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目的探讨新生儿肺炎流行的病原。方法对2004年2月25日～3月11日发生流行的新生儿肺炎25例均进行常规咽拭子和血培养;22例检测血清抗衣原体、支原体、柯萨奇病毒和埃柯病毒IgM抗体;10例进行呼吸道分泌物病毒抗原检测[包括腺病毒,呼吸道合胞病毒(RSV),流感A、B,副流感1、2、3]、RSV分离和PCR检测并测序。结果25例中1例咽拭子培养及血培养均为肺炎克雷伯菌,余咽拭子培养及血培养结果临床意义不确定;22例血清抗衣原体、支原体、柯萨奇病毒和埃柯病毒IgM抗体检测均为阴性;采集呼吸道分泌物的10例患者中,1例呼吸道分泌物中RSV抗原阳性,1例RSV病毒分离阳性;10例鼻咽分泌物中RSV的PCR检测均阳性,经测序表明与分离到的野毒株为同一株病毒,A5基因型。结论本次新生儿肺炎爆发流行为RSV感染所致。在RSV流行季节,应加强RSV感染的监测和预防。
Objective To explore the pathogen of neonatal pneumonia. Methods Twenty-five neonates with pneumonia were detected by routine throat swab and blood culture from February 25 to March 11, 2004. Twenty-two patients were tested for serum anti-Chlamydia, Mycoplasma, Coxsackie virus and echovirus IgM antibodies ; 10 cases of respiratory secretions virus antigen detection [including adenovirus, respiratory syncytial virus (RSV), influenza A, B, parainfluenza 1,2,3], RSV isolation and PCR detection and sequencing. Results Of the 25 cases, one of the throat swabs and blood cultures were Klebsiella pneumoniae. The clinical significance of the culture of the throat swab and blood culture was uncertain. Twenty-two serum anti-Chlamydia, Mycoplasma, Coxsackie virus and Eke RSV antigen was positive in respiratory secretions and positive in 1 case of RSV virus in 10 patients with respiratory secretions. PCR detection of RSV in 10 cases of nasopharyngeal secretions was positive. Sequencing showed that the virus isolated from the wild type strain, A5 genotype. Conclusion The epidemic of neonatal pneumonia is caused by RSV infection. In the RSV epidemic season, surveillance and prevention of RSV infection should be strengthened.