烟台233例流感样病例流感阴性的病原体分布及流行特征分析

Analysis of pathogen distribution and epidemic characteristics of 233 influenza virus negative influenza-like cases in Yantai

目的了解烟台市流感阴性的流感样病例中呼吸道病原谱及其流行特征,为疾病防控和临床诊疗提供参考依据。方法于2020年3月至2021年2月在烟台市国家流感网络实验室监测的所有哨点医院采集了233例流感阴性的流感样病例的鼻咽拭子样本,使用多重荧光定量聚合酶链式反应法检测22种呼吸道病原体,分析流行病学特征。结果233份标本中总病原学检出率为69.96%(163/233),共检出17种呼吸道病原体,检测率前三位的病原体是冠状病毒(human coronavirus,HCoV)(32.62%)、鼻/肠病毒(rhinovirus,RhV)/(enterovirus,EV)(17.17%)和嗜肺军团杆菌(legionella pneumophila,LP)(16.74%)。不同年龄组检出率分别为0~15岁组80.28%(57/71)、16~30岁组62.65%(52/83)、31~45岁组68.18%(30/44)、46~60岁组64.28%(9/14)、>60岁组71.43%(15/21),差异无统计学意义。呼吸道病原体全年均有检出,以单一病原体携带模式为主(44.21%),各季节呼吸道病原体检出率差异无统计学意义。多种病原体的季节流行规律具有差异,HCoV 229E型春季检出率最高(68.75%);RhV/EV在秋季(26.98%)和冬季(23.08%)的检出率较高;LP在春季(19.05%)和夏季(27.27%)的检出率较高;副流感病毒(human parainfluenza virus,HPIV)在春季的检出率(22.22%)显著高于夏季(3.64%)。且HPIV和百日咳鲍特菌(bordetella pertussis,BP)均以0~15岁组的检出数量最多,检出率在不同年龄组之间差异有统计学意义。结论应加强HCoV、RhV、EV、LP、HPIV等呼吸道病原体的持续性监测,了解其流行特征及致病力的标化,为对可能由其他病原体引起的疫情暴发提供了数据支持和流行病学调查提供参考依据。

Objective To understand the spectrum of pathogens and epidemic characteristics of respiratory infectious diseases in influenza virus-negative influenza-like cases in Yantai,and provide reference for disease prevention and control and clinical diagnosis and treatment.Methods From March 2020 to February 2021,nasopharyngeal swab samples of 233 influenza virus-negative influenza like cases were collected in all sentinel hospitals monitored by Yantai National Influenza Network Laboratory,and 22 respiratory pathogens were detected by multiple fluorescence quantitative polymerase chain reaction to analyze epidemiological characteristics.Results The total pathogen detection rate of 233 samples was 69.96%(163/233).A total of 17 respiratory pathogens were detected.The top three pathogens were human coronavirus(HCoV,32.62%),rhinovirus/enterovirus(RhV/EV,17.17%)and Legionella pneumophila(LP,16.74%).The detection rates in different age groups were 80.28%(57/71)in the 0-15 years old group,62.65%(52/83)in the 16-30 years old group,68.18%(30/44)in the 31-45 years old group,64.28%(9/14)in the 46-60 years old group,and 71.43%(15/21)in the>60 years old group.There was no significant difference among the groups.Respiratory pathogens were detected throughout the year,mainly in a single pathogen carrying mode(44.21%),and there was no significant difference in the physical examination rate of respiratory pathogens in different seasons.The seasonal prevalence of various pathogens was different,and the detection rate of HCoV 229E was the highest in spring(68.75%);the detection rate of rhinovirus/enterovirus was higher in autumn(26.98%)and winter(23.08%);the detection rate of LP was high in spring(19.05%)and summer(27.27%);the detection rate of human parainfluenza virus(HPIV)in spring(22.22%)was significantly higher than that in summer(3.64%).The number of HPIV and Bordetella pertussis(Bp)detected in the 0-15 year old group was the highest,and the detection rate was statistically significant among different age groups.Conclusions The continuous monitoring of respiratory pathogens such as HCoV,RhV,EV,LP,HPIV should be strengthened to understand their epidemiologic characteristics and the standardization of pathogenicity,which provides data support and reference for epidemiological investigation of outbreaks that may be caused by other pathogens.