22990例儿童急性呼吸道感染的病原学及流行病学调查

Aetiological and Epidemic Analysis of 22990 Children with Acute Respiratory Infection

目的:对2015年本院收治的22 990例儿童急性呼吸道感染患儿进行9种病原体的病原学及流行病学调查分析。方法:采用间接免疫荧光法检测血清肺炎支原体(MP)、乙型流感病毒(INFB)、腺病毒(ADV)、副流感病毒(PIV)、呼吸道合胞病毒(RSV)、甲型流感病毒(INFA)、肺炎衣原体(CP)、肺炎军团菌血清Ⅰ型(LP)以及Q热立克次体(RB)等9种呼吸道病原体的IgM抗体。结果:2015年武汉地区9种呼吸道病原体总检出率为36.95%,其检出率由高到低依次为:MP 20.34%、INFB 6.84%、ADV 5.37%、RSV 1.87%、PIV 1.55%、LP 0.55%、INFA0.29%、CP 0.07%、RB 0.07%;两种以上病原体混合感染率为20.94%,其中MP和INFB混合感染最为常见,构成比为30.97%。MP在2015年全年都维持较高的流行水平,在2月、6月和9月出现三次流行高峰;IFNB在冬春出现两个发病高峰期,其中1月份发病率最高,10月份次之;ADV在春季出现了流行高峰,然后呈逐渐下降趋势,其中3月份发病率最高,4月份次之。急性呼吸道感染患儿年龄集中于1岁以内儿童,并且随着年龄的增加发病率逐渐降低;男女患儿人数之比为2.02∶1,婴幼儿人数明显多于幼托儿童和学生。结论:2015年武汉地区儿童急性呼吸道感染病原体以MP最为多见,其次为INFB和ADV,并且混合感染情况严重,不同病原体存在季节流行的趋势,了解本地区急性呼吸道感染患儿的病原学和流行病学特征对今后呼吸道疾病的防治有重要意义。

Objective：To investigate the aetiological and epidemiological characteristics of 22 990 children with acute respiratory infection（ARI）in 2015.Methods：The serum samples were obtained from 22 990 children with ARI.IgM of nine antibodies of respiratory pathogens was detected by indirect immune-fluorescence,which included mycoplasma pneumonia（MP）,influenza virusB（INFB）,adenovirus（ADV）,respiratory syncytial virus（RSV）,parainfluenze virus（PIV）,legionella pneumoniaⅠ（LP）,influenza virus A（INFA）,chlamydia pneumonia（CP）and rickettsia burneti（RB）.Results：Among the 22 990 children with ARI,8 494 cases were detected positively,which accounted for 36.95%（8 494/22 990）.MP infection was predominant and the positive rate was 20.34%（4 677/22 990）,and the positive rates of other pathogens were INFB6.84%（1 573/22 990）,ADV 5.37%（1 235/22 990）,RSV 1.87%（429/22 990）,PIV 1.55%（356/22 990）,LP 0.55%（126/22 990）,INFA 0.29%（66/22 990）,CP 0.07%（17/22 990）and RB 0.07%（15/22 990）respectively.The mixed infection accounted for 20.94%（1 779/22 990）,and MP combined with INFB were most common（30.97%,551/1 779）.Seasonal distribution analysis showed that MP was virtually prevalent in the whole year,with three peaks in February,June and September.INFB peaked in January and October,and ADV peaked in May and April.The peak incidence of ARI appeared in children less than one year old,and the incidence rate gradually decreased as the age increased.The ratio of male to female was 2.02∶1,most of whom were nurselings.Conclusion：MP,IFNB,and ADV were the dominant pathogens associated with ARI among children of Wuhan district in 2015.Mixed infections of the respiratory agent presented a high frequency in our study.Understanding the characteristics of epidemiology will provide laboratory data for the control and prevention of epidemic diseases among children in future.