成人重症呼吸道感染的病原体流行病调查
Epidemiological Investigation of Pathogens Causing Severe Respiratory Tract Infections in Adults

目的：分析义乌地区成人重症呼吸道感染的常见病原体及流行病学特征。方法：选取本院收治的750例成人重症呼吸道感染患者为研究对象，利用痰液病原菌培养的方法检测呼吸道病原菌感染谱的病原菌类型。结果：750例成人重症呼吸道感染患者痰液标本的病原体培养检出阳性432例，检出率为57.6%。所有检测病例中，男性组和女性组患者各病原体检出阳性率差异无统计学意义(P > 0.05)。各年龄组(15~45岁组、45~60岁组、>60岁组)呼吸道病原体谱的检出率分别为37.11%，52.3%，74%，各组间比较，差异有统计学意义(P < 0.05)。呼吸道病原谱的检出率以春季和冬季的检出率较高，夏季和秋季的检出率较低(P < 0.05)。培养结果分析革兰氏阴性菌感染率最高，占74.77%，革兰氏阴性菌和真菌感染率较低。其中最主要的革兰氏阴性菌为鲍曼不动杆菌、铜绿假单胞菌和肺炎克雷伯杆菌。肺炎克雷伯杆菌在15~45岁人群中检出率最高，为49.5% (P < 0.05)，铜绿假单胞菌在60岁以上人群中检出率最高，为50% (P < 0.05)。结论：义乌地区引起成人重症呼吸道感染的病原体主要是鲍曼不动杆菌、铜绿假单胞菌和肺炎克雷伯杆菌，不同季节、不同年龄患者的病原体检出率及种类存在差异。临床可依据流行病学调查结果制订相应的预防、干预措施。
Objective: To analyze the common pathogens and epidemiological characteristics of adult severe respiratory tract infection in Yiwu area. Methods: 750 cases of adult patients with severe respirato-ry tract infection in XX Hospital from November 2016 to December 2020 were selected as the re-search objects, and the sputum pathogen culture method was used to detect the pathogen types of respiratory tract pathogen infection spectrum. Results: 432 of 750 sputum samples of adult pa-tients with severe respiratory tract infection were positive, and the detection rate was 57.6%. There was no significant difference in the positive rate of each pathogen between male group and female group (P > 0.05). The detection rate of respiratory tract pathogen spectrum in each age group (15~45 years old group, 45~60 years old group and >60 years old group) was 37.11%, 52.3% and 74% respectively, and the difference was statistically significant (P < 0.05). The detection rate of respiratory disease spectrum was higher in spring and winter, and lower in summer and autumn (P < 0.05). The infection rate of Gram-negative bacteria was the highest, accounting for 74.77%. The infection rate of Gram-negative bacteria and fungi was low. The main gram negative bacteria were Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae. The main gram negative bacteria were Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneu-moniae. The detection rate of Klebsiella pneumoniae was the highest in the population aged 15~45 (49.5%) (P < 0.05), and the detection rate of Pseudomonas aeruginosa was the highest in the popu-lation aged over 60 (50%) (P < 0.05). Conclusion: Acinetobacter baumannii, Pseudomonas aerugino-sa and Klebsiella pneumoniae are the main pathogens causing severe respiratory tract infection in adults in Yiwu area. The detection rates and types of pathogens in patients with different seasons and ages are different. The corresponding prevention and