武汉地区冬春季儿童急性呼吸道感染病原学研究

Research on etiology of acute respiratory tract infection in children from Wuhan during winter and spring

目的了解武汉地区冬春季儿童急性呼吸道感染不同病原体的检出率、构成等相关流行病学特征。方法对6348例于2010年10月-2011年3月到医院就诊,诊断为呼吸道感染的儿童,用间接免疫荧光法检测9种呼吸道病原体IgM抗体。结果病原体总阳性检出率为34.40%,9种病原体检出率由高到低依次为:肺炎支原体占21.88%、腺病毒占10.41%、乙型流感病毒占10.03%、呼吸道合胞病毒占7.36%、副流感病毒占5.01%、肺炎军团菌血清1型占1.02%、甲型流感病毒占0.72%、Q热立克次体占0.09%、肺炎衣原体0.02%;肺炎支原体在整个冬春季其间检出率均较高,腺病毒在10月份检出率较低,但在随后月份中其检出率均比较高,乙型流感病毒在2011年1月呈暴发态势,阳性病例数和检出率上升5倍,呼吸道合胞病毒阳性检出率在2010年12月份达到最高。结论引起武汉地区冬春季急性呼吸道感染患儿的主要病原体为肺炎支原体、腺病毒、乙型流感病毒、呼吸道合胞病毒、副流感病毒,且乙型流感病毒在2011年1月有暴发流行的趋势。

OBJECTIVE To study the epidemiologic features suchas the detection rate and composition of pathogens causing acute respiratory tract infections in children in Wuhan during the winter and spring.METHODS A total of 6348 children who were diagnosed with acute respiratory tract infections from Oct.2010 to Mar.2011 were collected.IgM antibodies against nine pathogens from respiratory tract were tested by indirect immunofluorescence assay.RESULTS The total positive detection rate of pathogen was 34.40%.The detection rates of 9 pathogens in the order from the highest to the lowest were as the following：Mycoplasma pneumonia（21.88%）,adenovirus（10.41%）,influenza virus B（10.03%）,respiratory syncytial virus（7.36%）,parainfluenze virus（5.01%）,Legionella pneumonia 1（1.02%）,influenza virus A（0.72%）,R.burneti（0.09%）,Chlamydia pneumoniae（0.02%）.Continued high detection rate of M.pneumonia was observed during the whole winter and spring.The detection rate of adenovirus was low in October,but high in the following months.Influenza virus B showed an outbreak trend in Jan 2011.The positive cases and the detection rate increased by 5 times.The detection rate of respiratory syncytial virus reached the peak in Dec 2010.CONCLUSION M.pneumonia,adenovirus,influenza virus B,respiratory syncytial virus and parainfluenze virus are the major pathogens causing acute respiratory infections in children in Wuhan area.The outbreak and prevalence of influenza virus B occurred in Jan 2011.