武汉地区儿童急性呼吸道感染的常见病原体检测

Detection of pathogens in children with acute respiratory infection in Wuhan region

目的本研究主要是检测15岁及以下急性呼吸道感染儿童病毒及非典型细菌,了解这些病原体在武汉地区的流行情况。方法收集2012年9月-2017年8月武汉大学人民医院住院儿科41 434例拟诊断为急性呼吸道感染(acute respiratory infection,ARI)的患儿血清,采用间接免疫荧光法检测其中九种常见病原体的IgM抗体,分别为:腺病毒(including adenovirus,ADV)、Q热立克次体(Coxiella burnetii,COX)、肺炎衣原体(Chamydophila pneumonia,CP)、甲型流感病毒(influenza A virus,FluA)、乙型流感病毒(influenza B virus,FluB)、嗜肺军团菌I型(Legionella pneumophila 1,LPN1)、肺炎支原体(Mycoplasma pneumoniae,MP)、副流感病毒(parainfluenza virus,PIV)、呼吸道合胞病毒(respiratory syncytial virus,RSV)。结果在检测的41 434例样本中,有20 373例检测出阳性(49. 17%),以MP的检出最高16 435例(39. 67%),其次为FluB和PIV,分别为7 541例(18. 20%)、2 297例(5. 54%)。FluB在2013年和2014年秋季有小流行; ADV在2013年和2014年春夏流行趋势明显; PIV在2013年冬季、2014年春季、2016年夏季和2017年春夏流行趋势明显; COX在2013年夏季和2014年秋季流行; FluA和LPN1在2013年夏季有小流行。九种病原体中ADV、CP、FluB、LPN1、MP、PIV、RSV病原体检出率在各年龄组之间差异有统计学意义(P<0. 05),<1岁年龄组中的病原体总检出率明显低于其他组(P<0. 05)。混合感染方式较复杂,2种病原体混合感染中,MP+FluB混合感染最多(3 656例,检出率为8. 82%)。结论武汉地区引起儿童ARI的病原体主要是MP、FluB和PIV;各种病原体检出率具有一定季节性且在不同年龄段有一定差异;混合感染比较普遍,主要是MP+FluB混合感染。

Objective To detect the viruses and atypical bacteria in acute respiratory infection(ARI) in children aged 15 years and below,and to investigate the prevalence of these pathogens in Wuhan region. Methods A total of 41,434 serum specimens were collected from inpatients who were intended to diagnose as ARI in Department of Pediatrics,Renmin Hospital of Wuhan University from September 2012 to August 2017. Indirect immunofluorescence assays were performed to detect IgM antibodies against nine kinds of common pathogens,including adenovirus(ADV),Coxiella burnetii(COX),Chamydophila pneumonia(CP),influenza A virus(FluA),influenza B virus(FluB),Legionella pneumophila 1(LPN1),Mycoplasma pneumoniae(MP),parainfluenza virus(PIV) and respiratory syncytial virus(RSV). Results Of the 41,434 detected specimens,20,373(49.17%) were tested positive for at least one pathogen. The detection rate of MP was the highest(39.67%,16,435/41,434),followed by FluB 7(18.20%,7,541/41,434) and PIV(5.54%,2,297/41,434). FluB appeared a little popular in spring in 2013 and 2014. ADV was very prevalent in spring and summer in 2013 and 2014,PIV very prevalent in winter in 2013,in spring in 2014,in summer in2016 and in spring and summer in 2017,and Cox prevalent in summer in 2013 and in autumn in 2014. FluA and LPN1 were a little popular in summer in 2013. Among the nine kinds of pathogens detected,the detection rates of ADV,CP,FluB,LPN1,MP,PIV and RSV showed statistically significant differences among different age groups(P< 0.05). The total detection rate of pathogens was significantly lower in the under 1-year age group than in the other age groups(P< 0.05). The patterns of mixed infections were complicated. In the mixed infection with 2 kinds of pathogens,MP +FluB was the most common pattern(8.82%,3,656/41,434).Conclusions The most common pathogens causing ARI among children in Wuhan region were MP,FluB and PIV. The detection rate of each pathogen displayed specific seasonal variations and differences among different age groups. Mixed infections were more common than single infections,and the most common co-infection was MP +FluB.