2018-2019年广州市急性呼吸道感染病原体分布特征分析

Analysis on pathogen distribution characteristics in acute respiratory tract infections in Guangzhou, 2018 - 2019

目的了解广州市急性呼吸道感染病原体分布特征,为临床诊疗和预防控制提供病原学依据。方法收集广州市两家定点医院2018-2019年急性呼吸道感染病例的鼻咽拭子标本1326份,通过一代测序确定病原体,检测范围包括甲型流感病毒(FluA)及其5个亚型、乙型流感病毒(FluB)、鼻病毒/肠病毒(HRV/EV)、呼吸道合胞病毒(RSV)、腺病毒(ADV)、副流感病毒(PIV)的4个亚型、人偏肺病毒(HMPV)、博卡病毒(HBoV)、冠状病毒(HCoV)的4个亚型、肺炎支原体(M.P)、肺炎衣原体(C.P),并结合流行病学信息进行统计分析。结果1326例病例的总阳性率为72.93%,其中单一感染841例,混合感染126例。病毒阳性率排前三位的是FluA(43.97%)、ADV(9.20%)、HRV/EV(7.16%)。病毒在5~13岁组的阳性率最高,为80.00%。HRV/EV(P<0.01)、HBoV(P<0.01)、RSV(P<0.01)、ADV(P<0.01)、HCoV-OC43(P<0.01)易发生在混合感染中,差异有统计学意义。结论急性呼吸道感染与年龄、病原体有关。FluA、ADV、HRV/EV是广州地区急性呼吸道感染的主要病原体。

Objective To understand the pathogen distribution characteristics of acute respiratory tract infections in Guangzhou,so as to provide etiological basis for clinical diagnosis and disease prevention and control.Methods A total of 1326 nasopharyngeal swabs were collected from cases of acute respiratory tract infection in two designated hospitals of Guangzhou from 2018 to 2019.Pathogens were detected by first-generation sequencing,including influenza A virus(FluA)and the 5 subtypes,influenza B virus(FluB),human rhinovirus/enterovirus(HRV/EV),respiratory syncytial virus(RSV),adenovirus(ADV),4 subtypes of parainfluenza virus(PIV),human metapneumovirus(HMPV),human bocavirus(HBoV),4 subtypes of human coronavirus(HCoV),Mycoplasma pneumoniae(M.P),Chlamydophila pneumoniae(C.P).In addition,statistical analysis was carried out with epidemiological information.Results Among all the 1326 samples,the overall positive rate was 72.93%,including 841 cases for single pathogen infection and 126 cases for co-infection.The top three positive rates were FluA(43.97%),ADV(9.20%),and HRV/EV(7.16%).The positive rate in 5~13 years old group was the highest,accounting for 80.00%.The differences in occurrence of co-infections were statistically significant for HRV/EV(P<0.01),HBoV(P<0.01),RSV(P<0.01),ADV(P<0.01)and HCoV-OC43(P<0.01),respectively,indicating that,these viruses were common in co-infections.Conclusions Acute respiratory tract infection was associated with age and pathogens.The main pathogens causing acute respiratory tract infection were FluA,ADV,HRV/EV in Guangzhou.