结核病与肺部健康杂志 ›› 2012, Vol. 1 ›› Issue (1): 36-41.

• 专家论坛 • 上一篇    下一篇

儿童急性呼吸道感染病原学及其检测技术研究进展

俞桑洁,杨永弘   

  1. 100045 首都医科大学附属北京儿童医院 北京市儿科研究所微生物免疫室
  • 收稿日期:2012-07-16 出版日期:2012-07-20 发布日期:2012-07-20
  • 通信作者: 杨永弘,Email:yyh66@vip.sina.com

Advances in etiology of acute respiratory tract in children and its detecting technology

YU Sang-Jie, YANG Yong-hong   

  1. Beijing Children Hospital, Capital Medical University. Beijing Institute of Pediatrics,Beijing 100045,China
  • Received:2012-07-16 Online:2012-07-20 Published:2012-07-20
  • Contact: YANG Yong-hong,Email: yyh66@vip.sina.com

摘要: 儿童急性呼吸道感染是儿科最常见的疾病,具有发病率高和死亡率高的特点。同时由于儿童免疫系统发育不完善,往往症状隐匿,不典型。再加上儿童下呼吸道标本不易获得,造成临床诊断的困难,也使得病原学研究相对滞后,造成临床上抗生素不合理使用,给儿童呼吸道感染的防控带来很大困难。引起儿童呼吸道感染的病原体很多,包括病毒、细菌、支原体等。呼吸道合胞病毒(RSV)是引起儿童呼吸道感染的最常见的病毒,人鼻病毒(HRV)、流感病毒A和B(INF)和副流感病毒1、2、3(PIV),以及腺病毒都是引起儿童呼吸道感染的主要病毒。最近研究结果显示,人类偏肺病毒(HMPV)、人类冠状病毒(HCoV)、人类博卡病毒(HBoV)、人类多瘤病毒(KIV)和吴病毒(WUV)也可引起儿童呼吸道感染。细菌感染中以肺炎链球菌最为常见,其他还包括流感嗜血杆菌(HI)、金黄色葡萄球菌(SA)和卡他莫拉菌(MC),此外还有肠杆菌科细菌及百日咳杆菌等,化脓性链球菌和革兰阴性肠道细菌也很常见。结核分枝杆菌引起的儿童肺结核和支原体肺炎等都在临床占有一定的比例。病原体的检测对于儿童呼吸道感染的诊断非常重要,除了传统的病原体培养等方法外,分子生物学检测技术的进步,特别是聚合酶链反应(polymerase chain reaction,PCR)技术的出现,大大提高了呼吸道感染病原体的检出率和检出速度。

Abstract: Acute respiratory tract infections are the most common pediatric diseases with high incidence and mortality. At the same time, symptoms tend to be hidden and atypical due to the immaturity of the child’s immune system. In addition, lower respiratory tract specimens in children are not readily available, the etiological research has lagged behind, resulting in the difficulties of clinical diagnosis and irrational use of antibiotics in clinical, and causing great difficulties for respiratory tract infection with children prevention and control. With the rapid progress of molecular biology methods in recent years, the clinics have achieved remarkable results of the main pathogens of respiratory tract infection in children. Respiratory tract infections were caused by many pathogens, including viruses, bacteria, mycoplasma, etc. Traditionally, respiratory syncytial virus (RSV) is the most common pathogen, human rhinoviruses (HRV), influenza virus A and B (INF), parainfluenzaviruses 1, 2 and 3 (PIV) and adenovirus are also the major virus pathogens. The recently described human metapneumovirus (HMPV), human coronavirus (HCoV), human bocavirus (HBoV), human polyomavirus KI (KIV) and Wu virus (WUV) have been detected in samples collected from acute respiratory infection with children. Streptococcus pneumoniae (Sp) is the most common bacterial infectious pathogen, followed by Haemophilus influenzae (HI), Staphylococcus aureus (SA) and Moraxella catarrhalis (MC). In addition, Bordetella pertussis, Streptococcus pyogenes and gram-negative enteric bacteria are also common. Finally, Mycobacterium tuberculosis and Mycoplasma pneumoniae also account for a certain percentage. Pathogen detection is very important for the diagnosis of respiratory infections in children. In addition to traditional culture methods of pathogens, the progress of molecular biology techniques, especially polymerase chain reaction (PCR) technology appears, greatly improving the detection rate and detection time of pathogens.