盲探鼻咽吸引法不是儿童肺炎病原体检测的有用工具。
The blind nasotracheal aspiration method is not a useful tool for pathogen detection of pneumonia in children.
机构信息
Epidemiology Department, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
出版信息
PLoS One. 2010 Dec 29;5(12):e15885. doi: 10.1371/journal.pone.0015885.
BACKGROUND
Acute lower respiratory infection (ALRI) is a major cause of hospitalization for children in China, while the etiological diagnosis of ALRI remains a challenge. This study was performed to evaluate the utility of the blind Nasotracheal aspiration (NTA) in the pathogen detection in ALRI through an evaluation of the test's specificity.
METHODOLOGY/PRINCIPAL FINDINGS: A hospital-based study of children ≤3 years was carried out from March 2006 through March 2007 in Suzhou University Affiliated Children's Hospital, including 379 cases with ALRI from the respiratory wards, and 394 controls receiving elective surgery. Nasopharyngeal swabs (NPS) and NTA specimens were taken on admission. S. pneumoniae was isolated from 10.3% of NTA samples from ALRI children, H. influenzae from 15.3%, and M. catarrhalis from 4.7%. The false positive rate--the strains from NTA in control group children--was 8.4% (95% CI: 5.8%-11.4%) for S. pneumoniae, 27.2% (95% CI: 22.7-31.5%) for H. influenzae, and 22.1% (95% CI: 18.0%-26.2%) for M. catarrhalis. The agreement between NPS and NTA in the control group was over 70%.
CONCLUSION/SIGNIFICANCE: The blind NTA test is not a useful test for etiologic diagnosis of ALRI.
背景
急性下呼吸道感染（ALRI）是导致中国儿童住院的主要原因，而 ALRI 的病因诊断仍然具有挑战性。本研究通过评估该检测的特异性，旨在评估盲鼻咽抽吸（NTA）在 ALRI 病原体检测中的应用价值。
方法/主要发现：这是一项 2006 年 3 月至 2007 年 3 月在苏州大学附属儿童医院进行的基于医院的研究，纳入了 379 例来自呼吸病房的 ALRI 患儿和 394 例接受择期手术的对照组患儿。入院时采集鼻咽拭子（NPS）和 NTA 标本。从 ALRI 患儿的 NTA 样本中分离出肺炎链球菌占 10.3%，流感嗜血杆菌占 15.3%，卡他莫拉菌占 4.7%。假阳性率——对照组儿童 NTA 中的菌株——肺炎链球菌为 8.4%（95%CI：5.8%-11.4%），流感嗜血杆菌为 27.2%（95%CI：22.7%-31.5%），卡他莫拉菌为 22.1%（95%CI：18.0%-26.2%）。对照组中 NPS 和 NTA 之间的一致性超过 70%。
结论/意义：盲鼻咽抽吸试验对 ALRI 的病因诊断没有帮助。
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