关键词: 肺炎支原体, 肺炎, 混合感染, 病原, 儿童

Abstract: 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