Location of Highly Pathogenic Porcine Reproductive and Respiratory Syndrome Virus in Tissues of Natural Cases

[ Objective] The aim of this study was to provide a theoretical basis for the prevention and treatment of highly pathogenic porcine reproductive and respiratory syndrome （HP-PRRS）. [Method] Antigen location and histopathological observation in natural cases infected by highly pathogenic porcine reproductive and respiratory syndrome virus （HP-PRRSV） were analyzed by immunohistochemistry and H. E. staining. [Result] The virus antigen mainly existed in epithelial calls, and also a few in mecrophages, lymphocytes and brain nerve cells. [ Conclusion] The cell and tissue tropism of HP-PRRSV strain in natural cases is different from that of previous strains.

Simultaneous Detection of 13 Key Bacterial Respiratory Pathogens by Combination of Multiplex PCR and Capillary Electrophoresis

Objective Lower respiratory tract infections continue to pose a significant threat to human health. It is important to accurately and rapidly detect respiratory bacteria. To compensate for the limits of current respiratory bacteria detection methods, we developed a combination of multiplex polymerase chain reaction （PCR） and capillary electrophoresis （MPCE） assay to detect thirteen bacterial pathogens responsible for lower respiratory tract infections, including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catorrholis, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, Mycoplasma pneumoniae, Legionella spp., Bordetella pertussis, Mycobacterium tuberculosis complex, Corynebactefium diphthefiae, and Streptococcus pyogenes. Methods Three multiplex PCR reactions were built, and the products were analyzed by capillary electrophoresis using the high-throughput DNA analyzer. The specificity of the MPCE assay was examined and the detection limit was evaluated using DNA samples from each bacterial strain and the simulative samples of each strain. This assay was further evaluated using 152 clinical specimens and compared with real-time PCR reactions. For this assay, three nested-multiplex-PCRs were used to detect these clinical specimens. Results The detection limits of the MPCE assay for the 13 pathogens were very low and ranged from 10-7 to 10-2 ng/μL. Furthermore, analysis of the 252 clinical specimens yielded a specificity ranging from 96.5%-100.0%, and a sensitivity of 100.0% for the 13 pathogens. Conclusion This study revealed that the MPCE with high specificity and sensitivity. This assay survey of respiratory pathogens. assay is a rapid, reliable, and high-throughput method has great potential in the molecular epidemiological.

Evaluation of the Pathogenicity of a Highly Pathogenic Porcine Reproductive and Respiratory Syndrome Virus Variant in Piglets

Since May 2006,a highly pathogenic porcine reproductive and respiratory syndrome virus （HP-PRRSV） variant characterized by 30 amino acids deletion within its NSP2-coding region emerged and caused extensive economic losses to China＇s pig industry.To investigate the in vivo pathogenicity and immune responses of the newly emerging PRRSV,3 groups of 60-d-old conventional piglets were inoculated intranasally with a representative strain of the HP-PRRSV variant HuN4 with 3 different infection doses （3×103-3×105 TCID50）.The results revealed that the virus variant caused severe disease in piglets and the significant clinical characteristics consisted of persistently high fever （41.0-41.9oC） and high morbidity and mortality （60-100%）,the marked clinical signs of PRRS and severe histopathogenic damages in multiple organs.It induced rapid and intense humoral immune responses and seroconversion was detected in most infected pigs at 7 d post-infection （DPI）.The virus vigorously replicated in vivo and the highest virus average titer was 9.7 log copies mL-1 serum at 7 DPI.Elevated levels of IFN-g and IL-10 cytokine production in serum in this study were also observed.Taken together,our results demonstrated that the HP-PRRSV variant HuN4 strain is highly pathogenic for piglets and suitable to be a reference strain of highly virulent PRRSV for evaluating the efficacy of the new vaccines.

Tracking Survey of Immune Effects of Highly Pathogenic Porcine Reproductive and Respiratory Syndrome (HP-PRRS) in Changping District, Beijing City

The epidemiology of highly pathogenic porcine reproductive and respiratory syndrome( HP-PRRS) in Changping District,Beijing City was investigated from 2010 to 2015. Through statistics of vaccine,immune procedure and antibody levels,the epidemic prevention effect of HP-PRRS in Changping District was scientifically assessed.

