状无特异性,故检测难度大。本研究旨在应用多重聚合酶链反应(M-PCR)诊断2014- 2015年在仰光儿童医院就诊的急性呼吸道感染患儿的非典型肺炎感染。采用Qiagen DNA迷你试剂盒从鼻咽拭子样本中提取细菌DNA, M-PCR检测。245例ARI患者中,男性140例(57%),女性105例(43%)。非典型肺炎阳性11例(4.4%),其中肺炎支原体4例(1.6%)、肺炎衣原体5例(2%)、嗜肺军团菌2例(0.8%)。非典型肺炎病例以1 ~ 5岁多见,性别分布基本相等。肺炎(36.4%)、重症肺炎(27.3%)、病毒性喘鸣(18.2%)、重症细支气管炎(9.1%)、细支气管炎(9.1%)。本研究强调了非典型肺炎感染在儿童急性呼吸道感染中的作用。
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Molecular Diagnosis of Atypical Pneumonia Infection in Children Presenting with Acute Respiratory Tract Infection Attending Yangon Children’s Hospital
Acute respiratory tract infection (ARI) is a clinical condition which causes high morbidity and mortality, especially in infants and young children. Pneumonia is a common complication of respiratory tract infection. Atypical pneumonia, which is commonly caused by Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legi-onella pneumophila, is difficult to be detected because the causal bacteria cannot be diagnosed by routine culture method and presenting with non-specific clinical symptoms. This study aimed to diagnose the atypical pneumonia infection in children presenting with ARI attending Yangon Children’s Hospital during 2014-15 by using multiplex polymerase chain reaction (M-PCR). The bacterial DNA was extracted from nasopharyngeal swab samples by using Qiagen DNA minikit and detected by M-PCR. Of 245 patients with ARI, 140(57%) were males and 105(43%) were females. Eleven samples (4.4%) were positive for atypical pneumonia infection, among which 4(1.6%) were Mycoplasma pneumoniae,5(2%) were Chlamydophila pneumoniae and 2(0.8%) were Legionella pneumophila. The atypical pneumonia cases were mostly seen among the age of 1 to 5 years and sex distribution was nearly equal. The infected cases were detected from pneumonia (36.4%), severe pneumonia (27.3%), viral-induced wheeze (18.2%), severe bronchiolitis (9.1%) and bronchiolitis (9.1%). This study highlights the role of atypical pneumonia infection in ARI cases among children.
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