Abstract
Objective To investigate the pathogen spectrum of community-acquired pneumonia(CAP)in children and provide a basis for clinical diagnosis,treatment,and prevention.Methods A total of 1,101 children hospitalized with CAP in the Department of Pediatrics of Tianjin People's Hospital from January to December 2024 were retrospectively selected.They were categorized by age into:<1 year group(n=34),1～<3 years group(n=96),3～<6 years group(n=227),and 6～14 years group(n=744);and by season into:spring group(n=156),summer group(n=269),autumn group(n=323),and winter group(n=353).Nasopharyngeal swabs and sputum samples were collected,and a multiplex nucleic acid detection kit for respiratory pathogens was used to detect 11 common respiratory pathogens.The analysis included the detection rates of respiratory pathogens by gender,age,and season;overall pathogen detection;distribution of detected pathogen strains;detection of different pathogens across age groups;and seasonal detection patterns of various pathogens.Results The overall pathogen positive rate among the 1,101 children was 89.56%(986/1,101).No statistically significant difference in pathogen positive rate was observed between different genders(χ2=3.759,P=0.053).However,significant differences were found across different age groups(χ2=7.927,P=0.048)and seasonal groups(χ2=9.127,P=0.028).The highest positive rates were in the 6-14 years age group(90.86%,676/744)and the winter group(92.92%,328/353).A total of 2,112 pathogenic strains were detected.Single pathogen infections accounted for 13.02%(275/2,112),while co-infections with multiple pathogens accounted for 86.98%(1,837/2,112).The top three detected pathogens were Streptococcus pneumoniae(SP,34.75%,734/2,112),Haemophilus influenzae(Hi,26.09%,551/2,112),and Mycoplasma pneumoniae(MP,22.21%,469/2,112).The distribution of the main pathogens(SP,Hi,MP)differed significantly across age groups(SP:χ2=15.235,P=0.002;Hi:χ2=17.143,P=0.001;MP:χ2=52.176,P<0.001).Significant seasonal variations were also observed for MP(χ2=20.469,P<0.001)and Hi(χ2=12.328,P=0.006),but not for SP(χ2=2.639,P=0.451).Conclusions Among hospitalized children with CAP,bacteria(SP and Hi)are the main pathogens,distributed in all age groups.MP infection is mainly in school-aged children,showing a trend of younger age,with a small peak in winter.Most cases of CAP in children are co-infections.It is recommended to conduct multi-pathogen nucleic acid testing as early as possible,especially in winter.When conducting initial empirical treatment,it is necessary to rationally select medications based on the pathogen spectrum characteristics of children in different age groups and the possible co-infected pathogens.关键词
儿童/社区获得性肺炎/病原学流行特征/感染/肺炎链球菌/流感嗜血杆菌/肺炎支原体Key words
children/community-acquired pneumonia/etiological epidemiological characteristics/infection/streptococcus pneumoniae/haemophilus influenzae/mycoplasma pneumoniae
