学龄前儿童和老年人呼吸道感染患者病原体分布特征

Characteristics of pathogen distribution in preschool children and elderly patients with respiratory tract infections

目的 调查学龄前儿童和老年人呼吸道感染患者六种呼吸道病原体的流行特征,为呼吸道患者的临床诊疗和预防提供科学依据。方法 选取2018至2021年就诊的呼吸道病原体检测阳性的28 d至6岁患儿和>65岁的老年人为研究对象,采用间接免疫荧光法对患者的血清标本进行检测,并对其阳性结果进行分析。结果 有2 546例病原体检测阳性的标本,病原体检测总阳性率从高到低依次为肺炎支原体(72.11%),乙型流感病毒(29.81%),副流感病毒(6.83%),呼吸道合胞病毒(6.79%),腺病毒2.79%,甲型流感病毒(1.57%)。儿童的肺炎支原体感染阳性检出率明显高于老年人(P<0.01),老年人在腺病毒和呼吸道合胞病毒的感染明显高于儿童(P<0.01)。肺炎支原体阳性检出率在秋季最高,而其他病原体检出率均在春季最高。各年龄组别中,病原体阳性检出最多的是肺炎支原体和乙型流感病毒,儿童中1~3岁、老年人中≥85岁是易感年龄。呼吸道合胞病毒的易感年龄集中在<1岁的幼儿中。结论 本地区学龄前儿童和老年人的呼吸道感染以肺炎支原体和乙型流感病毒感染为主,感染高峰季节是秋季和春季,易感年龄儿童中是1~3岁、老年人中是≥85岁,呼吸道道合胞病毒的易感年龄是<1岁。

Objective To identify the epidemiological characteristics of six respiratory pathogens in preschool children and elderly patients with respiratory tract infection,and to provide scientific basis for clinical diagnosis,treatment and prevention of respiratory tract infection.Methods Children aged from 28 days to 6 years and elderly people over 65 years who were diagnosed with positive respiratory pathogen infection in our hospital from 2018 to 2021 were selected as the research objects.Their serum samples were detected by the indirect immunofluorescence method,and the positive results were analyzed.Results There were 2546 specimens with positive pathogen detection.Mycoplasma pneumoniae(72.11%)was the most frequently detected pathogen,followed by the influenza B virus(29.81%),parainfluenza virus(6.83%),respiratory syncytial virus(6.79%),adenovirus(2.79%)and influenza A virus(1.57%).The positive detection rate of Mycoplasma pneumoniae infection in children was significantly higher than that in the elderly(P<0.01),and the infection rate of adenovirus and respiratory syncytial virus in the elderly was significantly higher than that in children(P<0.01).The positive detection rate of Mycoplasma pneumoniae was the highest in autumn,while that of other pathogens was the highest in spring.Among all age groups,the most detected positive pathogens were Mycoplasma pneumoniae and Influenza B virus.Children aged 1-3 years and elderly people>85 years were susceptible ages.Respiratory syncytial virus infection was most susceptible to young children under 1 year of age.Conclusion Mycoplasma pneumoniae and influenza B virus are the major viruses responsible for the respiratory tract infections in preschool children and the elderly in this area.The peak onset season of respiratory tract infections is autumn and spring.The susceptible age of respiratory tract infections is 1-3 years and>85 years,which,of the respiratory syncytial virus infection is<1 year.