21242例急性呼吸道感染住院患儿肺炎支原体、呼吸道合胞病毒及腺病毒分布特点分析

Distribution and characteristics of mycoplasma pneumonia,respiratory syncytial virus and adenovirus in 21242 children hospitalized due to acute respiratory tract infection

目的:分析急性呼吸道感染(ARTI)住院患儿肺炎支原体(MP)、呼吸道合胞病毒(RSV)和腺病毒(ADV)感染的分布特点。方法:选取2015年1月至2019年12月,连续5年21242例ARTI住院患儿为研究对象,留取全血,采用被动凝集法检测血清MP,ELISA法检测血清RSV、ADV。结果:21242例ARTI住院患儿共采集63726份血标本,检测结果阳性共5842例(9.17%),其中MP、RSV、ADV的阳性率分别为3131例(14.74%)、1585例(7.46%)、1126例(5.30%),MP阳性率为最高(均P<0.0125)。2019年MP、RSV、ADV的阳性率均为最高(均P<0.0045)。MP、RSV、ADV在每个季节均可检出,各个季节均以MP的阳性率为最高(均P<0.001)。MP、RSV、ADV总共感染阳性率为1.02%,以RSV+ADV共感染阳率最高(均P<0.0071)。在各年龄段中,MP、RSV、ADV总检出阳性率最高年龄段是5~<16岁(均P<0.0071)。在不同诊断的ARTI患儿中,支气管肺炎患儿MP、RSV、ADV总检出阳性率为最高(均P<0.0045)。结论:MP、RSV及ADV是本地区ARTI患儿重要的病原体,其中以MP感染为最常见,存在混合感染情况,RSV、ADV感染率有逐年上升的趋势,需临床重视。

Objective:To investigate the distribution and characteristics of Mycoplasma pneumonia(MP),respiratory syncytial virus(RSV)and adenovirus(ADV)infections in children hospitalized due to acute respiratory tract infection(ARTI).Methods:Included in this study were 21242 children hospitalized due to ARTI in five consecutive years between January 2015 and December 2019.From these subjects,whole blood samples were collected for detection of serum MP by passive agglutination assay and detection of serum RSV and ADV by ELISA.Results:A total of 63726 blood samples were collected from 21242 children hospitalized due to ARTI,yielding an overall positive rate of 9.17%in 5842 cases.The MP,RSV,and ADV were positive in 3131(14.74%),1585(7.46%),and 1126(5.30%)cases,respectively,with the positive rate of MP being the highest(all P<0.0125).The positive rates of MP,RSV and ADV in 2019 were the highest among all years studied(all P<0.0045).MP,RSV,and ADV were detectable in all seasons.In given season,MP accounted for the highest positive rate among all of the three pathogens(all P<0.001).The overall rate of co-infection with at least two of MP,RSV,and ADV was 1.02%,and the co-infection rate of was the highest with RSV+ADV combination(all P<0.0071).Among all age groups,the overall positive rate of MP,RSV,and ADV was highest with children aged 5 to 16 years old(all P<0.0071).Among children with different causes of ARTI,the overall positive rate of MP,RSV,and ADV was the highest in children with bronchial pneumonia(all P<0.0045).Conclusion:MP,RSV and ADV are important pathogens in children with ARTI in this region where MP infection is most commonly seen and mixed infections are also noted.The increasing infections with RSV or ADV over these years should prompt for clinical attention.