Kowalewska-Pietrzak Magdalena, Młynarski Wojciech, Pankowska Anna
Oddzial Chorób Pluc i Alergii Ukladu Oddechowego dla Dzieci Mlodszych, Centrum Leczenia Chorób Pluc i Rehabilitacji w Lodzi.
Med Wieku Rozwoj. 2011 Jan-Mar;15(1):56-61.
Very few recent Polish data are available on the epidemiology of Chlamydophil pneumoniae (C. pneumoniae) as causative agent among paediatric patients, hospitalized with respiratory tract disorders. Extending these data would serve as rationale for empirical antimicrobial therapy. The aim of the study was to evaluate the frequency of C. pneumoniae infections in younger children hospitalized with prolonged cough and/or prolonged pneumonia.
110 children, aged 0.3-7.0 yrs., hospitalized from January 1st to March 3 1st 2009 for the above reasons were retrospectively enrolled in the study. Diagnosis of C. pneumoniae was based on ELISA IgM antibodies positive test. Patients with ambiguous IgM titre were excluded from further study (n=12).
Of 98 finally investigated children, C. pneumoniae infection was found in 28 patients (28.5%) with the highest frequency in February 2009 (15 cases). It was diagnosed more frequentlyin toddlers (over 1.73 yrs. of age) than in infants and youngest children (p=0,014; OR=4,10 95%C1=1,4-12,0). In patients with active C pneumoniae infection WBC were significantly lower (p=0,001), but within normal range (8647/mm3, +/- SD: 3247/mm3). Other factors such as sex, clinical symptoms and some chosen laboratory markers did not differ significantly between subgroups of sero-positive/sero-negative patients.
Performed analysis suggests a significant role of C. pneumoniae etiology in younger children with prolonged respiratory tract symptoms and can be a useful tool in empirical antibacterial treatment. Further studies for a longer period, larger groups of patients and additional confirmation of sero-positive cases are needed.
目前波兰关于肺炎衣原体（C. pneumoniae）作为呼吸道疾病住院儿童致病原的流行病学最新数据极少。扩充这些数据可为经验性抗菌治疗提供依据。本研究旨在评估因长期咳嗽和/或长期肺炎住院的年幼儿童中肺炎衣原体感染的频率。
回顾性纳入2009年1月1日至3月31日因上述原因住院的110名0.3 - 7.0岁儿童。肺炎衣原体的诊断基于ELISA IgM抗体阳性检测。IgM滴度不明确的患者被排除在进一步研究之外（n = 12）。
在最终研究的98名儿童中，28例（28.5%）发现有肺炎衣原体感染，2009年2月感染频率最高（15例）。幼儿（1.73岁以上）的诊断频率高于婴儿和最小儿童（p = 0.014；OR = 4.10，95%CI = 1.4 - 12.0）。肺炎衣原体感染活跃的患者白细胞显著降低（p = 0.001），但在正常范围内（8647/mm³，±标准差：3247/mm³）。血清阳性/血清阴性患者亚组之间的其他因素，如性别、临床症状和一些选定的实验室指标，差异无统计学意义。
所进行的分析表明肺炎衣原体病因在有长期呼吸道症状的年幼儿童中起重要作用，并且在经验性抗菌治疗中可能是一个有用的工具。需要进行更长时间、更大患者群体的进一步研究以及血清阳性病例的额外确认。
