合肥地区儿童呼吸道感染病原体情况分析

Analysis of respiratory tract infection pathogens in children in Hefei area

目的了解合肥地区儿科就诊病人呼吸道感染病原体分布特征以及流行特点。方法收集2018年9—12月安徽省立医院儿科就诊疑似呼吸道感染病人的呼吸道标本共257例,包括250份咽拭子和7份肺泡灌洗液。利用13种呼吸道病原体多重聚合酶链式反应(PCR)检测试剂盒对所有标本进行检测。结合临床诊疗资料,对多重PCR检测结果进行统计学分析。结果257份标本总阳性率为66.1%(170/257),其中病毒阳性率为60.7%(156/257),以呼吸道合胞病毒(RSV)、鼻病毒(HRV)和腺病毒(ADV)为主,阳性率分别为31.5%(81/257)、17.5%(45/257)、5.1%(13/257);非典型病原体阳性率为8.2%,以肺炎支原体(MP)为主,阳性率为7.8%(20/257)。23例标本检出2种及以上病原体,以呼吸道合胞病毒和鼻病毒同时感染较为常见。男性呼吸道感染病原体阳性率为67.81%(99/146),女性呼吸道感染病原体阳性率为63.96%(71/111),呼吸道病原体感染性别间阳性率差异无统计学意义(χ^(2)=0.416,P=0.519)。呼吸道合胞病毒感染多发生在1~2岁组儿童(χ^(2)=16.562,P=0.001),各年龄组间阳性率依次为37.8%(34/90)、40.9%(36/88)、13.7%(7/51)、14.3%(4/28),其阳性率随着年龄的增长而降低。肺炎支原体感染多发生在6~15岁组儿童(χ^(2)=34.346,P<0.001),各年龄组间阳性率依次为0.0%(0/90)、3.4%(3/88)、13.7%(7/51)、35.7%(10/28),其阳性率随年龄的增长而上升。结论呼吸道合胞病毒、腺病毒、鼻病毒、肺炎支原体在儿童呼吸道感染病原体中较为常见,病原体感染在性别间不存在差异,呼吸道合胞病毒和肺炎支原体感染在年龄组间存在差异。

Objective patients in Hefei.Methods A total of 257 respiratory tract specimens from pediatric patients with suspected respiratory tract infection in Anhui Provincial Hospital from September to December 2018 were collected,including 250 pharyngeal swabs and 7 alveolar lavage fluid.All specimens were detected by multiplex PCR kits of 13 respiratory pathogens.Combined with clinical data,the results of multiplex PCR were analyzed statistically.Results rate was 60.7%(156/257).The positive rate of respiratory syncytial virus(RSV,31.5%,81/257)was the highest followed by the human rhinovirus(HRV,17.5%,45/257),adenovirus(ADV,7.8%,20/257).The detection rate of atypical pathogens was 8.2%,of which Mycoplasma pneumoniae was more common,and the positive rate was 7.8%(20/257).Two or more pathogens were detected in 23 cases,and respiratory syncytial virus and rhinovirus co-infection ranked first.The positive rate of pathogens in male respiratory tract infection was67.81%(99/146)and that in female respiratory tract infection was 63.96%(71/111).There was no significant difference in the positive rate between male and female respiratory tract infections(χ^(2)=0.416,P=0.519).The highest positive rate of respiratory syncytial virus was observed in 1-2 years old group(χ^(2)=16.562,P=0.001).The positive rates among different age groups were 37.8%(34/90),40.9%(36/88),13.7%(7/51),14.3%(4/28),and the positive rate of respiratory syncytial virus decreased with age.Mycoplasma pneumoniae infection mostly occurred in 6-15 years old group(χ^(2)=34.346,P<0.001).The positive rates among different age groups were 0.0%(0/90),3.4%(3/88),13.7%(7/51),35.7%(10/28),and the positive rate of mycoplasma pneumoniae increased with age.Conclusion Respiratory syncytial virus,adenovirus,rhinovirus and Mycoplasma pneumoniae are more common among the pathogens of respiratory tract infection in children.There is no difference in pathogen infection between genders.Respiratory syncytial virus and Mycoplasma pneumoniae infections are different among age groups.