广元市238例住院儿童呼吸道感染病原谱检测与流行特征分析

Analysis of pathogen spectrum detection and epidemiological characteristics of 238 hospitalized children with respiratory tract infection in Guangyuan

目的建立广元市儿童急性呼吸道感染病原谱,为儿童呼吸道感染疾病的临床诊治和精准防控提供依据。方法选取2021年广元市流感哨点监测医院238例住院儿童严重急性呼吸道感染病例,采用实时荧光定量PCR法对病例样本进行22种呼吸道病原体核酸检测,并对其流行特征进行分析。结果238例严重急性呼吸道感染住院儿童,呼吸道病原体核酸检测总阳性率为95.38%(227/238),其中混合感染175例,占阳性样本的77.09%(175/227)。共检出18种感染性病原体,以肺炎链球菌、流感嗜血杆菌、肠道病毒、人鼻病毒、呼吸道合胞病毒为主。男童病原体阳性率(93.91%)与女童病原体阳性率(96.74%)差异无统计学意义(χ^(2)=1.084,P>0.05)。病原体阳性检出率由高到低依次为3~<6岁(98.59%)、1~<3岁(97.89%)、0~<1岁(87.23%)、6~<12岁(92.00%)(χ^(2)=10.747,P<0.05)。呼吸道病原体全年各季节以肺炎链球菌阳性率最高,流感嗜血杆菌次之;除以上两者外,春夏季以肠道病毒和人鼻病毒为主,秋季以呼吸道合胞病毒和乙型流感病毒为主,冬季以呼吸道合胞病毒和呼吸道腺病毒为主。结论广元市急性呼吸道病原谱组成复杂,呼吸道疾病的流行特征多样,应持续进行研究,并建立完善病原谱数据库,识别有暴发或流行风险的病原体,提升传染病疫情的实验室病原学触发能力,为精准防控呼吸道传染病提供科学依据。

Objective To establish the pathogen spectrum of children′s acute upper respiratory tract infection in Guangyuan City,and to provide a basis for the clinical diagnosis,treatment and precise prevention and control of respiratory tract infections in children.Methods Real-time fluorescent quantitative PCR was used to detect 22 kinds of respiratory pathogens in 238 hospitalized children with severe acute respiratory infection from the influenza sentinel surveillance hospital in Guangyuan City in 2021,and the epidemic characteristics of these cases were analyzed.Results Of the 238 hospitalized children with SARI,the total positive detection rate of respiratory pathogen nucleic acid was 95.38%(227/238).There were 175 cases of mixed infection,accounting for 77.09%(175/227)of the positive samples.A total of 18 infectious pathogens were detected,mainly Streptococcus Pneumoniae,Haemophilus influenzae,Enterovirus,Human rhinovirus and Respiratory syncytial virus.There was no significant difference in the pathogen positive rate between boys(93.91%)and girls(96.74%)(χ^(2)=1.084,P>0.05).The positive detection rate of pathogens,from high to low,was 3-<6 years old(98.59%),1-<3 years old(97.89%),0-<1 years old(87.23%),and 6-<12 years old(92.00%)(χ^(2)=10.747,P<0.05).The positive rate of Streptococcus pneumoniae was the highest in all seasons of the year,followed by Haemophilus influenzae.In addition to the above two,Enterovirus and Human rhinovirus dominated in spring and summer,Respiratory syncytial virus and Influenza B virus dominated in autumn,and Respiratory syncytial virus and Adenovirus dominated in winter.Conclusion The etiological spectrum of acute upper respiratory tract in Guangyuan City is complex,and the epidemological characteristics of respiratory tract diseases are diverse,and should be continuously studied,and establish a complete pathogen spectrum database to identify the pathogens with outbreak or epidemic risk.The laboratory pathogen triggering ability of the laboratory to deal with infectious diseases outbreaks should be improved,so as to provide a scientific basis for the precise prevention and control of respiratory infectious diseases.