甘肃省发热呼吸道症候群哨点医院监测结果分析

Analysis of surveillance results of febrile respiratory syndrome in sentinel hospitals in Gansu Province

目的了解甘肃省发热呼吸道症候群(febrile respiratory syndrome,FRS)病原学监测情况,评价监测结果,为提升其监测能力提供参考依据。方法收集2009-2019年甘肃省17所哨点医院FRS监测病例,采用观察性研究,分析病原监测状况并评价其监测结果。结果甘肃省2009-2019年FRS病原总检测率为89.00%,总检出率为31.43%。所有病原(病毒/细菌)的检出能力高于任一病原(病毒/细菌)(P<0.001),其中任一病毒检测率及检出率均高于任一细菌(P<0.05),所有病毒检测率高于所有细菌(χ^2=2876.656,P<0.001),检出率低于所有细菌(χ^2=84.237,P<0.001);病原检测种类方面,病毒以人流感病毒检测率最高(99.93%)、鼻病毒检测率最低(53.77%),细菌以同时检测肺炎支原体与肺炎衣原体居多,检出率较低(4.15%);临床症状以发热、咳嗽、咳痰为主,病原检测阴性者容易出现发热、胸痛、乏力和呼吸困难症状。监测结果评价显示病例类型的均衡性、采样时间的连续性有待提高。结论甘肃省FRS病原检测水平较高,建议通过合理调整病原检测种类、采集匹配的标本类型和重复检测阴性病例等措施提高病原检出能力,完善监测平台,提高监测能力。

Objective To understand the etiological surveillance of febrile respiratory syndrome(FRS)in Gansu Province,and evaluate the monitoring results,so as to provide reference basis for improving its monitoring ability.Methods The cases of FRS surveillance in 17 sentinel hospitals were collected in Gansu Province from 2009 to 2019.The method of observational epidemiological study was used to analyze the status of pathogen surveillance and evaluate the surveillance results.Results The total testing rate of FRS pathogens was 89.00%in Gansu Province during 2009-2019,and the total detection rate was 31.43%.The detection ability of all pathogens(virus/bacteria)was higher than that of any pathogen(virus/bacteria)(P<0.001),in which the detection rate of any virus was higher than that of any bacteria(P<0.05).For all bacteria,the testing rate was lower than that of all viruses(χ^2=2876.656,P<0.001),but the detection rate was higher than that of all viruses(χ^2=84.237,P<0.001).As for the types of pathogen detection,the testing rate of human influenza virus was the highest(99.93%),and that of rhinovirus was the lowest(53.77%).The bacteria were mostly simultaneous test for Mycoplasma pneumoniae and Chlamydia pneumoniae,but the detection rate was low(4.15%).The clinical symptoms were mainly fever,cough and expectoration,the cases with negative pathogens were prone to fever,chest pain,fatigue and dyspnea.The evaluation of surveillance results showed that the balance of case types and the continuity of sampling time needed to be improved.Conclusions The level of FRS pathogen testing is relatively high in Gansu Province.It is recommended that the detection capability of pathogens should be improved by reasonably adjusting the species of pathogen testing,collecting matched specimen types,and repeatedly testing negative cases to improve the monitoring platform and the monitoring system.