2016—2018年北京地区儿童急性呼吸道感染病原体流行特征分析

Epidemiology of pathogens causing acute respiratory infections in children in Beijing during 2016 to 2018

目的探讨2016年12月至2018年2月北京地区呼吸道病原体在急性呼吸道感染儿童中的流行特征。方法回顾分析2016年12月到2018年2月在北京儿童医院因急性呼吸道感染就诊的34665例儿童病例,采用间接免疫荧光法定性检测人血清中抗8种常见呼吸道病原体的IgM抗体。8种常见呼吸道病原体包括呼吸道合胞病毒(respiratory syncytial virus,RSV)、甲型流感病毒(influenza virus A,IFA)、乙型流感病毒(influenza virus B,IFB)、副流感病毒(parainfluenza virus,PIV)、腺病毒(adenovirus,ADV),以及肺炎支原体(Mycoplasma pneumonia,MP)、衣原体(Chlamydia pneumonia,CP)、嗜肺军团菌(Legionella pneumophila,LP)。采用SPSS19.0软件对数据进行统计分析。结果在34665例患儿中,50.45%的儿童至少感染1种病原体,门诊轻症患儿感染率为56.11%,住院重症患儿感染率为44.06%。IFB阳性率最高,为36.56%,合并感染检出率为9.78%,以IFB与MP合并感染多见。RSV在28d<~≤1岁的患儿中检出率最高,IFA、IFB、PIV病原体检出率在3<~≤5岁儿童中最高。ADV、MP、CP及LP病原体随年龄增加检出阳性率升高。IFB、MP、IFA及RSV在冬春季节高发,其余病毒呈全年散发状态。在住院重症患者及门诊轻症患者中,8种呼吸道病原体IgM抗体的检出率差异有统计学意义(P=0.00)。结论本研究对北京地区2016至2018年15个月份的急性呼吸道感染的儿童呼吸道病原体IgM抗体检测情况进行回顾性分析,了解这期间北京地区呼吸道病原体在儿童中的流性特征,对防止滥用抗菌药物对儿童造成影响及减轻家长经济负担可起到积极作用。

Objective To investigate the epidemiology of pathogens causing acute respiratory infections in children in Beijing from December 2016 to February 2018.Methods Clinical data of 34 665 cases of acute respiratory infections in Beijing Children′s Hospital from December 2016 to February 2018 were reviewed.Indirect immunofluorescence antibody test(IFAT)was performed to detect IgM antibodies against eight common respiratory pathogens including respiratory syncytial virus(RSV),influenza virus A(IFA),influenza virus B(IFB),parainfluenza virus(PIV),adenovirus(ADV),Mycoplasma pneumonia(MP),Chlamydia pneumonia(CP)and Legionella pneumophila(LP).SPSS19.0 software was used for statistical analysis.Results In the 34 665 cases,50.45% children were infected with at least one kind of respiratory pathogen.There were 56.11%(10 309/18 372)in mild outpatient group and 44.06%(7 179/16 293)in severe inpatient group.IFB was the most prevalent pathogen with a positive rate of 36.56% and co-infection rate of 9.78%.IFB and MP co-infection was more common.Most of RSV strains were detected in children under 1 year of age.The positive rates of IFA,IFB and PIV peaked in patients at ages of 4-5 years.The rates of ADV,MP,CP and LP infections increased with age.IFB,MP,IFA and RSV were more prevalent in winter and spring.Other pathogens caused sporadic cases throughout the year.There were significant differences in the detection rates of IgM antibodies against the eight respiratory pathogens between the mild and severe groups(P=0.00).Conclusions This study analyzed the epidemiology of respiratory pathogens in Beijing from December 2016 to February 2018 through reviewing test results of IgM antibodies against eight common respiratory pathogens in children with acute respiratory infections.It might be conductive to the prevention of antimicrobial abuse and reduction of economic burden to families.