新兵急性呼吸道疾病病原体检测结果分析

Etiologic investigation of acute febrile respiratory illness in military recruits

目的调查入伍新兵急性呼吸道疾病的常见病原体,为预防控制呼吸道传染病提供科学依据。方法留取40例老兵、204例新兵和40例急性呼吸道疾病新兵咽拭子,提取DNA和RNA,检测15种病原体的核酸,并留取急性呼吸道疾病新兵双份血清检测抗病原体抗体。结果老兵组咽拭子流感病毒、肺炎支原体和肺炎链球菌核酸的检出率分别为32.5%、25.0%和15.0%,高于新兵组的2.5%、2.5%和2.9%(P<0.05);在40例散发的患有急性呼吸道疾病的新兵中,甲型和乙型流感病毒核酸阳性率分别为5.0%和55.0%,肺炎支原体、肺炎链球菌和嗜肺军团菌的阳性率分别为20.0%、7.5%和15.0%,与老兵组(分别为25.0%、15.0%和17.5%)或新兵入营时(分别为2.5%、2.9%和7.4%)相比,差异均无统计学意义(均有P>0.05);对患有急性呼吸道疾病的新兵急性期和恢复期双份血清检测发现,乙型流感病毒感染发生率为65.0%(26/40),甲型流感病毒感染率为5.0%(2/40),无甲型流感病毒H5N1等感染病例发生。结论入伍新兵在入训期间散发的急性呼吸道疾病以流感病毒感染为主。

Objective To investigate the common causes of acute respiratory illness（ARI） in conscripts.Methods The throat swabs from 40 military personnel,204 conscripts and 40 conscripts with ARI were collected for detection of 15 common respiratory pathogens by a real-time fluorescent quantitative PCR assays;the sera were collected in acute stage of infection and in convalescent stage for serologic detection.Results The positive rates of nucleic acids of influenza A or B virus,Microplasma pneumoniae and Streptococcus pneumoniae in military personnel were 32.5%,25.0% and 15.0%,much higher than 2.5%,2.5% and 2.9% in conscripts（P0.05）;during two-month training periods,40 recruits had ARI with 5.0% of influenza A and 55.0% of influenza B virus infection;the positive rates of nucleic acids of Microplasma pneumoniae,Streptococcus pneumoniae and Legionella pneumophila in febrile conscripts were 20.0%,7.5% and 15.0%,not significantly different as compared to 25.0%,15.0% and 17.5% in military personnel or to 2.5%,2.9% and 7.4% in conscripts at recruitment;the serologic detection showed that influenza B infection accounted for 65.0%（26/40）,and influenza A infection for 5.0%（2/40）;the detection results were negative for adenovirus,measles virus,severe acute respiratory syndrome（SARS） associated coronavirus,human coronavirus,epidemic mumps virus,human respiratory syncytial virus,influenza A virus H5N1,rubella virus,Streptococcus suis and Chlamydia pneumoniae.Conclusions The ARI in conscripts in our series is mainly caused by influenza B and A virus infection.