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目的:调查昆明地区2004~2006年婴幼儿急性下呼吸道感染(ALRI)中嗜肺军团菌(LP)感染情况。方法:采用间接免疫荧光法(IFA)、微量凝集法(MAT),对临床诊断为ALRI患儿血清检测LP IgM抗体。结果:6 953例ALRI患儿血清标本,检出阳性标本723例,阳性率10.40%,其中2004年771例,阳性58例,阳性率7.52%;2005年1 302例,阳性155例,阳性率11.90%;2006年4 880例,阳性510例,阳性率10.45%,三年LP1感染阳性率比较差异有统计学(χ2=10.03,P<0.01)。6 953例检测对象中,<1岁4 281例,阳性269例,阳性率6.28%;1~3岁2 672例,阳性454例,阳性率16.99%,两个年龄段LP1感染阳性率比较差异有统计学意义(χ2=202.4,P<0.01)。所有标本中,男性4 320例,阳性416例,阳性率9.63%;女性2 633例,阳性307例,阳性率11.66%,两者LP1感染阳性率比较差异有统计学意义(χ2=7.24,P<0.01),以女性组阳性率高。检测阳性结果判断标准为单份血清IgM>1∶16,双份血清抗体效价4倍升高。无明显季节流行性。结论:昆明地区小儿嗜肺军团菌感染不容忽视,双份血清抗体检测有确诊价值。
Objective: To investigate the infection of Legionella pneumophila (LP) in infants with acute lower respiratory tract infection (ALRI) in Kunming from 2004 to 2006. Methods: Serum samples of LPRI were detected by indirect immunofluorescence assay (IFA) and microagglutination assay (MAT). Results: Serum samples of 6 953 children with ALRI were positive in 723 cases, with a positive rate of 10.40%, of which 771 were positive in 2004 and 58 were positive, with a positive rate of 7.52%. In 2005, 302 cases were positive and 155 were positive 11. 90%. In 2006, 4880 cases were positive and 510 cases were positive, the positive rate was 10.45%. There was significant difference in the positive rate of LP1 infection in three years (χ2 = 10.03, P <0.01). Of 6 953 subjects, 4 281 patients <1 year old were positive and 269 were positive, the positive rate was 6.28%. There were 2 672 cases aged 2 to 3 years with 454 positives, the positive rate was 16.99%. The positive rates of LP1 infection in two age groups were significantly different There was statistical significance (χ2 = 202.4, P <0.01). In all specimens, there were 4 320 males and 416 males, the positive rate was 9.63%. There were 2 633 females and 307 males, the positive rate was 11.66%. The positive rates of LP1 infection between the two groups were statistically significant (χ2 = 7.24, P <0.01), the positive rate of female group was high. Test positive results to determine the standard single serum IgM> 1:16, double the serum antibody titer 4 times higher. No obvious seasonal epidemics. Conclusion: Legionella pneumophila infection in children in Kunming area can not be ignored, double serum antibody test has confirmed the value.