南通地区2014年急性下呼吸道感染儿童常见病毒病原学分析

The aetiological study on common viruses among children with acute lower respiratory infection in Nantong during 2014

目的：了解2014年南通地区急性下呼吸道感染（ALRI）住院患儿常见病毒病原学特征,为临床合理用药提供依据。方法：收集752例患儿鼻咽部拭子标本,采用直接免疫荧光法检测流感病毒A（IVA）、流感病毒B（IVB）、副流感病毒Ⅰ（PIVⅠ）、副流感病毒Ⅱ（PIVⅡ）、副流感病毒Ⅲ（PIVⅢ）、呼吸道合胞病毒（RSV）、腺病毒（ADV）7种常见呼吸道病毒感染情况,并结合临床资料进行分析。结果：752例鼻咽分泌物标本中,7种呼吸道病毒抗原阳性的标本有317例,总检出率为42.1%,其中RSV检出率最高,构成比为58.7%,其次为PIVⅢ（18.9%）。不同年龄呼吸道病毒检出率不同,0∽6月、6月∽1岁患儿检出率较高,分别为53.33%和51.09%。不同月份呼吸道病毒检出率不同,2014年1月、3月、12月份检出率最高,分别为53.63%、58.75%、53.54%,6月份病毒检出率最低为32.39%,其余月份病毒的检出率接近。不同疾病呼吸道病毒检出率不同,毛细支气管炎病毒检出率最高62.50%,其次分别为喘息型支气管炎49.54%、支气管哮喘合并感染45.95%、肺炎36.12%,支气管炎无喘息的病毒检出率最低31.21%。各组疾病检出的最主要病毒均为RSV。结论：2014年南通地区儿童急性下呼吸道感染主要病毒病原体为RSV,0∽1岁婴幼儿是其主要感染人群,并因季节和疾病不同而不同。

Objective：To investigate the features of common viruses in acute lower respiratory infection（ALRI） among hospitalized children in Nantong during 2014. Methods：Swab samples were collected from 752 hospitalized children with ALRI. Seven common respiratory viruses, including influenza virus A and B（IVA A, IVA B）, parainfluenza virus（PIVⅠ,PIVⅡ and PIVⅢ）, respiratory syncytial virus（RSV） and adenovirus（ADV） were detected with direct immunofluorescence assay, and to make epidemiological analysis by detailed clinical data. Results：In 752 cases respiratory tract samples, there were 317 cases of positive samples（42.1%）. Of these, the proportion of RSV（58.7%） was the highest, followed by PIV Ⅲ（18.9%）. The positive rate of virus was different with age. The positive rate of tested viruses among the 0∽6 months old infants（53.33%） and 6 months1 year old infants（51.09%） were the highest. The positive rate of virus was different with season. The positive rate in Jan（53.63%）, Mar（58.75%） and Dec（53.35%） were higher than other months. The positive rate in Jun（32.39%） is the lowest. The positive rate of virus was different with disease of acute lower respiratory infection.Among these, the positive rate of virus in bronchiolitis（62.50%） was highest, followed by asthmatic bronchitis（49.54%）,bronchial asthma concurrent infection（45.94%）, pneumonia（36.12%）. The positive rate in bronchitis with no gasp（31.21%）was lowest. RSV was the major viral pathogen in each group of diseases. Conclusions：RSV is the predominant viral pathogen associated with ALRI in the hospitalized children in Nantong. 0∽1 year old infants are the main infected population. The prevalence of these viruses exhibits the season-dependence and disease-dependence.