武汉地区22482例婴幼儿呼吸道感染常见病原体流行病学调查

Epidemiological investigation of the detection of common pathogens causing respiratory tract infection in 22482 infants and young children in Wuhan area

目的了解武汉地区住院儿童呼吸道感染的病原体检出率及流行特征，为临床诊断提供有效依据。方法收集22482例于2012年1月～2014年12月到武汉大学人民医院就诊并诊断为呼吸道感染患儿的血清标本，使用间接免疫荧光法检测9种呼吸道病原体IgM抗体。结果①12607例患儿病原体抗体阳性。病原体总阳性检出率为56．08％，检出率较高的病原体为肺炎支原体（MP）、乙型流感病毒（FluB）、呼吸道合胞病毒（RSV）和腺病毒（ADV），其他病原体检出率较低；其中，单一感染6317例（50．11％），混合感染6290例（49．89％），单一感染以是MP为主，混合感染以MP＋FluB模式多见。②女性患儿呼吸道9项病原体IgM阳性检出率均高于男性；男女患儿之间单重感染比较差异无统计学意义（P〉0．05），多重感染比较差异有高度统计学意义（P〈0．01）。③不同年龄段分组显示，婴儿组呼吸道感染者人数最多（47．75％），学龄组呼吸道感染者人数最少（6．95％）；各年龄组MP检出率最高，其次主要为FluB和ADV，≥1岁患儿各病原体检出率明显高于〈1岁患儿。结论武汉地区引起儿童呼吸道感染的病原体主要是MP、FIuB、ADV和RSV，不同年龄段病原体感染率不同。

Objective To investigate the relevance ratio and epidemiologic characteristics of pathogens in hospitalized children with respiratory tract infection in Wuhan area, so as to provide evidence for clinical diagnosis. Methods The serum specimens were collected from 22 482 hospitalized children with respiratory infection in Renmin Hospital of Wuhan University from January 2012 to December 2014, and were tested by indirect immunofluorescence assay for IgMs of 9 pathogens. Results ①12 607 children were positive for the respiratory pathogens, the total positive rate of infection was 56.08%. The higher detection rate of the pathogens were M. Pneumoniae （MP）, influenza B virus （HUB）, respiratory syncytial virus （RSV） and adenovirus （ADV）, the other pathogens detection rates were low. Among the posi- tive cases, 6317 cases （50.11%） were mono-infections and 6290 case （49.89%） were co-infections. Among the mono- infection, MP was the leading causative agent, and MP plus FluB was the most frequent pathogens combination in co- infections. ②The positive detection rate with IgMs of 9 pathogens in female children were higher than in male children. Between male and female children, the positive percentage had no significant difference in single infections （P 〉 0.05）, and had significant difference in co-infections （P 〈 0.01）. ③Different age groups results showed that, the most frequent ages of children with respiratory tract infection were in infants group （47.75%） and the least frequent ages were in school age group （6.95%）. In all age groups, MP was predominan, followed by FluB and ADV, and the rate of respiratory infec- tions was much higher in children ≥ 1 year old compared with 〈1 year old. Conclusion The main pathogens in children with respiratory tract infections in Wuhan area are MP, FluB, ADV and RSV. The incidence of the infection rates are caused by the pathogens vary in all ages.