2011—2018年广东省发热呼吸道症候群病原谱研究

Pathogen spectrum of febrile respiratory syndrome in Guangdong province from 2011 to 2018

目的了解广东省发热呼吸道症候群病原谱及其流行特征,为疾病防控和临床诊疗提供参考依据。方法使用实时荧光聚合酶链式反应法,对1891份鼻咽拭子进行病原体检测,采用卡方检验与Bonferronni两两比较法对不同的检出率进行比较。结果1891份标本中,病毒核酸阳性样本有810例,总检出率42.78%;感染以副流感病毒(Parainfluenza virus,PIV)、鼻病毒(Rhinovirus,RhV)、冠状病毒(Coronavirus,CoV)为主。在年龄分布中,"<5岁"组与"5~岁"组病原体检出率偏高。不同症状的患者病原体检测,偏肺病毒(Metapneumovirus,MPV)在肺炎患者检出率相对较高;甲型流感病毒(Influenza virus A,FLuA)、PIV、CoV、RhV在非肺炎患者检出率较高;FLuA与腺病毒(Adenovirus,ADV)在高热与超高热组的检出率相对较高;CoV与肺炎支原体(Mycoplasma pneumonia,MP)在中度发热组的检出率相对较高;PIV在咳嗽患者检出率相对较高。多个病毒流行具有较强的季节性,普遍在冬春季检出率较高;在不同年份,不同的病毒检出率有较强规律性。结论PIV、RhV、CoV为广东省近年呼吸道感染的主要病原体。

Objective To understand the pathogenic spectrum and epidemiological characteristics of febrile respiratory syndrome in Guangdong province,and to provide reference for disease prevention,clinical diagnosis and treatment.Methods The pathogens of 1891 nasopharyngeal swabs collected from 2011 to 2018 were detected by real-time fluorescent polymerase chain reaction.The different rates were compared by chi-square test or Bonferronni method of comparison.Results Among 1891 samples,810 samples were positive for viral nucleic acid,with a total detection rate of 42.78%.The main infectious agents were Parainfluenza virus(PIV),Rhinovirus(RhV)and Coronavirus(CoV).The pathogen detection rate was higher in<5 years group and 5~years group.Pathogen detection in patients with different symptoms showed that the detection rate of Metapneumovirus(MPV)in pneumonia patients was relatively high.Influenza virus A(FluA),PIV,CoV and RhV had higher detection rate in patients without pneumonia.FLuA and Adenovirus(ADV)had a relatively high detection rate in the high and ultra-high fever groups.The detection rate of CoV and Mycoplasma pneumonia(MP)in moderate fever group was relatively high.The detection rate of PIV in cough patients was relatively high.The prevalence of several viruses has strong seasonality,and the detection rate was generally higher in winter and spring.Different virus detection rates also have strong regularity in years.Conclusions PIV,RhV and CoV are the main pathogens of febrile respiratory syndrome in Guangdong in recent years.