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儿童肺炎衣原体和肺炎支原体感染的频率

Frequency of Chlamydia pneumoniae and Mycoplasma pneumoniae infections in children.

作者信息

Sidal Mujgan, Kilic Ayse, Unuvar Emin, Oguz Fatma, Onel Mustafa, Agacfidan Ali, Aydin Derya, Koksalan Kaya, Beka Hayati

机构信息

Institute of Child Health, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

出版信息

J Trop Pediatr. 2007 Aug;53(4):225-31. doi: 10.1093/tropej/fmm003. Epub 2007 May 21.

Abstract

OBJECTIVE

Chlamydia pneumoniae and Mycoplasma pneumoniae are among the most important pathogens of acute respiratory infections in children between the ages of 5 and 15 years. We aimed to investigate seasonal frequency of respiratory infections caused by C. pneumoniae and M. pneumoniae, frequency of coinfection, clinical findings and to determine relationship between clinical findings and laboratory results.

MATERIAL AND METHODS

Total of 284 patients (ranging 5-15 years of age), admitted to out-patient clinic with symptoms of respiratory tract infections between January 2004 and June 2005, were enrolled in the study. IgA, IgG and IgM antibodies against C. pneumoniae were quantitatively detected in all serum samples by using microimmunofluorescence (MIF). For the M. pneumoniae infection an IgM titer in the ELISA test were analyzed. Nasopharyngeal smear samples were collected for PCR detection.

RESULTS

Mean age was 8 +/- 2.2 (range 5-14) years. Mycoplasma pneumoniae IgM in 86 (30.2%) cases, C. pneumoniae IgM in one (0.3%) case, IgA in six (2.1%) cases and IgG in 10 (3.5%) cases were found positive. In 10 (3.5%) cases, both C. pneumoniae IgG (a titer of >1/216) and M. pneumoniae IgM were found positive concomitantly. The M. pneumoniae IgM in winter was found significantly higher compared to other seasons. Mycoplasma pneumoniae PCR method was performed on a total of 203 samples in 33 (16.2%) of which M. pneumoniae was found positive. The false positive ratio of PCR technique was found 16.2%. In a total of 217 examined samples by PCR method, the DNA of C. pneumoniae was found positive in two patients.

CONCLUSION

Mycoplasma pneumoniae was a common pathogen in respiratory infections. The otherwise C. pneumoniae infections were rarely seen in children. A Comparison of serology diagnostic tests for M. pneumoniae infections was found more sensitive and specific than PCR.

摘要

目的

肺炎衣原体和肺炎支原体是5至15岁儿童急性呼吸道感染最重要的病原体之一。我们旨在调查由肺炎衣原体和肺炎支原体引起的呼吸道感染的季节性频率、合并感染频率、临床症状,并确定临床症状与实验室结果之间的关系。

材料与方法

共有284例年龄在5至15岁之间、于2004年1月至2005年6月因呼吸道感染症状到门诊就诊的患者纳入本研究。通过微量免疫荧光法(MIF)定量检测所有血清样本中针对肺炎衣原体的IgA、IgG和IgM抗体。对于肺炎支原体感染,分析ELISA试验中的IgM滴度。采集鼻咽涂片样本进行PCR检测。

结果

平均年龄为8±2.2(范围5至14)岁。86例(30.2%)肺炎支原体IgM阳性,1例(0.3%)肺炎衣原体IgM阳性,6例(2.1%)IgA阳性,10例(3.5%)IgG阳性。10例(3.5%)患者同时肺炎衣原体IgG(滴度>1/216)和肺炎支原体IgM阳性。发现冬季肺炎支原体IgM明显高于其他季节。共对203份样本进行肺炎支原体PCR检测,其中33份(16.2%)肺炎支原体呈阳性。发现PCR技术的假阳性率为16.2%。通过PCR方法共检测217份样本,2例患者肺炎衣原体DNA呈阳性。

结论

肺炎支原体是呼吸道感染的常见病原体。相比之下,肺炎衣原体感染在儿童中很少见。发现肺炎支原体感染的血清学诊断试验比PCR更敏感和特异。

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