2021年山东省菏泽市流感哨点监测医院儿童呼吸道病原体感染监测分析

Analysis on surveillance of respiratory pathogen infection among children in influenza sentinel surveillance hospital, Heze city,2021

目的 了解山东省菏泽市儿童急性上呼吸道感染病原体谱与流行特征。方法 收集2021年1-6月菏泽市流感哨点监测医院儿科门诊(0~15岁散居、幼托儿童及中小学生)的,符合国家流感监测方案诊断标本的流感样病例咽拭子标本及符合流感暴发疫情标准采集的咽拭子标本548份作为研究对象。荧光定量PCR检测流感病毒。随机抽取140份标本,采用荧光定量PCR联合呼吸道多重病原体快速PCR检测法,对22种呼吸道病原体进行筛查。结果 548份标本中,检出流感病毒阳性81份,阳性14.78%(81/548)。不同月份流感病毒阳性率差异有统计学意义(P<0.01)。140份标本中筛出96份阳性,8种阳性病原体。其他肠道病毒(EV-U)阳性率最高为29.29%(41/140),其次是鼻病毒(RV)13.57%(19/140)、副流感病毒1型(PIVs1)7.86%(11/140)、人偏肺病毒(HMPV)5.00%(7/140)、腺病毒(AdV) 4.29%(6/140)、肺炎支原体(MP)3.57%(5/140)、副流感病毒4型(PIVs4)2.14%(3/140)、冠状病毒229E (CoV229E) 2.14%(3/140)、呼吸道合胞病毒(RSV)0.71%(1/140)。不同性别均为EV-U检出率最高,其次为RV。8种呼吸道病原体在0~4与5~15岁阳性率差异无统计学意义(P>0.05)。2例3种病原体混合感染,20例2种病原体混合感染。结论 2021年1-6月有9种呼吸道病原体在菏泽市流行。BV型流感、EV-U、RV、PIVs1、HMPV、AdV、MP为主要病原体。流感病毒、其他肠道病毒具有明显的季节性。不同病毒在各自流行季节有混合感染的情况。

Objective To understand the pathogen spectrum and epidemiological characteristics of acute upper respiratory tract infection in children in Heze city, Shandong province. Methods A total of 548 throat swabs of influenza-like cases which were in line with the diagnostic specimens of the national influenza surveillance program and the standards for influenza outbreak were collected from the pediatric outpatient department of influenza sentinel surveillance hospital(0-15 years old scattered, nursery children and primary and secondary school students) during January-June 2021.The influenza virus was detected by Real-time PCR.The 140 samples were randomly selected and detected by Real-time PCR combined with rapid PCR detection of respiratory multiple pathogens to screen 22 respiratory pathogens. Results Among 548 samples, 81 cases were positive for influenza virus, with the positive rate of 14.78%(81/548).There was significant difference in the positive rate of influenza virus among different months(P<0.01).Among 140 cases, 96 cases were positive and 8 kinds of positive pathogens were screened.The most positive numbers were human enterovirus(EV-U) 29.29%9(41/140),followed by rhinovirus(RV) 13.57%(19/141),parainfluenza virus 1(PIVs1) 7.86%(11/140),human metapneumo virus(HMPV) 5.00%(7/140),adenovirus(AdV) 4.29%(6/140),mycoplasma pneumoniae(MP) 3.57%(5/140),parainfluenza virus 4(PIVs4) 2.14%(3/140),coronavirus 229 E(CoV229 E) 2.14%(3/140),respiratory syncytial virus(RSV) 0.71%(1/140).The positive rate of enterovirus(EV-U) was the highest in different gender, followed by rhinovirus(RV).There was no significant difference in the positive rate of 8 respiratory pathogens between 0-5 and 5-15 years old(P>0.05).2 cases were 3 kinds of mixed pathogens infected and 20 cases were 2 kinds of mixed pathogens infected. Conclusion A total of 9 kinds of respiratory pathogens were prevalent in Heze during January to June 2021.The dominant pathogens contain BV influenza, human enterovirus, rhinovirus, parainfluenza virus 1,human metapneumo virus, adenovirus and mycoplasma pneumoniae.There are significant seasonal distribution of influenza virus and enterovirus.There are mixed infection of different virus in their respective epidemic seasons.