2018—2019年昆明地区严重急性呼吸道感染病例病原学分析

Analysis of etiology of severe acute respiratory infection cases in Kunming from 2018 to 2019

目的通过分析昆明市住院严重急性呼吸道感染(severe acute respiratory infection,SARI)病例病毒病原谱构成及其流行病学特征,为SARI临床诊治及预防控制提供病原学依据。方法实时荧光定量PCR的方法检测多种呼吸道病毒,结果采用软件SPSS20.0进行统计分析。结果2018年1月至2019年3月共检测了291份SARI病例咽拭子标本,检测出86份阳性标本,阳性率达29.55%。检出率最高的单病原分别为人甲型流感病毒(11.34%)、人偏肺病毒(3.44%)及人呼吸道合胞病毒(3.09%),有6份标本出现了两种病毒的混合感染,混合感染率为2.06%。男性病例病毒检出率高于女性病毒检出率(χ^2=6.183,P=0.013),2~5岁年龄组病例病毒检出阳性率最高,呼吸道病毒检出阳性高峰在第4季度和第1季度,病毒阳性组和病毒阴性组的比较,除咳痰(χ^2=5.107,P=0.024)及流涕(χ^2=4.683,P=0.030)两个症状外,其余临床症状及体征、并发症和基础疾病在两组间差异均不具有统计学意义。结论2018—2019年流感病毒为昆明市SARI病例最主要的感染病原体,检出的病原体在不同年龄段、季节有一定的流行规律。

Objective By analyzing the viral pathogen spectrum and epidemiological characteristics of hospitalized severe acute respiratory infection(SARI)cases in Kunming city to provide the pathogenic basis for the clinical diagnosis,treatment,prevention and control of acute respiratory tract infection.Methods Respiratory viruses were detected by real-time PCR,and the results were statistically analyzed using software SPSS20.0.Results A total of 291 SARI cases’pharyngeal swab specimens were detected from January 2018 to March 2019,and 86 positive specimens were detected,the positive rate was 29.55%.The top three pathogens detected were human influenza A virus(11.34%),human metapneumovirus(3.44%),and human respiratory syncytial virus(3.09%),and there were 6 specimens with mixed infection of two viruses,and the mixed infection rate was 2.06%.The virus detection rate of male cases was higher than that of female cases(χ^2=6.183,P=0.013),and the positive rate of virus detection was the highest in the 2 to 5 years age group,and positive respiratory virus detection peaks were in the fourth and the first quarter.Comparison of virus positive and negative group showed that there were no statistically significant differences in clinical symptoms,signs,complications and underlying diseases between the two groups except for expectorant cough(χ^2=5.107,P=0.024)and runny nose(χ^2=4.683,P=0.030).Conclusions Influenza virus is the main pathogen of SARI cases in Kunming city,and the detected pathogens have certain epidemic rules in different age groups and seasons.