2016—2018年53851例急性呼吸道感染儿童七项病毒检测结果分析

Detection results of seven respiratory viruses in 53,851 children with acute respiratory tract infections, 2016-2018

目的了解2016—2018年湖南省儿童医院就诊病人常见呼吸道病毒感染病原谱及病例流行病学特征。方法2016年1月—2018年12月期间,采集湖南省儿童医院门诊和住院病人急性呼吸道感染儿童鼻咽拭子标本,采用直接免疫荧光法对副流感病毒1-3型、呼吸道合胞病毒、流感病毒A与B型和腺病毒共七项呼吸道病毒抗原进行检测,对病例信息进行统计学分析。结果共采集检测病例53 851例,总阳性检出率为23.25%(12 519/53 851),副流感病毒1-3型、呼吸道合胞病毒、流感病毒A与B型和腺病毒阳性检出率分别为0.68%、0.10%、5.63%、13.44%、1.51%、0.74%和1.15%,呼吸道合胞病毒阳性率最高(χ~2=23 427.78,P<0.001)。不同年份七项呼吸道病毒检出率存在差异(χ~2=196.21,P<0.001);总阳性检出率冬季最高,夏季最低;呼吸道合胞病毒和副流感病毒3型阳性检出率随着时间波动较大,存在明显的季节性;年龄越小,总阳性检出率越高,0~1岁阳性检出率最高为29.93%;七项总阳性检出率男性高于女性(P=0.003),呼吸道合胞病毒阳性检出率男性高于女性(P=0.013)其它各项呼吸道病毒阳性检出率没有性别差异(P>0.05)。结论 2016—2018年急性呼吸道感染儿童七项病毒阳性检出率存在明显差异,不同年份、不同季节、不同年龄、不同性别七项呼吸道病毒检出率亦存在差异,研究有助于临床诊断和制定预防感染的措施。

Objective To investigate the pathogenic spectrum and epidemiological characteristics of respiratory viral infections caused by common respiratory viruses in patients in Hunan Children’s hospital during 2016-2018.Methods Nasopharyngeal swabs were collected from outpatients and inpatients with acute respiratory tract infections in Hunan Children’s hospital from January 2016 to December 2018.Direct immunofluorescence assay was used to detect the antigens of seven respiratory viruses,including parainfluenza virus type 1-3(PIV 1-3),respiratory syncytial virus(RSV),influenza virus A and B(Flu A,B),and adenovirus(ADV).The case information was statistically analyzed.Results A total of 53,851 cases were collected and detected,and the total positive detection rate was 23.25%(12,519/53,851).The positive detection rates of PIV1,PIV2,PIV3,RSV,Flu A,Flu B and ADV were 0.68%,0.10%,5.63%,13.44%,1.51%,0.74%and 1.15%,respectively.The positive detection rate of RSV was the highest(χ~2=23,427.78,P<0.001).There were statistically significant differences in the positive detection rates of the seven respiratory viruses in different years(χ~2=196.21,P<0.001).The total positive detection rate was the highest in winter,but the lowest in summer.The positive detection rates of RSV and PIV3 fluctuated greatly with time,and had obvious seasonality.The younger the age,the higher the total positive detection rate.The positive detection rate of the age group of 0-1 year was found to be the highest(29.93%).The total positive detection rate of the seven respiratory viruses and the positive detection rate of RSV were both higher in males than in females(P=0.003,P=0.013),but no gender difference was observed in the positive rates of other respiratory viruses(P>0.05).Conclusions Statistically significant differences were observed in the positive detection rates of the seven respiratory viruses in the children with acute respiratory tract infections during 2016-2018.The positive detection rates of the seven respiratory viruses in different years,seasons,ages and genders also showed differences.This study is conducive to clinical diagnosis and development of measures for infection prevention.