上海市普陀区监测点医院697例急性上呼吸道感染病例监测结果研究

Study on surveillance results of 697 cases of acute upper respiratory tract infection in hospital of Shanghai Putuo District

目的了解上海市普陀区急性呼吸道感染病原谱构成和流行病学特征,为制定和完善呼吸道传染病防控策略提供科学依据。方法依托上海市急性呼吸道感染监测网络,对普陀区哨点监测医院发热门诊的急性呼吸道感染病例,按5∶1抽样间隔进行调查,并采集鼻咽拭子进行病原学检测。结果共登记3431例病例,采集697例病例样本,其中阳性病例519例,阳性率为74.46%。病毒阳性率为45.05%,主要为甲型流感病毒(阳性率为30.42%)、乙型流感病毒(阳性率为6.89%)、鼻病毒/肠道病毒(阳性率为3.30%);细菌阳性率为10.62%,主要为肺炎克雷伯菌(阳性率为5.74%)、金黄色葡萄球菌(阳性率为3.59%);混合感染阳性率为18.79%。每年的冬春季和夏秋季出现阳性检出率的双流行峰。不同年龄阳性检出率比较差异无统计学意义(P>0.05),男女性别阳性检出率比较差异有统计学意义(P<0.05)。结论上海市普陀区急性呼吸道感染病原谱较为广泛,流感病毒和肺炎克雷伯菌是感染的主因,应进一步加强病原监测和系统研究。

Objective To understand the pathogenic spectrum composition and epidemiological characteristics of acute respiratory infections in Putuo District of Shanghai,and to provide scientific basis for formulating and improving strategies for the prevention and control of respiratory infections.Methods Relying on the Shanghai Acute Respiratory Infection Surveillance Network,the cases of acute respiratory infections sent to the outpatient surveillance hospital in Putuo District were investigated at 5:1 sampling intervals,and nasopharyngeal swabs were collected for pathogenic detection.Results A total of 3431 cases were registered and 697 cases were collected,of which 519 were positive cases,with a positive rate of 74.46%.The virus positive rate was 45.05%,mainly influenza A virus(positive rate was 30.42%),influenza B virus(positive rate was 6.89%),rhinovirus/enteric virus(positive rate was 3.30%).The bacterial positive rate was 10.62%,mainly Klebsiella pneumoniae(positive rate was 5.74%)and Staphylococcus aureus(positive rate was 3.59%).The positive rate of mixed infection was 18.79%.There was a double prevalence of positive detection rates in winter,spring and summer and autumn each year.There was no significant difference in the positive detection rate at different ages(P>0.05).There was a statistically significant difference in the positive detection rate of male and female genders(P<0.05).Conclusion The pathogenic spectrum of acute respiratory infections in Putuo District of Shanghai is relatively extensive.Influenza virus and Klebsiella pneumoniae are the main causes of infection.The pathogenic surveillance and systematic research should be further strengthened.