大连地区住院患儿急性呼吸道感染流行病学调查

Investigation on the pathogens in hospitalized children with acute respiratory infection

目的分析大连地区急性呼吸道感染患儿病原体检测结果及流行情况,为临床早期诊断、治疗及预防提供依据。方法调查2015年1月-2016年7月医院住院急性呼吸道感染患儿2 944例,采用间接免疫荧光法（IFA）对呼吸道感染患儿血液中的呼吸道合胞病毒（respiratory syncytial virus,RSV）、腺病毒（adenovirus,ADV）、流感病毒A型（influenza virus type A,IFA）、流感病毒B型（influenza virus type B,IFB）、副流感病毒（parainfluenza virus,PIV）、肺炎衣原体（Chlamydia pneumoniae,CP）、肺炎支原体（Mycoplasma pneumonia,MP）和嗜肺军团菌（Legionella pneumophila,LP）8种病原体进行检测。结果 2 944例患儿中血清IgM抗体阳性共1 280例,总阳性率为43.48%（1 280/2 944）,主要为IFB和MP感染：IFB阳性率最高,为16.68%（491/2 944）;其次为MP,阳性率为14.44%（425/2 944）。ADV各年龄组之间差异无统计学意义（χ~2=0.286,P=0.593〉0.05）,其余各种病原体不同年龄组之间差异均有统计学意义。其中IFB、MP在3~6岁组中检出率最高;RSV在0~1岁组中检出率明显高于其他年龄组。MP男女患儿组间差异有统计学意义（χ~2=7.671,P=0.006〈0.05）,其余各项差异均无统计学意义（P〉0.05）。IFB第二季度和第三季度检出率高于其他季度,MP在第三季度检出率最高,IFA、LP、CP也同样是第三季度检出率最高,PIV和ADV各季度检出率差异无统计学意义（P〉0.05）,RSV在第一季度检出率略高于其他季度。结论大连地区引起患儿呼吸道感染的病原体主要是IFB和MP,针对不同年龄组、不同季度的感染情况,应做好重点预防工作。

Objective To investigate the epidemic status and pathogens of acute respiratory tract infection among Dalian children, and provide evidences for early diagnosis, therapy and prevention in clinical practice. Methods Two thousand nine hundred and forty-four children with acute respiratory tract infection admitted from January 2015 to July 2016 were included. Indirect immunofluorescence assay was performed to detect the IgM of 8 pathogens in serum, including respiratory syncytial virus （RSV）, adenovirus （ADV）, influ- enza virus type A （IFA）, influenza virus type B （IFB）, parainfluenza virus （PIV）, Chlamydia pneumo- nia （CP）, Mycoplasma pneumonia （MP）, and Legionella pneumophila （LP） . Results Among the 2 944 children, pathogens were identified in 1 280 children （43.48%） . The main pathogens were IFB （16.68 %） and MP （14.44 %） . There were statistically significant differences among the pathogens except ADV. The positivity rates of IFB and MP in children aged 3 - 6 years were the highest. The positivity rate of RSV in children under one year was higher than those in other age groups. There were no statistically significant differences between boys and girls except the rate of MP. The rate of IFB was higher in the second and the third quarter. The rate of MP was higher in the third quarter. There were no statistically significant differences in the rates of PIV and ADV between different quarters. The rate of RSV was higher in the first quarter. Conclusion IFB and MP were the main pathogens in hospitalized children with acute respiratory tract infection in Dalian. Preventive measures should be taken according to different age, gender and quarter.