上海市浦东周康航地区儿童急性呼吸道感染病原体流行特点分析

Analysis on the epidemic characteristics of acute respiratory tract pathogens in children in Zhoukanghang area of Pudong,Shanghai

目的了解儿童急性呼吸道感染常见病原体在上海市浦东周康航地区的流行特点。方法选取2019年9月至2020年2月在上海健康医学院附属周浦医院儿科就诊的急性呼吸道感染患儿382例,查阅就诊病历,回顾性收集患儿年龄、性别、临床诊断、病原体检测等资料。采用间接免疫荧光法检测患儿血清中九项急性呼吸道感染病原体IgM抗体。结果急性呼吸道感染病原体IgM抗体总阳性检出率为52.87%,其中单一感染占比75.74%,混合感染占比24.26%;急性呼吸道感染病原体IgM抗体阳性检出率前三位的分别为:肺炎支原体(24.35%)、乙型流感病毒(16.23%),腺病毒(10.21%);女性肺炎支原体IgM抗体的阳性检出率高于男性(χ^2=11.89,P<0.05),其阳性检出率随年龄增长呈升高趋势(χ^2=41.29,P<0.05),呼吸道合胞病毒感染率随年龄增长而下降(χ^2=8.86,P<0.05);冬季乙型流感病毒IgM抗体阳性检出率高于秋季(χ^2=8.15,P<0.05);不同疾病类型患儿呼吸道病原体IgM抗体阳性率之间有统计学差异(χ^2=26.38,P<0.05),支气管肺炎病原体IgM抗体阳性检出率最高,达52.97%;肺炎支原体IgM抗体在不同疾病类型中阳性检出率之间有统计学意义差异(χ^2=24.95,P<0.05)。结论 2019年秋冬季上海市浦东周康航地区急性呼吸道感染儿童常见九项病原体以肺炎支原体为主,且病原体在不同性别、年龄、季节及疾病类型中的流行具有一定特点,为临床诊治工作提供参考。

Objective To understand the epidemic characteristics of common pathogens in children with acute respiratory infection in Zhoukanghang area,Pudong District,Shanghai.Methods From September 2019 to February 2020,382 children with acute respiratory infection were selected from the pediatric department of Zhoupu Hospital Affiliated to Shanghai Medical College.The medical records were reviewed,and the data of age,gender,clinical diagnosis and pathogen detection were collected retrospectively.IgM antibodies of nine pathogens of acute respiratory tract infection were detected by indirect immunofluorescence.Results The total positive rate of nine pathogens IgM antibodies was 52.87%,among which 75.74% were single infection and 24.26% were mixed infection.The top three positive rates were mycoplasma pneumoniae(24.35%),influenza B(16.23%) and adenovirus(10.21%).The positive detection rate of mycoplasma pneumoniae in female was higher than that in male(χ^2=11.89,P<0.05).The positive detection rate of mycoplasma pneumoniae increased with age(χ^2=41.29,P<0.05),but the positive infection rate of respiratory syncytial virus decreased with age(χ^2=8.86,P<0.05).The positive detection rate of influenza B virus in winter was higher than that in autumn(χ^2=8.15,P<0.05).The positive rate of IgM antibodies of respiratory pathogens infection in children with different disease types was statistically different(χ^2=26.38,P<0.05).The positive rate of bronchopneumonia pathogens was the highest(52.97%).The positive rate of mycoplasma pneumoniae in different disease types was significantly different(χ^2=24.95,P<0.05).Conclusions Mycoplasma pneumoniae is the main pathogen of nine common pathogens in children with acute respiratory infections in Zhoukanghang area of Pudong,Shanghai in autumn and winter of 2019.And the prevalence of pathogens in different genders,ages,seasons and types of diseases has certain characteristics,which provides a reference for clinical diagnosis and treatment.