中国西南地区发热呼吸道症候群病原学研究

Etiological analysis of febrile respiratory syndrome in southwest region of China

目的了解中国西南地区发热呼吸道症候群病原谱的构成及流行特征。方法通过国家"十二五"重大专项发热呼吸道症候群病原谱监测平台,收集2012年1月12日至2015年3月14日云南省、四川省、贵州省、重庆市和西藏自治区上报的具有发热呼吸道症状的10384例监测病例的呼吸道标本,收集其基本信息。对标本中的流感病毒(Flu)、呼吸道合胞病毒(RSV)、人副流感病毒(HPIV)、人腺病毒(ADV)、人冠状病毒(HCoV)、人偏肺病毒(HMPV)、人博卡病毒(HBoV)和鼻病毒(HRV)进行检测,并对不同特征病例的不同病毒阳性率进行描述。结果10384例监测病例中,共检测8013份样本。病毒阳性率为33.31%(2669例),其中HRV的阳性率最高(10.23%,820),HMPV最低(1.05%,84)。RSV、HRV、HPIV和HBoV阳性率在0~5岁组最高,分别为14.74%、14.64%、9.71%和7.16%。另外,HCoV在鼻咽拭子样本中的阳性率最高(2.47%)。RSV和HRV在鼻咽抽吸物样本中的阳性率最高,分别为20.28%和21.74%。贵州省HRV和Flu的阳性率较高,分别为13.66%和11.95%。重庆市RSV的阳性率居于首位,为16.95%,四川省则以HRV和HPIV为主,阳性率分别为13.55%和9.81%。监测病例中,656例病例样本同时检出两种及以上病毒,两种病毒感染占多重感染总数的83.54%。结论各省病原体种类不同,流行程度各异,鼻咽抽吸物病毒检出率最高。加强和完善发热呼吸道症候群病原监测平台,尽早确定病原为临床诊断、治疗提供依据。

ObjectiveTo understand the distribution and epidemiological characteristics of pathogens for febrile respiratory syndrome in southwest region of China.MethodsFrom Jan 12, 2012 to March 14, 2015, samples and information of 10 384 patients were collected from five provinces in southwest region of China, including Yunnan, Sichuan, Chongqing, Tibet and Guizhou, through Pathogens Surveillance Platform for Febrile Respiratory Syndrome of National "12th Five Year" Major Project. Influenza virus (Flu), respiratory syncytial viruses (RSV), human para-influenza viruses (HPIV), human adenovirus (ADV), human coronavirus (HCoV), human metapneumovirus (HMPV), human boca virus (HBoV) and human rhinovirus (HRV) were tested, and the positive rates of different viruses were characterized.ResultsFrom 10 384 surveillance cases, 8 013 samples were tested, and the positive rate of all viruses was 33.31% (2 669 cases). The positive rate of HRV was the highest (10.23%, 820 cases) and HMPV was the lowest (1.05%, 84). The positive rates of RSV, HRV, HPIV and HBoV in 0-5 years old group were the highest (14.74%, 14.64%, 9.71% and 7.16%, respectively). In addition, the positive rate of HCoV in naopharyngeal swabs was the highest among all samples, accounting for 2.47%. Both positive rates of RSV and HRV were the highest in nasopharyngeal aspirate samples, accounting for 20.28% and 21.74%, respectively. The detection rates of HRV and Flu in Guizhou were rather high, reaching 13.66% and 11.95%, respectively. In Chongqing, positive rate of RSV was the highest, accounting for 16.95%. In Sichuan, the detection rates of HRV and HPIV were the highest, accounting for 13.55% and 9.81%, respectively. More than one virus were detected from 656 samples among all surveillance cases. Infections with two viruses accounted for 83.54% (548 cases) of the multiple infections.ConclusionsThe pathogens were different in different areas. Detection rate of virus in nasopharyngeal aspirate samples was the highest. So it is very important to strengthen and to improve surveillance platform, so as to provide references for clinical diagnosis, diseases treatment.