淮安市儿童急性呼吸道感染病原学分析

Etiology of acute respiratory tract infections in children in Huaian

目的探讨急性呼吸道感染(ARI)患儿呼吸道病原体的感染情况及季节流行特点,为临床实施行之有效地预防和诊治提供依据。方法应用间接免疫荧光法(IFA)检测该院2015年1月-2015年12月3 461例0~12岁ARI患儿血清中呼吸道合胞病毒(RSV)、腺病毒(ADV)、甲型流感病毒(Flu A)、乙型流感病毒(Flu B)、副流感病毒(PIV)、肺炎支原体(MP)、肺炎衣原体(CP)、嗜肺军团菌(LP)Ig M抗体。结果 3 461份血清中呼吸道感染病原体Ig M抗体阳性检出率为69.17%,最常检测到的病原体是Flu B(51.11%)、Flu A(36.38%)、MP(25.14%)和RSV(9.04%)。Flu A、Flu B和MP感染无明显季节性,检出率整年均较高;RSV呈现流行高峰在冬、春季;ADV和CP为春、夏季多发;PIV和LP发病率终年较低。随年龄增长RSV发病率下降,而其他病原体则相反。病原体混合感染检出1 627例,占47.01%;混合感染最常见病原体为Flu A+Flu B和Flu A+Flu B+MP。结论淮安地区2015年8种呼吸道病原体阳性率达69.17%,以Flu B检出率最高;呼吸道病原体感染的流行季节各有不同;伴随年龄的增长RSV阳性率降低,而其他病原体阳性率则逐步增长;以Flu A和Flu B的混合感染为最多见;早期检测呼吸道病原体,将有助于儿科医生诊治和控制呼吸道感染。

Objective To investigate respiratory pathogens and seasonal epidemic features of acute respiratory tract infections in children so as to provide the basis for effective clinical prevention and treatment. Methods Indirect immunofluorescence assay was utilized to detect serum Ig M antibodies against respiratory viruses and atypical pathogens from 3,461 children of 0-12 years with acute respiratory tract infections in our hospital between January 2015 and December 2015. The pathogens included Respiratory syncytial virus（RSV）, Adenovirus（ADV）, Influenza A virus（Flu A）, Influenza B virus（Flu B）, Parainfluenza virus（PIV）, Mycoplasma pneumonia（MP）, Chamydophila pneumonia（CP）, and Legionella pneumophila（LP）.Results Of 3,461 serum samples detected, the total Ig M positive rate of respiratory tract infection pathogens was 69.17%. The most frequently detected pathogens were Flu B（51.11%）, Flu A（36.38%）, MP（25.14%） and RSV（9.04%）. The detection rates of Flu A, Flu B and MP infections did not exhibit a pronounced seasonality and kept at a high level almost throughout the year. RSV epidemic peak appeared in winter and spring. ADV and CP had higher detection rates in spring and summer. PIV and LP kept at a low level throughout the year. While RSV incidence decreased significantly along with the age growth, the opposite was observed for infections of other pathogens. Mixed-infections of pathogens were detected in 1,627 cases with the positive rate of 47.01%. The most common pathogens in the co-infections were Flu A ＋Flu B and Flu A ＋Flu B ＋MP.Conclusions The total positive rate of 8 kinds of respiratory pathogens was 69.17% in Huaian in 2015, and the positive rate of Flu B was the highest. The incidences of the infections caused by the respiratory pathogens varied in the seasons. With the growth of the age, the positive rate of RSV was significantly decreased, while the positive rates of other pathogens were gradually increased. Flu A and Flu B were the most common in mixed infections. Early detection of respiratory pathogens will be helpful for pediatricians to diagnose, treat and control respiratory tract infections.