A direct real-time polymerase chain reaction assay for rapid high-throughput detection of highly pathogenic North American porcine reproductive and respiratory syndrome virus in China without RNA purification

Background： Porcine reproductive and respiratory syndrome virus （PRRSV）, and particularly its highly pathogenic genotype （HP-PRRSV）, have caused massive economic losses to the global swine industry. Results： To rapidly identify HP-PRRSV, we developed a direct reaL-time reverse transcription polymerase chain reaction method （dRT-PCR） that could detect the virus from serum specimen without the need of RNA purification Our dRT-PCR assay can be completed in 1.5 h from when a sample is received to obtaining a result. Additionally, the sensitivity of dRT-PCR matched that of conventional reverse transcription PCR （cRT-PCR） that used purified RNA The lowest detection limit of HP-PRRSV was 6.3 TCIDs0 using dRT-PCR. We applied dRT-PCR assay to 144 field samples and the results showed strong consistency with those obtained by cRT-PCR. Moreover, the dRT-PCR method was able to tolerate 5-20% （v/v） serum. Conclusions： Our dRT-PCR assay allows for easier, faster, more cost-effective and higher throughput detection of HP-PRRSV compared with cRT-PCR methods. To the best of our knowledge, this is the first report to describe a real-time RT-PCR assay capable of detecting PRRSV in crude serum samples without the requirement for purifying RNA. We believe our approach has a great potential for application to other RNA viruses.

Pathogen Distribution and Laboratory Diagnosis of Acute Respiratory Infectious Diseases

Objective: To investigate the etiology distribution and laboratory diagnosis of acute respiratory infectious diseases. Methods: By searching, collecting and summarizing the etiology distribution and laboratory diagnosis of respiratory infectious diseases, the latest research progress of acute respiratory infectious diseases was studied in order to provide reference for clinical prevention and treatment. Results: In the relevant literature collected, it is considered that acute respiratory infectious diseases refer to infectious diseases caused by pathogens invading human body from the nasal cavity, throat, trachea and bronchus. The main acute respiratory infectious diseases are SARS (acute severe respiratory syndrome), MERS (Middle East respiratory syndrome), 2019-ncov infection (new coronavirus pneumonia), pulmonary plague, influenza, measles, diphtheria, pertussis, rubella, meningitis, mumps, tuberculosis, etc. Different types of infection have different diagnostic methods, and different treatments are given according to different diseases. Conclusion: The etiology distribution and laboratory diagnosis of acute respiratory tract infectious diseases are understood through reference, which can provide better reference for clinical practice. Acute respiratory infectious disease is the most common clinical disease, which seriously endangers people’s health.

Molecular Characterization of a Highly Pathogenetic Porcine Reproductive and Respiratory Syndrome Virus Variant in Hubei, China

Porcine reproductive and respiratory syndrome virus (PRRSV) has been recognized as one of the most important pathogens of pigs throughout the world. In 2006, more than 10 provinces of China have experienced an epizootic outbreak of pig diseases characterized by high fever, reddened skin and high morbidity and mortality. From June 2006 to April 2007, we have investigated some clinical samples in Hubei province by RT-PCR and cloned several major genes, N, GP5 and NSP2 gene, shown in this study. Phylogenetic analysis of these genes revealed that the highly pathogenic PRRSV variant, ZB, was responsible for 2006 emergent outbreak of pig disease in Hubei province similar with those variants isolated from other provinces in China in 2006, and belongs to the NA-type PRRSV. In the PRRSV variants, the N and GP5 shear about 90% identity with prototypic ATCC VR-2332 and some typical NA-type Chinese isolates, except the 2850bp NSP2 gene (only shares 65% identity with ATCC VR-2332). But they all shear more than and 97% identity with other highly pathogenetic Chinese PRRSV strains. Additionally, there are extensive amino acid (aa) mutations in the GP5 protein and 2 deletions in the Nsp2 protein when compared with the previous isolates. Most of the variants found in 2006 epizootic outbreak of pig diseases in China were the farthest variants from the typical NA-type PRRSV in phylogenetic distance, and these diversities may be responsible for the differences in the pathogenicity observed between these variants and original Chinese PRRSV strains.

