惠州市秋冬季急性下呼吸道感染患儿病毒感染亚型分布调查

Investigation on the distribution of virus subtypes among children with acute lower respiratory tract infection in autumn and winter in Huizhou

目的探讨惠州市秋冬季急性下呼吸道感染患儿病毒感染亚型分布。方法选取2016-2018年惠州市第一人民医院收治的511例急性下呼吸道感染患儿,就诊时间为每年7-12月份。取患儿鼻咽分泌物,采用直接免疫荧光法检测7种常见的下呼吸道病毒:呼吸道合胞病毒、甲型流感病毒、乙型流感病毒、副流感病毒1型、副流感病毒2型、副流感病毒3型和腺病毒。结果511例急性下呼吸道感染患儿痰液标本中病毒阳性检出率30.72%。各亚型分布中,呼吸道合胞病毒占比最高69.43%,副流感病毒1型占比最低为2.55%。不同性别的下呼吸道病毒感染率和各病毒亚型占比比较均无统计学意义(P>0.05)。不同年龄段中,患儿呼吸道病毒感染占比随年龄增长逐渐降低,29 d~<1岁年龄段患儿呼吸道病毒感染占比最高为36.31%。病毒感染类型中,患儿均以呼吸道合胞病毒感染占比最高。29 d~<1岁年龄段患儿呼吸道合胞病毒感染占比高于1~<3岁、3~<14岁年龄段患儿;1~<3岁年龄段患儿甲型流感病毒感染占比和乙型流感病毒感染占比高于0~≤28 d、29 d~<1岁年龄段患儿,腺病毒感染占比高于0~≤28 d、29 d~<1岁、3~≤6岁年龄段患儿,差异有统计学意义(P<0.05)。结论惠州市秋冬季急性下呼吸道感染患儿病原体以呼吸道合胞病毒、革兰阴性菌为主,病毒感染及亚型分布与患儿年龄关系密切。

Objective To investigate the distribution of virus subtypes among children with acute lower respiratory tract infection in autumn and winter in Huizhou.Methods A total of 511 children with acute lower respiratory tract infection admitted to our hospital from 2016 to 2018 were enrolled.The visit time was from July to December each year.Nasopharyngeal secretions were taken and 7 common lower respiratory viruses were detected by direct immunofluorescence.They included respiratory syncytial virus,influenza A virus,influenza B virus,parainfluenza virus type 1,parainfluenza virus type 2,parainfluenza virus type 3 and adenovirus.Results The positive rate of virus detection in sputum samples of 511 children with acute lower respiratory tract infection was 30.72%(157/511).Among the subtypes,the respiratory syncytial virus accounted for the highest proportion of 69.43%(109/157),and the parainfluenza virus type 1 accounted for the lowest of 2.55%(4/157).There was no significant difference in the rate of infection of lower respiratory tract virus and the proportion of each virus subtype(P>0.05).The proportion of respiratory viral infection in children with different age groups gradually decreased with age.The highest proportion of respiratory virus infection in children aged 29 days to<1 year old was 36.31%(57/157).Among the types of viral infections,children with respiratory syncytial virus accounted for the highest proportion.Respiratory syncytial virus infection in children aged 29d-<1 year old was higher than that in 1-3 years old and 3 years old-<14 years old children(P<0.05).The proportion of influenza A virus infection and influenza B virus infection in children aged 1 to 3 years old is higher than that of children aged 0 to≤28 days and 29 days to<1 year old,the proportion of adenovirus infection was higher than that of children aged 0-≤28 d,29 d-<1 year old and 3 years old-≤6 years old.The difference was statistically significant(P<0.05).Conclusion The pathogens of children with acute lower respiratory tract infection in Huizhou are mainly respiratory syncytial virus and Gram-negative bacteria.The distribution of virus subtype is closely related to the age of children.