2018-2019年广东地区急性呼吸道感染人群病原谱监测分析

Surveillance and analysis of pathogen spectrum of acute respiratory tract infections in Guangdong from 2018 to 2019

目的:明确2018-2019年广东地区急性呼吸道感染人群的病原谱,并了解其流行病学特征和感染特点,为防控工作提供科学依据。方法:2018年5月至2019年5月,以广东地区200余家医院送检至金域医学检验中心的急性呼吸道感染患者鼻咽拭子为标本,应用荧光定量聚合酶链反应技术进行流感病毒、鼻病毒、腺病毒等10余种常见呼吸道病原体检测,描述其流行情况,其中流感病毒流行数据与国家流感中心发布的南方地区监测数据进行比较。结果:广东地区呼吸道感染人群检出率最高的是呼吸道合胞病毒(14.69%),其次是腺病毒(13.98%)、EB病毒(10.09%)、甲型流感病毒(9.31%)、柯萨奇CA16病毒(7.99%)、肺炎支原体(6.44%)、副流感病毒(6.18%)、巨细胞病毒(6.16%)、鼻病毒(5.91%)。同时,人鼻病毒、EB病毒、甲型流感病毒、呼吸道合胞病毒、腺病毒等病原体检出率在秋季(9~11月)开始明显上升,但乙型流感病毒、副流感病毒在冬季后检出率才有明显上升。另外,本研究中甲型流感病毒检出率高峰有2个(分别为2018年22~26周和2018年48周至2019年18周),后者与国家流感中心南方地区的发布高峰(2018年45周至2019年18周)相近。但在流感散发的时间段,本研究监测到的平均阳性检出率(5.88%)高于国家流感监测中心(1.04%)。结论:总体上,广东地区呼吸道感染人群病原谱丰富,其中本地区呼吸道感染儿童呼吸道合胞病毒的检出率高达19.48%。临床医师诊疗过程中应注意尽快明确病原体,减少儿童肺炎的发生。另外,本地区呼吸道病原体季节流行规律比较明晰,可以为防控工作提供科学依据。

Objective To determine the pathogen spectrum of acute respiratory tract infections(ARTI)in Guangdong from 2018 to 2019,and to understand its epidemic pattern and infection characteristics,so as to provide scientific basis for prevention and control.Methods From May 2018 to May 2019,nasopharyngeal swabs from patients with acute respiratory tract infections were submitted to KingMed Medical Center for pathogen testing by quantitative real-time polymerase chain reaction.More than ten common respiratory pathogens such as influenza virus,rhinovirus,adenovirus were tested.The influenza virus epidemic data were compared with the surveillance data in southern China published by Chinese National Influenza Center.Results The detection rate of respiratory syncytial virus was the highest in patients with respiratory infections in Guangdong(14.69%),followed by adenovirus(13.98%),EB virus(10.09%),influenza A virus(9.31%),Coxsackie virus(7.99%),Mycoplasma pneumoniae(6.44%),parainfluenza virus(6.18%),cytomegalovirus(6.16%),rhinovirus(5.91%).From the seasonal distribution,the detection rates of rhinovirus,EB virus,influenza A virus,respiratory syncytial virus,adenovirus and other pathogens began to increase significantly in autumn(September-November),while the detection rates of influenza B virus and parainfluenza virus were increased till winter.There were two epidemic peaks of influenza A in this study,one of which was basically consistent with the report of Chinese National Influenza Center.During the sporadic period of influenza,the positive detection rate monitored in this study was generally higher than that of Chinese National Influenza Center(5.88%vs 1.04%).Conclusions Overall,the pathogenic spectrum of respiratory infections in Guangdong is abundant.Among them,the detection rate of respiratory syncytial virus in children with respiratory tract infection in this area is as high as 19.48%.Clinicians should pay attention to identify the pathogen as soon as possible during the diagnosis and treatment to reduce the incidence of pneumonia in children.In addition,the seasonal epidemic of respiratory pathogens in this area is relatively clear,which can provide scientific basis for prevention and control.