北京市顺义区儿童呼吸道感染病原体检测及流行特征分析

Detection and epidemiological analysis of pathogen RNA detection in children with respiratory tract infection in Shunyi District of Beijing

目的 分析我院2018~2019年住院的呼吸道感染患儿的病原体检测情况及流行特征,为临床诊疗及疾病防控提供依据。方法 采集1 730例呼吸道感染患儿咽拭子,其中73例重症肺炎行纤支镜灌洗患儿留取肺泡灌洗液标本作为对照,采用双扩增技术(DAT)进行FluA、FluB、RSV、PIV、ADV、MP和CP七种病原体RNA检测。结果 1730例标本总阳性检出率为44.91%,各病原体检出率分别为FluA4.45%、FluB1.50%、RSV9.08%、PIV6.36%、ADV3.76%、MP22.37%和CP0.40%,其中混合感染率为2.95%。不同年龄组间病原体的检出率差异有统计学意义(χ^2=30.05,P<0.05)。不同季节病原体的检出率差异有统计学意义(χ^2=28.14,P<0.05)。MP是引起患儿呼吸道感染的主要病原体,夏秋季节高发。因肺炎就诊的患儿数量最多,且检出率最高(49.66%),其次为支气管炎(32.09%),不同疾病病原体的检出率差异有统计学意义(χ^2=55.30,P<0.05)。结论 2018年8月~2019年8月本院儿童呼吸道感染的病原体以MP为主,RSV和PIV次之,FluB在今年春季流行。病原体检出率随年龄增长有升高趋势,在肺炎、支气管炎等下呼吸道感染中检出率高于上呼吸道感染和其他疾病。双扩增技术可为临床提供全面、早期、精准的病原学诊断信息,指导临床合理用药。

Objective To analyze the detection of pathogens and epidemiological in children with respiratory tract infection in our hospital,and provide evidence for clinical diagnosis,treatment and prevention.Methods Oropharyngeal swab and BALF were collected from 1730 children with respiratory tract infection,and seven pathogens RNA including FluA,FluB,RSV,PIV,ADV,MP and CP were detected by DAT.Results The total positive rate of 1730 specimens was 44.91%,respectively FluA was 4.45%,FluB was 1.50%,RSV was 9.08%,PIV was 6.36%,ADV was 3.76%,MP was 22.37%and CP was 0.40%,and the mixed infection rate was 2.95%.The pathogen RNA detection rate among different age had statistically significant difference(χ^2=30.05,P<0.05).The pathogen RNA detection rate among the different seasons had statistically significant difference(χ^2=28.14,P<0.05).MP was the main pathogen of respiratory tract infection in children.The number of children treated for pneumonia was the largest and the detection rate was the highest(49.66%),followed by bronchitis(32.09%).The comparison of detection rate among different diseases was statistically significant(χ^2=55.30,P<0.05).Conclusion The pathogens of espiratory tract infection in children in our hospital is mainly MP,followed by RSV and PIV,FluB has prevalent trends in this spring.The detection rate increases with age.Higher detection rate is also found in lower respiratory tract infections such as pneumonia and bronchitis than that of upper respiratory tract infections and other diseases.DAT can provide comprehensive early,precise etiological diagnosis information,guide clinical rational use of drugs.