Study on Pathogen of Lower Respiratory Tract Infection in Children in Pediatric Intensive Care Unit and Common Ward

doi:10.3877/cma.j.issn.1673-5250.2012.06.017

Objective

To investigate the pathogen of low respiratory tract infection in children in pediatric intensive care unit (PICU) and common ward.

Methods

From May to July, 2011, a total of 397 cases (240 boys and 157 girls) with low respiratory tract infection were included into this study. They were divided into two groups, PICU group (n=77) and common ward group (n=320). There had no significant differences in age and gender between two groups (P>0.05). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Maternity and Child Care Hospital of Guangxi Zhuang Autonomous Region. Informed consent was obtained from all participates' parents. The samples were collected from two groups for the test of indirect immunofluorescence assay (FIA). The following items were detected, IgM antibody of 5 viruses (7 types), including respiratory syncytial virus (RSV), adenovirus(ADV), influenza virus type A (IV-A), influenza virus type B (IV-B), parainfluenza virus type (PIV-1, 2, 3) and 4 atypical pathogens, including Mycoplasma pneumonia (MP), Legionella pneumophila 1 (LP 1), Chlamydia pneumonia (CPn), Q fever rickettsia (QFR).

Results

Among PICU group (n=77), positive rate of pathogen was 55.84% (43/77), of which, atypical pathogens detected rate was 68.83% (53/77), and virus detected rate was 19.48% (15/77), mixed infection were detected in 22 of 43 positive infectors (51.16%). Among common ward group (n=320), positive rate of pathogen was 35.94% (115/320), of which, atypical pathogens detected rate was 42.5% (136/320), and virus detected rate was 16.56% (53/320), mixed infection were detected in 58 of 115 positive infectors (50.43%). MP was the most common pathogen with higher positive rate of two groups (41.56% vs. 24.69%).

Conclusions

Atypical pathogens was the mostly pathogen of lower respiratory tract infection in pediatric clinics, especially PICU children. Further more, dual mixed infections (MP + LP 1) is the most prevalent.

Key words: respiratory tract infection, atypical pathogen, virus, pediatric intensive care unit, common ward

表1 非典型病原体感染情况[n(%)]

Table 1 Statistics of atypical pathogens infections [n(%)]

组别	n	MP	LP1	QFR	CPn	合计
普通病房组	320	79(24.69)	36(11.25)	19 (5.94)	2(0.63)	136(42.50)
PICU组	77	32(41.56)	12(15.58)	8(10.39)	1(1.30)	53(68.83)
χ²	?	8.77	0.19	1.94	0.38	17.25
P	?	<0.01	>0.05	>0.05	>0.05	< 0.01

表1 非典型病原体感染情况[n(%)]

Table 1 Statistics of atypical pathogens infections [n(%)]

组别	n	MP	LP1	QFR	CPn	合计
普通病房组	320	79(24.69)	36(11.25)	19 (5.94)	2(0.63)	136(42.50)
PICU组	77	32(41.56)	12(15.58)	8(10.39)	1(1.30)	53(68.83)
χ²	?	8.77	0.19	1.94	0.38	17.25
P	?	<0.01	>0.05	>0.05	>0.05	< 0.01

表2 病毒感染情况[n(%)]

Table 2 Statistics of virus infections [n(%)]

组别	n	RSV	IV－B	PIV－1，2，3	IV－A	ADV	合计
普通病房组	320	24 (7.50)	21(6.56)	7(2.19)	1(0.31)	0(0.00)	53(16.56)
PICU组	77	11(14.29)	1(1.30)	0(0.00)	1(1.30)	2(2.60)	15(19.48)
χ²	?	3.55	3.29	1.71	1.20	10.99	0.37
P	?	>0.05	>0.05	>0.05	>0.05	< 0.01	>0.05

表2 病毒感染情况[n(%)]

Table 2 Statistics of virus infections [n(%)]

组别	n	RSV	IV－B	PIV－1，2，3	IV－A	ADV	合计
普通病房组	320	24 (7.50)	21(6.56)	7(2.19)	1(0.31)	0(0.00)	53(16.56)
PICU组	77	11(14.29)	1(1.30)	0(0.00)	1(1.30)	2(2.60)	15(19.48)
χ²	?	3.55	3.29	1.71	1.20	10.99	0.37
P	?	>0.05	>0.05	>0.05	>0.05	< 0.01	>0.05

表3 病原混合感染情况[n(%)]

Table 3 Statistics of the mix－infection [n(%)]

组别	n	MP＋LP 1	MP＋QFR	MP＋RSV	MP＋IV－B	MP＋RSV＋QFR	RSV＋IV－B
普通病房组	115	17(14.78)	5(4.35)	5(4.35)	4(3.48)	5(4.35)	7(6.09)
PICU组	43	7(16.28)	3(6.98)	4(9.30)	1(2.33)	0(0.00)	0(0.00)
χ²	?	0.05	0.45	1.43	0.14	1.93	2.74
P	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

表3 病原混合感染情况[n(%)]

Table 3 Statistics of the mix－infection [n(%)]

组别	n	MP＋LP 1	MP＋QFR	MP＋RSV	MP＋IV－B	MP＋RSV＋QFR	RSV＋IV－B
普通病房组	115	17(14.78)	5(4.35)	5(4.35)	4(3.48)	5(4.35)	7(6.09)
PICU组	43	7(16.28)	3(6.98)	4(9.30)	1(2.33)	0(0.00)	0(0.00)
χ²	?	0.05	0.45	1.43	0.14	1.93	2.74
P	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

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