Analysis of Common Respiratory Infected Pathogens in 3100 Children after the Coronavirus Disease 2019 Pandemic

Objective To investigate the epidemiological features in children after the coronavirus disease 2019(COVID-19)pandemic.Methods This study collected throat swabs and serum samples from hospitalized pediatric patients of Renmin Hospital of Wuhan University,Wuhan,Hubei province,China before and after the COVID-19 pandemic.Respiratory infected pathogens[adenovirus(ADV),influenza virus A/B(Flu A/B),parainfluenza virus 1/2/3(PIV1/2/3),respiratory syncytial virus(RSV),Mycoplasma pneumoniae(MP),and Chlamydia pneumoniae(CP)]were detected.The pathogens,age,and gender were used to analyze the epidemiological features in children after the COVID-19 pandemic.Results The pathogen detection rate was significantly higher in females than in males(P<0.05),and the infection of PIV1 and MP was mainly manifested.After the COVID-19 pandemic,PIV1,PIV3,RSV,and MP had statistically different detection rates among the age groups(P<0.05),and was mainly detected in patients aged 0–6 years,0–3 years,0–3 years,and 1–6 years,respectively.When comparing before the COVID-19 pandemic,the total detection rate of common respiratory pathogens was lower(P<0.05).Except for the increase in the detection rate of PIV1 and CP,the infection rate of other pathogens had almost decreased.Conclusion The prevention and control measures for the COVID-19 pandemic effectively changed the epidemiological features of common respiratory tract infectious diseases in pediatric children.

Porcine Respiratory Pathogens in Swine Farms Environment in Mexico

Respiratory pathogens are the main health problem in the swine industry worldwide. These pathogens are transmitted by direct contact between animals or by aerosols and however are not well known yet, if the environment works as its reservoir, inoculum and/or dispersion medium. The objective of this study was to determine the presence of respiratory pathogens in environmental samples from swine farms in Aguascalientes, Mexico, through of PCR and RT-PCR techniques. The bacteria Actinobacillus pleuropneumoniae and Pasteurella multocida were found viable in samples from water, food, soil and air. Streptococcus suis was found in a viable state in water samples. Haemophilus parasuis, Porcine Reproductive and Respiratory Syndrome virus and Swine Influenza virus (H1N1 and H3N2) were detected in drinking water samples. Mycoplasma hyopneumoniae and Porcine Circovirus type 2 (PCV2) were not detected in environmental samples. These results suggest that the environment of the farms acts as a reservoir, inoculum and/or vehicle of dispersion for these pathogens except for M. hyopneumoniae and PCV2.

Prevention and Treatment Strategy of Highly Pathogenic Porcine Reproductive and Respiratory Syndrome(HP-PRRS)

At the present stage, the social economy in China has developed by leaps and bounds. China's pig industry has been well developed un-der the background of this era. However, the number of pig diseases increases due to the influence of many factors, and highly pathogenic porcine reproductive and respiratory syndrome(HP-PRRS) is one of the very common diseases, causing growing mortality rate of pigs. The disease increases the economic loss of pig industry to a large extent, and brings difficulties in prevention and control of pig diseases. The staff must analyze and sum-marize the basic characteristics of pig diseases, and combine some practical problems in prevention and control of pig disease to find effective mea-sures. The scope and scale of pig production in different parts of China have been continuously expanded under the background of further develop-ment of pig industry in the new era. But for pig production, pig disease has been a problem that delays its further development. Related personnel must analyze and summarize the status quo of HP-PRRS, to find effective prevention measures and strategy.

