Abstract: Objective    To investigate the distribution and features of pathogens of children with community-acquired pneumonia （CAP） and provide evidence for clinical diagnosis and treatment. Methods    Retrospectively analyze the pathogenic characteristics of 2665 children with CAP hospitalized in the respiratory department of Shanxi Children's Hospital from January 2019 to December 2021. Results    Pathogens were detected in 1879 of 2665 children with CAP，and the detection rate was 70.5%. It included 1608 cases of single infection （85.6%）and 271 cases of mixed infection （14.4%）. The pathogen detection rates in 2019，2020 and 2021 were 67.5%（918/1361），44.7%（144/322） and 83.2%（817/982，the highest）， respectively. Streptococcus pneumoniae was detected in all age groups，and was higher in young children and preschool than in infancy and schoolage. Respiratory syncytial virus infection was mainly in the infant group，and the detection rate of Mycoplasma pneumoniae was the highest in the school-age group. The pathogen detection rates of mild and severe CAP were 69.1% and 72.3%， respectively. Conclusion    Mycoplasma pneumoniae is the main pathogen of hospitalized children with CAP in this region，with a trend of low age. There was prevalence of Mycoplasma pneumoniae in this region in 2021. Streptococcus pneumoniae is the first bacterial pathogen of CAP in children，and RSV is the first viral pathogen. The pathogen detection rate of severe CAP caused by Mycoplasma pneumoniae is higher than that of mild CAP. 

Key words: community-acquired pneumonia, pathogeny, child

摘要： 目的    了解儿童社区获得性肺炎（CAP）住院患儿病原分布及特点，为临床诊治提供依据。方法    采集2019年1月至2021年12月于山西省儿童医院呼吸科住院治疗的2665例CAP患儿标本并进行病原检测，回顾性分析CAP患儿的病原学特点。结果    2665例CAP患儿中1879例检出病原体，病原检出率为70.5%。其中单一感染1608例（85.6%），混合感染271例（14.4%）。2021年检出率最高83.2%（817/982），其次为2019年67.5%（918/1361），2020年44.7%（144/322），肺炎链球菌在各年龄组均有检出，幼儿期和学龄前期高于婴儿期和学龄期。呼吸道合胞病毒（RSV）感染主要在婴儿组，肺炎支原体在学龄期组检出率最高。轻症CAP和重症CAP患儿病原检出率分别是69.1%和72.3%。结论    肺炎支原体是该地CAP住院患儿的主要病原体，存在低龄化趋势，2021年出现了肺炎支原体的流行。肺炎链球菌是儿童CAP首位细菌病原体，RSV为首位病毒病原体，肺炎支原体引起的重症CAP的病原检出率高于轻症CAP。

关键词: 社区获得性肺炎, 病原学, 儿童