广东省惠州市呼吸道感染病原体特征分析

Pathogen characteristics of respiratory tract infection in Huizhou of Guangdong province

目的 调查广东惠州市呼吸道感染患者病原体分布及新型冠状病毒肺炎疫情后的变化情况,分析其感染特征。方法 选取2018年7月1日至2022年6月30日惠州市第一人民医院收治的呼吸道感染患者5 215例,通过间接免疫荧光法检测患者血清军团菌、肺炎支原体、Q热立克次体、肺炎衣原体、腺病毒、呼吸道合胞病毒、甲型流感病毒、乙型流感病毒、副流感病毒免疫球蛋白(Ig)M抗体水平。结果 5 215例呼吸道感染患者病原体IgM抗体阳性率为44.31%,其中肺炎支原体感染阳性率最高,为32.98%。混合感染748例,占14.34%。肺炎支原体和肺炎衣原体感染患者女性感染率高于男性(P<0.01)。除了腺病毒外,其余病原体在不同年龄组间阳性率差异均有统计学意义(P<0.01)。除了肺炎支原体、Q热立克次体感染外,不同季节患者呼吸道病原体感染情况差异有统计学意义(P<0.01)。呼吸道感染患者中出现发热症状1 229例,占23.57%。军团菌和腺病毒感染患者中出现发热症状的患者明显较多(P=0.045和P=0.006)。2020—2022年肺炎支原体、呼吸道合胞病毒和乙型流感病毒阳性率比2018—2019年均下降(P<0.01)。结论广东省惠州市呼吸道感染患者以肺炎衣原体感染最为常见,病原体感染分布具有性别、年龄、季节特点,其年份变化特征可能与新型冠状病毒肺炎防控有关。

Objective To investigate the distribution and characteristics of pathogens in patients with respiratory tract infection in Huizhou of Guangdong Province,and their changes after the novel coronavirus pneu-monia(COVID19)epidemics.Methods Five thousand two hundred and fifty-one patients with respiratory tract infection admitted to Huizhou First People′s Hospital between July 1,2018 and June 30,2022 were included in this study,and measured for their serum Immunoglobulin M(IgM)antibody levels against Legionella,Mycoplas-ma pneumoniae,Q fever Rickettsia,Chlamydia pneumoniae,adenovirus,respiratory syncytial virus,influenza A virus,influenza B virus and parainfluenza by indirect immunofluorescence assay.Results The positive rate of IgM antibody to the pathogens in these 5215 patients with respiratory tract infection was 44.31%,with highest positive rate noted for mycoplasma pneumoniae(32.98%).Mixed infections were found in 748,accounting for 14.34%of all patients.The infections with mycoplasma pneumoniae and chlamydia pneumoniae were significantly more common in females than in males(P<0.01).Except for adenovirus,the positive rates of other pathogens differed statistically across age groups(P<0.01).Except for mycoplasma pneumoniae and Q fever Rickettsia infections,there were statistical differences in seasonality of infections with other respiratory pathogens among patients(P<0.01).Febrile symptom was recorded in 1229(23.57%)patients with respiratory tract infection,and was significantly more frequent in patients infected with Legionella and adenovirus(P=0.045 and P=0.006).The positive rates of mycoplasma pneumoniae,respiratory syncytial virus and influenza B virus were significantly lower during 2020-2022 than those during 2018-2019(P<0.01).Conclusion Chlamydia pneumoniae is the most common pathogen of respiratory tract infection in Huizhou of Guangdong Province.Certain pathogens of the infections show a distribution pattern associated with gender,age and season.The changes in the infection characteristics over years may be related to the prevention and control of COVID-19.