8种病原体所致儿童急性呼吸道感染的流行病学分析

Epidemiological investigation on eight pathogens in children with acute respiratory infection

目的了解绵阳地区儿童急性呼吸道感染人群病原学流行现状,分析预测病原流行趋势及特点。方法对2014年3月1日至2015年2月28日绵阳地区某三甲医院住院儿科收治的急性呼吸道感染1 099例患儿血清采用间接免疫荧光法（ⅡF）检测8种常见的呼吸道病原体特异性IgM抗体,包括呼吸道合胞病毒（RSV）、腺病毒（ADV）、流感病毒A（FluA）、流感病毒B（FluB）、副流感病毒（PFlu）、肺炎支原体（MP）、肺炎衣原体（CP）和嗜肺军团菌（LP）,并对检测结果进行统计分析。结果 1 099例急性呼吸道感染患儿,至少一种呼吸道病原体或病毒阳性检出率为53.3%,其中,FluB阳性检出率最高,为36.9%;其次是FluA为28.3%;阳性检出率最低的是ADV为2.7%。单一感染阳性检出率为13.3%,两种及以上混合感染阳性检出率为40.0%,提示混合感染比较普遍。混合感染之二重感染模式中,FLuA＋FLuB阳性检出率最高,为15.2%;其次是RSV＋MP,3.73%;第三是RSV＋FluB,1.91%。三重感染模式中,FLuA＋FLuB＋LP阳性检出率最高,为1.91%;其次是RSV＋FLuA＋FLuB和FLuA＋FLuB＋MP,均为1.09%。各年龄组内比较,FluB阳性率均为最高,其次是FluA。组间比较,3~〈6岁组的FluB阳性率为最高,达73.8%;其次是FluA,为57.3%。季节间比较,冬季阳性检出率最高,达59.6%;其次是秋季,为57.6%。FluB和FluA在冬、秋季的阳性率明显高于夏、春季（P〈0.05）。结论 FluB、FluA、MP和RSV是本地区儿童急性呼吸道感染的主要病原体;混合感染流行情形比较普遍,且以FluB＋FluA的二重感染模式最为多见;病原体的感染有季节流行趋势,病原体的检出率与年龄和地域有相关性。

Objective To investigate the epidemiological characteristics in children with acute respiratory infection in Mianyang region,and to analyze and forecast prevalence trend and characteristics of pathogen.Methods Totally 1 099 children with acute respiratory tract infection between March 1,2014 to February 28,2015 were selected.And 8kinds of specific IgM antibodies of pathogens in respiratory tract infections including respiratory syncytial virus（RSV）,adenovirus（ADV）,influenza virus A（FluA）,influenza virus B（FluB）,parainfluenza（PFlu）,mycoplasma pneumonia（MP）,chlamydia pneumoniae（CP）and legionella pneumophila（LP）were detected by immunofluorescence assay（ⅡF）,and the testing results were analyzed.Results The subjects who carried at least one kind of virus or atypical pathogen accounted for 53.3%,and who carried only one kind of pathogen accounted for 13.3%.Children infected with two kinds or more pathogens accounted for 40.0%.Among them,the detection rate of FluB was the highest（36.9%）,followed by FluA（28.3%）and the least was ADV（2.7%）.In double infection mode,the detection rate of FLuA＋FLuB was the highest（15.2%）,followed by RSV＋ MP（3.73%）,and the least was RSV＋FluB（1.91%）.In triple infection mode,the detection rate of FLuA＋FLuB＋LP was the highest（1.91%）,followed by RSV＋FLuA＋FLuB（1.09%）and FLuA＋FLuB＋MP（1.09%）.Among age group of 3to 〈6years old,the positive rate of FluB were the highest（73.8%）,followed by FluA（57.3%）.The positive rate of pathogens was the highest in winter（59.6%）,followed by the rate in autumn（57.6%）.In addition,the positive rates of FluA and FluB in winter and autumn were significantly higher than those of spring and summer（P〈0.05）.Conclusion FluB,FluA,MP and RSV are the main pathogens in children with respiratory tract infection in Mianyang region,and mixed infection are universal.The double infections mode of FluB＋FluA is common.Pathogen infection has the characteristic of seasonal epidemic,which is associated with age,season and region.