青海省儿童发热呼吸道症候群病例病原学分析

Pathogens inducing febrile respiratory syndrome among children in Qinghai province

目的了解青海省儿童发热呼吸道症候群病例病原种类及其流行特征,为儿童发热呼吸道症候群的预防控制提供参考依据。方法收集2010年1月—2014年12月在青海省妇女儿童医院和青海红十字医院2家哨点医院就诊的255例<14岁急性呼吸道感染病例的病历资料,采集呼吸道、血液、尿液标本进行常见6种细菌的培养鉴定,并应用实时定量荧光聚合酶链式反应(real-time PCR)方法进行8种病毒以及支原体和衣原体的核酸检测。结果 255例<14岁急性呼吸道感染病例共检出细菌(支原体、衣原体)阳性菌株21株,阳性检出率为8.24%,其中以肺炎链球菌检出率最高,占阳性标本总数的52.38%,其次为流感嗜血杆菌,占23.81%;检出病毒样本阳性35份,检出率为13.73%,主要为人腺病毒,占阳性标本总数的37.14%,其次为人副流感病毒,占22.86%;细菌和病毒检出率比较,差异有统计学意义(χ2=3.932,P<0.05);细菌病原检出集中在7—9月,病毒病原检出主要集中在10—12月;男性患儿细菌和病毒检出率分别为8.67%和13.33%,女性患儿分别为7.61%和14.29%,不同性别患儿细菌和病毒检出率比较,差异均无统计学意义(均P>0.05)。结论青海省儿童发热呼吸道症候群病例以病毒感染占优势,主要为人腺病毒和人副流感病毒。

Objective To study prevalence characteristics of pathogens inducing febrile respiratory syndrome among children in Qinghai province and to provide references for the control of the epidemic. Methods Totally 255 children aged less than 14 years seeking medical service for acute respiratory infection symptoms at 2 influenza surveillance senti- nel hospitals in Xining city of Qianghai province were recruited and their clinical records were extracted and specimens of blood,respiratory secretions and urine were collected for isolations of 6 bacteria and nucleate detections of 8 viruses and Mycoplasma and Chlamydia with real-time quantitative reverse transcription PCR （RT-PCR）. Results Overall 2l strains of bacteria （ including Mycoplasma and Chlamydia） were detected in the child patients and the detection rate of pathogen- ic bacteria was 8.24 % , with a major pathogen of Streptococcus penumoniae （52. 38 % ）. Totally 35 patients were positive to pathogenic viruses and the viral detection rate was 13.73% ;the major pathogenic virus deteted was human adenovirus （37.14%） ,followed by human parainfluenza virus （22. 86% ）. The detection rate of viruses was significantly higher than that of bacteria （X2 = 3. 932, P 〈 0. 05 ）. More bacterial positive samples were detected in July, August and Septem- ber of a year and virus positive samples in October to December of a year. The bacterial and viral detection rates were 8.67% and 13.33% for the male patients and 7.61% and 14. 29% for the female. There were no significant gender differences in the detection rates （P 〈 0. 05）. Conclusion The major pathogens related to febrile respiratory syndrome were human adenovirus, parainfluenza virus, and influenza virus among children in Qinghai province.