河南地区呼吸道感染住院儿童鼻病毒流行病学分析

Epidemiological analysis of rhinovirus in hospitalized children with respiratory tract infection in Henan

目的了解河南地区呼吸道感染住院儿童鼻病毒(human rhinovirus,HRV)的流行病学情况。方法选取2019年3月至2020年2月就诊于郑州大学附属儿童医院的11214例呼吸道感染住院患儿,采用RT-PCR与毛细管电泳联用技术对HRV等12种病原体进行检测,分析HRV感染与患儿性别、年龄及发病季节的关系。结果HRV检出率为25.33%(2841/11214)。HRV阳性标本中,与其它病原混合感染的构成比为41.08%(1167/2841),其中与肺炎支原体(mycoplasma pneumoniae,MP)合并感染最多(28.36%,331/1167)。咽拭子(25.16%)和痰液(33.40%)HRV检出率较高,肺泡灌洗液(13.94%)最低(x^2=32.345,P<0.01)。不同年龄段患儿HRV检出率差异有统计学意义(x^2=76.433,P<0.01)。咽拭子样本中男童HRV感染率(26.55%)较女童(23.16%)高(x2=15.523,P<0.01)。夏季(37.31%)、秋季(37.11%)HRV检出率较高(x^2=1056.254,P<0.01),且HRV合并感染夏、秋季(13.74%、14.18%)较春、冬季(6.50%、5.78%)高(x^2=329.094,P<0.01)。结论河南地区呼吸道感染住院患儿夏、秋季HRV的检出率较高,以上呼吸道感染为主,3岁以下婴幼儿期是HRV的易感人群。HRV常与其他病原合并感染,其中以MP、RSV和HPIV最为常见,且夏、秋季合并感染较高。

Objective To investigate the epidemiology of human rhinovirus(HRV)in hospitalized children with respiratory tract infection in Henan.Methods A total of 11214 hospitalized children with respiratory infections who were admitted to the Children’s Hospital Affiliated of Zhengzhou University from March 2019 to February 2020 were selected.Multiple RT-PCR combined with capillary electrophoresis technology was used to detect the 12 pathogens including HRV,and the relationships between HRV infection and children’s gender,age and seasons of onset were analyzed.Results The positive rate of HRV was 25.33%(2841/11214).In HRV positive specimens,the composition ratio of mixed infection with other pathogens was 41.08%(1167/2841),and Mycoplasma pneumoniae(MP)was the most common pathogen(28.363%,331/1167).The detection rates of HRV in throat swab(25.16%)and sputum samples(33.40%)were relatively high,and the lowest was 13.94%in alveolar lavage fluid(x2=32.345,P<0.01).There was a statistically significant difference in the detection rate of HRV among children of different age groups(x^2=76.433,P<0.01).The HRV infection rate of male children(26.55%)in throat swab samples was higher than that of female children(23.16%),and the difference was statistically significant(x^2=15.523,P<0.01).The detection rates of HRV in summer(37.31%)and autumn(37.11%)were higher(x^2=1056.25,P<0.01).HRV co-infection rates in summer(13.74%)and autumn(14.18%)were higher than those in spring(6.50%)and winter(5.78%),(x^2=329.094,P<0.01).Conclusions The detection rate of HRV in hospitalized children with respiratory tract infection in Henan was higher in summer and autumn,and mainly infected upper respiratory tract.Children under 3 years of age were the most susceptible to HRV infection.HRV was often co-infected with other pathogens,among which MP,RSV and HPIV were the most common pathogens.Co-infections were higher in summer and autumn.