2009―2011年广东省急性呼吸道感染者病毒病原学分析

Investigation of viral etiology of acute respiratory infection in Guangdong Province,2009- 2011

目的了解广东省2009―2011年急性呼吸道感染（ARI）患者病毒病原体的感染状况,为临床诊断和制定治疗措施提供依据。方法 2009―2011年在广州、珠海、湛江、韶关和汕头市各选取1家医院,收集ARI患者发病1~3 d内的鼻咽拭子,采用荧光定量PCR方法检测样本中流感病毒A型和B型（Flu A、Flu B）、腺病毒（ADV）、鼻病毒（HRV）、呼吸道合胞病毒（RSV）、副流感病毒1、2、3型（HPIV1、HPIV2、HPIV3）、人偏肺病毒（h MPV）、冠状病毒229E型（HCo V-229E）、冠状病毒OC43型（HCo V-OC43）、人博卡病毒（HBo V）等12种病毒的核酸,采用描述性流行病学方法分析各种病毒感染的流行病学特征。结果共采集1 234份样本,检出病毒核酸阳性555份,病毒总阳性检出率为45.0%,其中检出HRV阳性数最多为168份,占阳性总数的30.3%,其次为Flu A 145份,占阳性总数的26.1%。不同年龄组病毒检出率差异有统计学意义（P〈0.01）,以0~4岁组人群检出率最高,为62.1%（185/298）。男性检出率为45.5%（326/716）,女性检出率为44.2%（229/518）,差异无统计学意义（P〉0.05）。除HRV外,其他病毒感染均有明显的季节特征。27份样本存在混合感染情况,混合感染率为2.2%（27/1 234）。结论 HRV和Flu A是引起广东省ARI的主要病毒病原体,各种病毒的感染率有明显的年龄和季节分布特征,ARI患者中部分存在混合感染情况。

Objective To investigate the infection status of viral pathogens in patients with acute respiratory tract infection （ARTI） in Guangdong Province, so as to provide evidence for clinical diagnosis and treatment. Methods During 2009 to 2011, one hospital was selected separately from cities of Guang- zhou, Zhuhai, Zhanjiang, Shaoguan, and Shantou. Nasal swabs were collected from patients with ARTI for 1 - 3 days in the selected hospitals. Influenza and other respiratory viruses were tested by molecular assays simultaneously. Descriptive epidemiological method was used to analyze the epidemiologieal characteristics of various viral infections. Results A total of 1 234 samples were collected, of which 555 （45.0%） were positive for viral nucleic acid. The most virus detected was HRV （30.3% , 168/555 ） , followed by FIuA （26.1% ,145/555 ）. The detection rates were statistically significant between different age groups （P 〈 0. 01）, and the highest detection rate was found in group aged at 0 to 4 years （62. lifo, 185/298）. The positive detections rates were 45.5% （326/716） for males and 44.2% （229/518） for females （P 〉 0. 05 ）. Except HRV, other viral infections had obvious seasonal characteristics. The mixed infection was found in 27samples, with a mixed infection rate of 2.2%. Conclusion HRV and FluA were predominant viral pathogens in patients with ARTI in Guangdong Province, viral infections had obvious age and seasonal characteristics, and co-infections were detected in parts of ARTI patients.