转化医学杂志2025，Vol.14Issue(5)：13-18,6.DOI:10.3639/j.issn.2095-3097.2025.05.004
严重急性呼吸道感染患儿不同标本的常见呼吸道病原体检测结果分析
Test Results of Common Respiratory Pathogens in Different Specimens from Children with Severe Acute Respiratory Infections
摘要
Abstract
Objective To analyze the differences in nucleic acid test results of 12 common respiratory pathogens across different respiratory specimens from children with severe acute respiratory infection(SARI),so as to provide guidance for diag-nosing pediatric SARI.Methods A total of 120 children with SARI treated at Wuhan Red Cross Hospital from August 2023 to August 2024 were enrolled.Their throat swabs,sputum specimens and bronchoalveolar lavage fluid(BALF)were collected.Pathogen nucleic acid testing and metagenomic sequencing were performed separately.The differences in pathogen profiles and positive detection rates of pathogens among different specimens were analyzed.The consistency between different specimens and the gold standard(metagenomic sequencing results)was discussed.Results The positive detection rate of nonbacterial respiratory pathogens in throat swabs was 30.00%,and the detected pathogens mainly included influenza A virus(IFVA),influ-enza B virus(IFVB),and respiratory syncytial virus.The positive detection rate of nonbacterial respiratory pathogens in sputum and BALF specimens was 50.83%and 70.83%,respectively,and the detected pathogens mainly included IFVA,IFVB,and mycoplasma pneumoniae.The positive detection rates in sputum were higher than those in throat swabs and lower than those in BALF,with statistically significant differences(χ2=40.027,P<0.05).The positive detection rates of bacterial respiratory patho-gens in throat swabs and sputum specimens were 27.50%and 47.50%,respectively,which were dominated by pseudomonas aeruginosa(PA),streptococcus pneumoniae(SP),and Klebsiella pneumoniae.The positive detection rate of pathogens in BALF specimens was 64.17%,which were dominated by PA,SP,and haemophilus influenzae.The positive detection rates in spu-tum were higher than those in throat swabs and lower than those in BALF,with statistically significant differences(χ2=35.525,P<0.05).Consistency analysis showed that the consistency between throat swab pathogen nucleic acid detection and metag-enomic sequencing results was poor(Kappa values=0.110,0.158),the consistency between sputum pathogen nucleic acid detection and metagenomic sequencing results was average(Kappa values=0.328,0.314),and the consistency between BALF pathogen nucleic acid detection and metagenomic sequencing results was good(Kappa values=0.753,0.735).Conclusion For children with SARI,the positive detection rates of respiratory pathogens in BALF specimens are higher than those in sputum and throat swabs.BALF results show good consistency with metagenomic sequencing results,indicating that BALF specimens has higher clinical application value.关键词
严重急性呼吸道感染/儿童/病原体/病原菌Key words
Acute respiratory tract infection/Child/Pathogen/Pathogenic bacteria分类
医药卫生引用本文复制引用
胡鹏,毛佳颖,陈梦思,徐丽君,赵淦..严重急性呼吸道感染患儿不同标本的常见呼吸道病原体检测结果分析[J].转化医学杂志,2025,14(5):13-18,6.基金项目
武汉市红十字会医院科研项目(WHRCH202307) （WHRCH202307）
科技部国家重点研发计划子课题项目(2022YFF0710300) （2022YFF0710300）
