2012—2017年湖北地区儿童呼吸道感染病毒流行特征分析

Epidemiological characteristics of children respiratory tract viral infection in Hubei area (2012-2017)

目的了解湖北地区儿童呼吸道感染病毒流行特征,为防控及临床诊疗提供科学依据。方法用实时荧光PCR法,对2012年3月至2017年2月间收集的579份发热呼吸道综合征患者样本进行病毒核酸检测。结果 579份样本中检出阳性261份,阳性率45.08%(261/579);检出病毒304份,病毒检出率52.50%(304/579)。阳性样本中,单一病毒感染219例,混合感染42例,病原谱构成以腺病毒、鼻病毒和流感病毒为主,占比分别为24.01%(73/304)、19.08%(58/304)和18.09%(55/304)。呼吸道合胞病毒、腺病毒和冠状病毒感染在各年龄组间差异有统计学意义(P<0.05),呼吸道合胞病毒以<1岁人群为主,腺病毒感染以3～6岁人群为主,冠状病毒感染以1～3岁人群为主。各病毒流行季节不同,具有显著季节差异性(P<0.05)。结论不同季节的主要病原体不同,腺病毒、鼻病毒和流感病毒是湖北地区儿童呼吸道病毒感染的主要病原体,6岁以下儿童为主要易感人群。加强对上述病毒的监测和研究,应作为该辖区呼吸道病毒的防控重点。

Objective To analyze the epidemiological characteristics of children respiratory tract viral infection in Hubei area, and provide scientific evidence for prevention and control and clinical diagnosis and treatment. Methods 579 specimens from patients of Febrile Respiratory Syndrome were collected between March 2013 and February 2017. The viral nucleic acid detection was conducted using real-time fluorescent PCR. Results 261 specimens were detected to be positive out of a total of 579 specimens tested. The positive rate was 45.08%(261/579). 304 viruses were detected, and the virus detection rate was 52.50%(304/579). Among the positive samples, 219 cases were infected with a single virus and 42 cases were mixed infection. The pathogen spectrum consisted mainly of adenovirus (AdV), rhinovirus (HRV) and influenza virus (IFV), accounting for 24.01%(73/304), 19.08%(58/304), and 18.09%(55/304), respectively. Respiratory syncytial virus (RSV), AdV and human coronavirus (HcoV) infection were statistically different among all age groups (P<0.05). RSV was predominantly in<1 year old group, and AdV infection was mainly in 3-6 years old group, while HcoV infection was predominantly in 1-3 years old group. The dominant viruses varied during the different seasons, and the detection rates of virus were significantly different in different seasons (P<0.05). Conclusion The epidemic of main pathogens varied during different seasons. AdV, HRV and IFV were the main pathogens of children respiratory tract viral infection in Hubei area, and children under 6 years old were the main susceptible population. Strengthening the monitoring and research of the above viruses should be the focus of prevention and control of respiratory viruses in Hubei area.