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马来西亚社区获得性肺炎住院儿童的肺炎支原体感染

Mycoplasma Pneumoniae infection in Malaysian children admitted with community acquired pneumonia.

作者信息

Chan P W, Lum L C, Ngeow Y F, Yasim M Y

机构信息

Department of Pediatrics, University Malaya Medical Center, Kuala Lumpur, Malaysia.

出版信息

Southeast Asian J Trop Med Public Health. 2001 Jun;32(2):397-401.

Abstract

Mycoplasma pneumoniae is increasingly recognized as an important cause of community acquired pneumonia (CAP) in children. We determined the importance of M. pneumoniae as a causative agent in 170 children aged 1 month to 15 years who were hospitalized with CAP over a 6-month period. The diagnosis of M. pneumoniae infection was based on serological evidence obtained by a particle agglutination test (SERODIA-MYCO II). A positive serological diagnosis was made if the acute phase serum titer was more than 1:160 or paired samples taken 2-4 weeks apart showed a four-fold or greater rise in the serum titer. M. pneumoniae was identified as the causative agent in 40 (23.5%) children. Children with M. pneumoniae infection were more likely to be older than 3 years (OR 4.0 95%CI 1.8-9.1, p<0.001), Chinese (OR 4.3 95%CI 2.0-8.9, p<0.001), have a duration of illness longer than 7 days prior to admission (OR 6.0 95%CI 2.7-13.5, p<0.001) and have perihilar interstitial changes on chest X-ray (OR 4.6 95%CI 2.2-9.9, p<0.001). A significant number of hospital admissions for CAP in Malaysian children can be attributed to M. pneumoniae. It is important to identify these children so as to administer the most appropriate antibiotic treatment.

摘要

肺炎支原体日益被认为是儿童社区获得性肺炎(CAP)的重要病因。我们确定了肺炎支原体作为病原体在170名1个月至15岁因CAP住院的儿童中的重要性,这些儿童是在6个月期间入院的。肺炎支原体感染的诊断基于通过颗粒凝集试验(SERODIA-MYCO II)获得的血清学证据。如果急性期血清滴度大于1:160或相隔2 - 4周采集的配对样本显示血清滴度升高四倍或更多,则做出血清学阳性诊断。在40名(23.5%)儿童中确定肺炎支原体为病原体。肺炎支原体感染的儿童更可能年龄大于3岁(比值比4.0,95%置信区间1.8 - 9.1,p<0.001),是华裔(比值比4.3,95%置信区间2.0 - 8.9,p<0.001),入院前病程超过7天(比值比6.0,95%置信区间2.7 - 13.5,p<0.001)且胸部X线显示肺门周围间质改变(比值比4.6,95%置信区间2.2 - 9.9,p<0.001)。马来西亚儿童因CAP住院的相当一部分可归因于肺炎支原体。识别这些儿童以便给予最恰当的抗生素治疗很重要。

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