2016—2022年广东中山地区急性呼吸道感染患儿7种呼吸道病毒抗原检测结果分析

Analysis on the antigen detection results of 7 respiratory viruses in pediatric patients with acute respiratory tract infection in Zhongshan area of Guangdong Province from 2016 to 2022

目的 分析2016—2022年广东中山地区急性呼吸道感染(ARTI)患儿呼吸道合胞病毒(RSV)、人腺病毒(HAdV)、流行性感冒病毒A型(IFV-A)、流行性感冒病毒B型(IFV-B)、人副流感病毒-1型(HPIV-1)、人副流感病毒-2型(HPIV-2)、人副流感病毒-3型(HPIV-3)等7种呼吸道病毒抗原检测结果。方法 回顾性收集2016年1月至2022年12月于中山市博爱医院住院治疗的60 265例ARTI患儿的临床资料,其中49 116例(81.50%)接受病原检查,年龄29 d~14周岁,将其纳入分析。于患儿入院当天或次日采集鼻咽拭子,应用直接免疫荧光法检测RSV、HAdV、IFV-A、IFV-B、HPIV-1、HPIV-2、HPIV-3抗原。结果 49 116例ARTI患儿中有11 210例(22.82%)至少1种病毒抗原检测结果为阳性,检出阳性11 462例次,检出率由高至低依次为RSV(13.84%)、IFV-A(3.14%)、HAdV(2.45%)、HPIV-3(1.76%)、IFV-B(1.15%)、HPIV-1(0.68%)、HPIV-2(0.32%)。RSV在2020年检出率最高,为19.15%,2022年最低,为7.74%;IFV-A在2021年检出率为0.00%,其他观察年份波动在2.32%~4.33%;HAdV在2019年检出率最高,为4.43%,2021年最低,为0.39%;IFV-B、HPIV-1、HPIV-2、HPIV-3在各观察年份检出率均较低。7种病毒在不同季节的检出率均存在显著差异(P<0.05)。RSV感染在夏季和冬季更常见;HAdV感染多发于夏季;IFV-A感染多发于冬季,秋季较少见。RSV、HPIV-3在29 d~<1岁年龄段检出率最高,分别为22.32%、2.90%;IFV-A、IFV-B在6~14岁年龄段检出率最高,分别为6.30%、3.17%;HAdV在3~<6岁年龄段检出率最高,为4.30%;HPIV-1在1~<3岁年龄段检出率最高,为0.85%。HPIV-2检出率在不同年龄段比较差异无统计学意义(P>0.05)。RSV在男性的检出率高于女性,差异有统计学意义(P<0.05),其他6种病毒在不同性别患儿检出率比较差异无统计学意义(P>0.05)。RSV主要检出于急性喘息性支气管炎患儿(28.17%);HAdV、IFV-A、IFV-B均在急性上呼吸道感染患儿检出率最高,分别为3.66%、4.91%、1.70%,而HPIV-3在急性上呼吸道感染患儿中检出率较低(1.20%)。结论 RSV、IFV-A、HAdV是广东中山地区ARTI患儿的主要病原。婴儿、男性为呼吸道病毒感染的高发群体。

Objective To analyse the antigen detection results of 7 respiratory viruses[including respiratory syncytial virus(RSV),human adenovirus(HAdV),influenza virus-A(IFV-A),influenza virus-B(IFV-B),human parainfluenza virus-1(HPIV-1),human parainfluenza virus-2(HPIV-2)and human parainfluenza virus-3(HPIV-3)]in pediatric patients with acute respiratory tract infection(ARTI)in Zhongshan area of Guangdong Province from 2016 to 2022.Methods The clinical data of 60265 pediatric patients with ARTI who were admitted to Boai Hospital of Zhongshan from January 2016 to December 2022 were retrospectively collected.Among the patients,49116 cases(81.50%,aged 29 days to 14 years)underwent pathogen examination and were included in this analysis.Nasopharyngeal swabs were used to collect the specimens on the day of admission or the next day.The antigens of RSV,HAdV,IFV-A,IFV-B,HPIV-1,HPIV-2 and HPIV-3 were detected by using direct immunofluorescence method.Results Of the 49116 pediatric patients with ARTI,11210 cases(22.82%)tested positive for at least 1 viral antigen.A total of 11462 cases tested positive for viral antigens,and the detectable rates in descending order were 13.84%in RSV,3.14%in IFV-A,2.45%in HAdV,1.76%in HPIV-3,1.15%in IFV-B,0.68%in HPIV-1 and 0.32%in HPIV-2.The detectable rate of RSV was the highest in 2020(19.15%)and the lowest in 2022(7.74%).The detectable rate of IFV-A in 2021 was 0.00%,and in the other observed years,the detectable rate of IFV-A fluctuated between 2.32%and 4.33%.The detectable rate of HAdV was the highest in 2019(4.43%)and the lowest in 2021(0.39%).The detectable rates of IFV-B,HPIV-1,HPIV-2 and HPIV-3 were low in each observed year.There were significant differences in the detectable rates of 7 viruses in different seasons(P<0.05).RSV infection were more common in summer and winter.HAdV infection was more common in summer.IFV-A infection occurred more frequently in winter and less frequently in autumn.The detectable rates of RSV and HPIV-3 were the highest in the age group of 29 days-<1 year,which were 22.32%and 2.90%,respectively.The detectable rates of IFV-A and IFV-B were the highest in the age group of 6-14 years,which were 6.30%and 3.17%,respectively.The detectable rate of HAdV was the highest in the age group of 3 years-<6 years(4.30%),and the detectable rate of HPIV-1 was the highest in the age group of 1 year-<3 years(0.85%).There were no significant differences in the detectable rates of HPIV-2 among different age groups(P>0.05).The detectable rate of RSV in males was higher than that in females,and the difference was statistically significant(P<0.05).There were no statistically significant differences in the detectable rates of the other 6 viruses between different genders in the pediatric patients(P>0.05).RSV was mainly detectable in the pediatric patients with acute asthmatic bronchitis(28.17%).The detectable rates of IFV-A,HAdV and IFV-B were the highest in the pediatric patients with acute upper respiratory tract infection,and the detectable rates of HAdV,IFV-A and IFV-B were 3.66%,4.91%and 1.70%,respectively.However,the detectable rate of HPIV-3 in the pediatric patients with acute upper respiratory tract infection was lower(1.20%).Conclusion RSV,IFV-A and HAdV are the main pathogens for the pediatric patients with ARTI in Zhongshan area of Guangdong Province.Infants and males are the high-incidence groups of respiratory virus infection.