2011-2023年南阳市临床检测呼吸道病原体流行趋势及新冠疫情防控的影响

Clinical detection of prevalence trends of respiratory tract pathogens and influence of prevention and control of COVID-19 in Nanyang from 2011 to 2023

目的分析本地区临床常见呼吸道病原体流行变迁及新冠疫情对呼吸道病原体流行变迁的影响.方法收集2011年1月-2023年6月111029例发热患者和南阳市结核病防治所2011-2021年结核病监测数据65651例患者数据,采用回顾性分析,从时间维度和年龄分布动态分析各呼吸道病原体和结核分枝杆菌(MTB)的流行变迁、新冠疫情前后的流行改变和患者年龄分布特征.结果临床送检呼吸道病原体检测标本量集中在每年5-8月和12月前后,肺炎支原体(MP)常年流行,腺病毒(ADV)和呼吸道合胞病毒(RSV)大流行发生于2012-2014年间,乙型流感病毒(IBV)和副流感病毒(HPIVs)交叉或同时段流行;呼吸道病原体流行趋势在疫情前后均发生显著变化且具有各自流行特征,MP感染阳性率在疫情前、中、后期分别为16.72%、27.11%、18.23%,阳性构成比分别为60.61%、90.83%、90.19%;MP合并IBV感染阳性率由疫情前7.75%降至疫情后期0.03%,IBV感染阳性率在疫情前、中、后期分别为4.21%、0.54%、0.31%,HPIVs感染阳性率在疫情前、中、后期分别为1.94%、1.50%、0.52%,ADV和RSV感染阳性率分别由疫情前的3.11%和1.38%改变为疫情后期的0.28%和2.37%;MTB感染随患者年龄增加患病率随之升高,但75岁以上人群患病率降至6.98%,以55~64岁年龄段感染患者最多;在MTB感染患者数量逐年下降的情况下,实验室检测出现涂阳患者逐渐上升的趋势.结论呼吸道病原体感染患者年龄分布和流行变迁各具特征,新冠疫情及防控措施改变了呼吸道病原体流行趋势,以期为呼吸道病原体有效防控措施的制定提供参考.

OBJECTIVE To analyze the impact of common clinical respiratory pathogens and novel coronavirus outbreak on the epidemiological variability.METHODS Clinical data on 111029 febrile patients from Jan.2011 to Jun.2023 and 65651 patients from 2011-2021 Mycobacterium tuberculosis(MTB)surveillance data of Nanyang Municipal Tuberculosis Control Center were collected,and retrospective analyses were used to analyze the epidemiological changes of respiratory pathogens and MTB,the changes before and after the COVID-19 outbreaks,and the characteristics the patients'age distribution by using the temporal dimension and the dynamics of the age distribution.RESULTS Clinical delivery of specimens for respiratory pathogens detection was concentrated around May to August and December each year,with perennial epidemics of Mycoplasma pneumoniae(MP),pandemics of adenoviruses(ADV)and respiratory syncytial viruses(RSV)occurring during the 2012-2014 period,and crossover or concurrent epidemics of influenza B viruses(IBV)and parainfluenza viruses(HPIV).The epidemiological trend of respiratory pathogens had undergone significant changes and had their own epidemiological characteristics before and after the COVID-19 outbreak.The positive rates of MP infection in the pre-epidemic,in the middle and late stage of the epidemic were 16.72%,27.11%,and 18.23%,respectively,and the positivity composition ratio was 60.61%,90.83%,and 90.19%,respectively.The positive rate of MP combined with the IBV infection decreased from 7.75%before the epidemic to 0.03%in the late stage of the epidemic,the positive rate of IBV infection was 4.21%,0.54%,0.31%in the pre-,mid-,and late-stage of the epidemic,respectively,and the positive rate of HPIVs was 1.94%,1.50%,0.52%,respectively,ADV were 3.11%,0.31%,0.28%,respectively,RSV were 1.38%,0.25%,2.37%,in the pre-,mid-,and late-stage of the epidemic,respectively,and the positive rate of ADV and RSV infection changed from 3.11%and 1.38%to 0.28%and 2.37%in the late epidemic.The prevalence of MTB infection increased with the age of the patients,and the prevalence of people over 75 years of age decreased to 6.98%,with the largest number of infected patients in the age group of 55-64 years old.While the number of patients with MTB infection decreased year by year,there was a trend of a gradual increase in the number of patients with smear-positive laboratory tests.CONCLUSION The age distribution and epidemiological changes of patients infected with respiratory pathogens had their own characteristics,and the COVID-19 pandemic and preventive and control measures had changed the epidemiological trends of respiratory pathogens,with a view to providing a reference for the development of effective preventive and control measures for respiratory pathogens.