Analysis Of Pathogenic Characteristics Of 2665 Hospitalized Children With Community-acquired Pneumonia

Objective:To investigate the pathogenic characteristics pathogens of children with community acquired pneumonia(CAP)in Shanxi Children’s Hospital and provide evidence for clinical diagnosis and treatment.Methods:A total of 2665 children with CAP who were hospitalized in the Respiratory Department of Shanxi Children’s Hospital from January 2019 to December 2021 were selected as the study subjects.After admission,sputum samples were collected from the children for bacterial culture and drug sensitivity analysis.For children undergoing bronchoscopy and alveolar lavage,samples of alveolar lavage fluid were collected for pathogenic testing.Nasopharyngeal swabs and/or venous blood were collected from the children for seven respiratory viruses Novel coronavirus and mycoplasma pneumoniae were detected,and the basic information and pathogenic results of children were collected by retrospective study.The children were divided into groups according to year,age,season and severity of disease,and the pathogenic results of children in each group were statistically analyzed.Results:1.A total of 2665 children’s samples were collected in this study,of which 1879 cases were detected pathogens,with a positive rate of 70.5%.Including 214 cases of single bacterial infection(11.4%),129 cases of single virus infection(6.9%),1265 cases of single mycoplasma pneumoniae infection(67.3%),and 271 cases of mixed infection(14.4%).2179 strains of pathogens were detected.Among them,487 strains of bacteria(22.3%),241 strains of virus(11.1%)and 1451 strains of mycoplasma pneumoniae(66.6%).2.Mycoplasma pneumoniae has the highest detection rate of pathogens,and the top three pathogens detected are Streptococcus pneumoniae,Haemophilus influenzae and Moraxella catarrhalis;Respiratory syncytial virus is the main pathogen of virus,and mixed infection of bacteria and mycoplasma pneumoniae is the most common.3.In terms of annual distribution,the highest detection of pathogens rate was 83.2%(817/982)in 2021,followed by 67.5%(918/1361)in 2019,and the lowest detection rate was 44.7%(144/322)in 2020.In 2019,the top three pathogens were Mycoplasma pneumoniae>Streptococcus pneumoniae>Haemophilus influenzae;The top three pathogens detected in 2020 were Mycoplasma pneumoniae>Respiratory syncytial virus>Streptococcus pneumoniae;The top three pathogens detected in 2021 are Mycoplasma pneumoniae>Streptococcus pneumoniae>Haemophilus influenzae.The detection rate of Mycoplasma pneumoniae in 2021 accounted for 90.6%of the total detection rate of pathogens in that year,significantly higher than in 2019 and 2020.4.In terms of age distribution,the detection rates of bacteria and viruses were the highest in the infant group and the lowest in the school-age group;The detection rate of Mycoplasma pneumoniae increased with age,with the highest detection rate in the school-age group.At the same time,the infection of Mycoplasma pneumoniae in infants under 3 years of age is not uncommon,accounting for 14.5%;The detection rate of mixed infection in the infant group is higher.5.In terms of seasonal distribution,the high incidence season of Mycoplasma pneumoniae is autumn and winter;Haemophilus influenzae is prevalent in winter;The epidemic season of Streptococcus pneumoniae,respiratory syncytial virus,and influenza virus is winter and spring;The highest detection rate of parainfluenza virus in spring;Staphylococcus aureus and Escherichia coli have a high incidence in summer.6.In terms of the severity of the disease,Mycoplasma pneumoniae infection causes more severe cases of CAP than mild cases.Conclusion:1.Mycoplasma pneumoniae is the main pathogen of community acquired pneumonia in our hospital,it occurs frequently in autumn and winter,and it is common in school-age children,at the same time,there is a trend of low age,and in 2021,there will be an epidemic of Mycoplasma pneumoniae in the region;2.Streptococcus pneumoniae is the main bacterial pathogen of community acquired pneumonia,which mainly occurs in early childhood and early school age,and is prevalent in winter and spring;3.Respiratory syncytial virus(RSV)is the main type of viral infection,which mainly occurs in children under 1 year old and is prevalent in winter;4.The common form of mixed infection is bacterial and mycoplasma pneumoniae,which is common in children aged 1-3 years old and has a high incidence in winter.5.Since the three year epidemic,COVID-19 has had an impact on the detection rate of pathogens in our hospital.