武汉地区儿童急性呼吸道感染病原学研究

Etiology research in children with acute respiratory infection of Wuhan

目的:了解武汉地区儿童急性呼吸道感染不同病原体的感染情况及流行病学特征。方法:对13 850例于2014-01-2014-12就诊被诊断为呼吸道感染的儿童,用间接免疫荧光法检测9种呼吸道病原体IgM抗体。结果:病原体总阳性检出率为31.00%,各病原体检出率由高到低依次为:肺炎支原体(MP,16.92%)、乙型流感病毒(IFNB,6.01%)、腺病毒(ADV,4.42%)、呼吸道合胞病毒(RSV,1.55%)、副流感病毒(PIV,1.29%)、肺炎军团菌血清I型(CP,0.45%)、甲型流感病毒(IFNA,0.25%)、肺炎衣原体(CP,0.07%)、Q热立克次体(RB,0.04%)。其中2种以上病原体混合感染率为20.12%,MP和IFNB混合感染率为29.98%。MP在2014年全年都维持较高的流行水平,并在6月和9月出现2次流行高峰;IFNB在冬春出现2个发病高峰期,其中以1月份发病率最高;ADV在春季出现了流行高峰,然后呈逐渐下降趋势,其中以3月份发病率最高。结论:2014年武汉地区急性呼吸道感染病原体以MP、IFNB和ADV为主,并且混合感染情况严重,了解本地区急性呼吸道感染患儿的流行病学特征对呼吸道疾病的防治有重要意义。

Objective：To study the epidemiologic feature of pathogen of acute respiratory infection in children from Wuhan in 2014. Method：The serum samples obtained from 13 850 children with acute respiratory infection, nine IgM antibody of respiratory pathogen were detected by indirect immunofluorescence. Result： The total isolating rate was 31.00% in these children, and 9 pathogen isolating rate was in order with 16.92%（mycoplasma pneumo- nia, MP）, 6.01% （influenza virus B, IFNB）, 4.42% （adenovirus, ADV）, 1.55% （respiratory syncytial virus, RSV）, 1.29 % （parainfluenze virus, PIV）, 0.45 % （legionella pneumonia I, LP）, 0.25 % （influenza virus A, IF- NA） ,0.07% （chlamydia pneumoniae, CP）, 0.04% （rickettsia burneti, RB）. The rate of mixed pathogens infec- tions was 20.12 %, in which MP was the agent most frequently involved, among which the most common co-infec- tion was MP and IFNB. Seasonal distribution analysis showed that MP was virtually prevalent in the whole year, with two peaks in June and September, while IFNB peaked in January, ADV peaked in March. Conclusion： MP, IFNB and ADV were the dominant pathogens associated with ARI among children of Wuban area in 2014. Mixed infections of the respiratory agent presented an high frequency in our study. Understanding the characteristics of epidemiology will provide laboratory data for the epidemic control and patient care of children in Wuhan.