2018年至2021年广州地区儿童急性呼吸道感染病原体的流行特征

Epidemiological features of pathogens of acute respiratory tract infection in children in Guangzhou area from 2018 to 2021

目的了解广州地区呼吸道病原体在急性呼吸道感染(ARTI)患儿中的流行特征。方法纳入2018年1月至2021年12月广州市妇女儿童医疗中心住院的13610例ARTI患儿。采集患儿咽拭子标本,采用荧光定量聚合酶链反应(PCR)检测11种呼吸道病原体,包括呼吸道合胞病毒(RSV)、腺病毒、副流感病毒(PIV)、人鼻病毒、人博卡病毒(HBoV)、人偏肺病毒(HMPV)、肠道病毒、甲型流行性感冒病毒(IFA)、乙型流行性感冒病毒(IFB)、肺炎支原体(MP)和肺炎衣原体(CP)。根据年龄(<1岁组、1~<3岁组、3~<6岁组、6~14岁组)和季节进行分组。统计学分析采用χ2检验。结果13610例患儿中,6331例检出至少1种病原体,总检出率为46.52%。各病原体的检出率由高到低依次为RSV[13.75%(1872/13610)]、腺病毒[4.82%(656/13610)]和PIV[4.82%(656/13610)]、MP[4.54%(618/13610)]、人鼻病毒[3.39%(462/13610)]、HBoV[2.64%(359/13610)]、HMPV[2.59%(352/13610)]、肠道病毒[1.76%(239/13610)]、IFA[1.29%(176/13610)]、IFB[0.90%(122/13610)]、CP[0.30%(41/13610)]。病原体检出率在各年龄组间差异有统计学意义(χ^(2)=49.91,P<0.001),其中1~<3岁组检出率最高,为50.83%(2196/4320)。病原体检出率在四季分布差异有统计学意义(χ^(2)=13.90,P=0.003),其中夏季检出率最高,为48.76%(1498/3072)。结论广州地区RSV、腺病毒、PIV、MP、人鼻病毒是导致儿童ARTI的主要病原体,呼吸道病原体的检出率与儿童年龄、季节等因素有关。

Objective To investigate the epidemiology of pathogens of acute respiratory tract infection(ARTI)in children in Guangzhou area.Methods A total of 13610 hospitalized children with ARTI in Guangzhou Women and Children′s Medical Center from January 2018 to December 2021 were enrolled.Throat swab specimens were collected,and fluorescent quantitative polymerase chain reaction(PCR)was performed to detect 11 respiratory pathogens,including respiratory syncytial virus(RSV),adenovirus(ADV),parainfluenza virus(PIV),human rhinovirus(HRV),human bocavirus(HBoV),human metapneumovirus(HMPV),enterovirus(EV),influenza A virus(IFA),influenza B virus(IFB),Mycoplasma pneumoniae(MP)and Chlamydia pneumoniae(CP).Grouping according to age(<one year group,one to<three years group,three to<six years group,six to 14 years group)and season.Chi-square test was used for statistical analysis.Results At least one pathogen was detected in 6331 cases among 13610 patients,and the overall positive rate was 46.52%.The detection rates from high to low were as follows:RSV(13.75%(1872/13610)),ADV(4.82%(656/13610)),PIV(4.82%(656/13610)),MP(4.54%(618/13610)),HRV(3.39%(462/13610)),HBoV(2.64%(359/13610)),HMPV(2.59%(352/13610)),EV(1.76%(239/13610)),IFA(1.29%(176/13610)),IFB(0.90%(122/13610))and CP(0.30%(41/13610)).The positive rate of viral detection showed significant differences among different age groups(χ^(2)=49.91,P<0.001),and the highest positive rate was in the age group of one to<three years(50.83%(2196/4320)).The positive rate of viral detection showed a significant difference in terms of seasonal distribution(χ^(2)=13.90,P=0.003),with a peak prevalence in summer(48.76%(1498/3072)).Conclusions RSV,ADV,PIV,MP and HRV are important pathogens causing ARTI in children in Guangzhou area.The distribution of pathogens in children with ARTI is associated with age and season.