2019—2023年河北地区儿童呼吸道合胞病毒流行特征分析

Epidemiological characteristics of respiratory syncytial virus in children in Hebei from 2019 to 2023

目的了解2019—2023年河北地区儿童呼吸道合胞病毒(RSV)的流行特征。方法收集2019—2023年在河北省儿童医院住院治疗患儿的下呼吸道标本46576例,采用多重RT-PCR和毛细电泳法检测13种常见呼吸道病原体,并对数据进行统计学分析。结果RSV总体阳性检出率为18.76%(8739/46576),男性患儿和女性患儿RSV总体阳性率分别为18.84%(5174/27462)和18.65%(3565/19114),性别比较差异无统计学意义(χ^(2)=0.916,P=0.339);RSV检出率与年龄增长存在线性关系(P<0.01);各年份RSV检出率之间差异有统计学意义(χ^(2)=723.71,P<0.01);2019—2021年的阳性检出率高峰期在12月至次年2月;2019年和2020年5—10月阳性检出率极低;2021年全年阳性检出率均在10%以上,且5月和8月出现了反季节流行的小高峰;2022年全年阳性检出率较低,无明显季节变化;2023年阳性检出率高峰出现在4—6月。各年龄组阳性检出率在疫情前、疫情期间和疫情后差异有统计学意义(P<0.01)。RSV与其他呼吸道病原体的混合检出率为29.20%(2522/8739),与鼻病毒(52.29%,1342/2552)混合检出最常见。结论RSV是河北地区儿童呼吸道感染的常见病原体,易感人群主要为3岁以下儿童,COVID-19疫情后出现了反季节流行。随着RSV流行特征的改变,有必要对RSV开展持续监测,为相关疾病的防控提供科学数据。

Objective To analyze the epidemiological characteristics of respiratory syncytial virus(RSV)among children in Hebei from 2019 to 2023.Methods A total of 46576 lower respiratory tract specimens were collected from hospitalized children in the Children′s Hospital of Hebei Province from 2019 to 2023.Multiple RT-PCR and capillary electrophoresis were used to detect 13 common respiratory pathogens in the specimens,and the results were statistically analyzed.Results The overall positive rate of RSV was 18.76%(8739/46576).The overall positive rates of RSV in male and female children were 18.84%(5174/27462)and 18.65%(3565/19114),respectively,showing no statistically significant difference between genders(χ^(2)=0.916,P=0.339).A linear relationship was found between the positive rate of RSV and age(P<0.01).There was a significant difference in the positive rates of RSV in different years(χ^(2)=723.71,P<0.01).The positive rate of RSV peaked in the period from December to February from 2019 to 2021.In 2019 and 2020,the positive rates of RSV were very low from May to October,while the positive rate of RSV was above 10%throughout the whole year of 2021 and small off-season epidemics occurred in May and August.The positive rate of RSV was low in 2022,and no significant seasonal change was observed.The rate of RSV infections peaked from April to June in 2023.There were significant differences in the rates of RSV infections before,during and after the COVID-19 epidemic in each age group(P<0.01).The rate of mixed infections was 29.20%(2522/8739),and the most common other respiratory pathogen was human rhinovirus(52.29%,1342/2552).Conclusions RSV is a common pathogen causing respiratory tract infections in children in Hebei,especially in children under 3 years old.After the COVID-19 epidemic,there are off-season RSV epidemics.Given the variations in the epidemiological features of RSV,it is necessary to carry out continuous monitoring of RSV to provide scientific data for the prevention and control of related diseases.