Traditional Chinese Medicine Nursing Protocols for Fever Caused by Exogenous Pathogens (Upper Respiratory Infection)

Fever caused by exogenous pathogens,also called upper respiratory infection( URI),refers to a classification of exogenous diseases induced by invasion of six pathogenic factors into the body leading to disharmony betw een nutrient Qi and defensive Qi and imbalance of Yin and Yang. As an extremely common symptom or sign,it is frequently seen in various processes of acute and chronic diseases. In recent years,traditional Chinese medicine( TCM) has achieved a certain efficacy in the treatment of fever caused by exogenous pathogens,such as modified formulae,Chinese patent drugs,self-made formulae,acupuncture,moxibustion and so on.This article mainly explored the key points of common syndromes,TCM nursing methods and health guidance of fever caused by exogenous pathogens,in order to further develop the advantages of TCM,improve its efficacy and standardize its nursing behavior.

2023年北京某医院呼吸道感染的流行病学分析

目的分析2023年我院呼吸道感染的流行病学特征及血清学指标变化,为呼吸道感染疾病的诊断和治疗提供依据。方法选取2023年1月至2023年12月就诊于北京佑安医院的483例呼吸道病原体IgM阳性者为研究对象,采用间接免疫荧光法检测血清中的肺炎支原体(MP)、肺炎衣原体(CP)、甲型流感病毒(INFA)、副流感病毒(PIV)、呼吸道合胞病毒(RSV)、腺病毒(ADV)、柯萨奇病毒(COX)、嗜肺军团菌(LP)、乙型流感病毒(INFB)9种病原体免疫球蛋白(Ig)M抗体。采用卡方检验对不同性别、年龄、季节患者的血清呼吸道病原体IgM阳性率进行统计分析,采用Kru’skal-Wallis检验分析不同病原体感染者间的血清学指标。结果(1)483例呼吸道感染患者中,单一病原体IgM阳性者占比为39.3%(190/483),>2种病原体IgM阳性者占比为60.7%(293/483)。单一病原体IgM阳性患者中,位居前3位的依次为INFB(39.5%,75/190)、INFA(24.2%,46/190)及MP(20%,38/190);混合病原体IgM阳性患者中,以2种病原体混合感染为主,占比为61.7%(181/293),其中以病原体INFA+INFB为主,占比43.3%(127/293),其次为MP+INFA+INFB,占比17.4%(51/293)。(2)女性患者血清MP、ADV IgM阳性率高于男性,INFB IgM阳性率低于男性,差异均具有统计学意义(P<0.05)。(3)0~18、19~45、46~59、>60岁4个年龄段患者血清MP、COX病原体IgM阳性率比较,差异均有统计学意义(P均<0.05),其中0~18岁MP、COX阳性率分别高于19~45、46~59、>60岁(P均<0.05),19~45岁MP阳性率高于46~59、>60岁(P均<0.05)。(4)春、夏、秋、冬4个季节血清MP、INFA IgM阳性率比较,差异有统计学意义(P<0.05);其中春季MP阳性率高于秋季(P<0.05),冬季阳性率分明高于夏季、秋季(P均<0.05);INFA阳性率冬季高于夏季(P<0.05)。(5)将483例呼吸道感染者分为MP IgM阳性组、病毒IgM阳性组、混合感染组,3组间eGFR、EOS、PLT比较,差异有统计学意义(P<0.05),其中混合感染组中EOS高于MP IgM阳性组(P<0.05),eGFR、PLT高于病毒IgM阳性组(P均<0.05),肝功能指标在3组间比较差异无统计学意义(P>0.05)。结论2023年全年以MP、INFA、INFB病原体感染为主,且混合感染多见;女性及年龄小的人群更易感染MP;春季和冬季更易发生MP感染,甲型流感病毒更易发生于冬季;混合感染可能更易引起机体的免疫反应。

非药物干预措施对成人感染呼吸道病原体流行特征的影响

目的探讨非药物干预措施(NPIs)对成人感染呼吸道病原体流行率的影响,深入了解NPIs的科学价值和长期效果。方法采用回顾性研究,收集2017-2023年四川大学华西医院呼吸道感染成人患者的临床资料和实验室检查数据,分时段对病原体、人群、季节等方面进行分析。分析时段包括2017-2019年(NPIs实施前),2020-2022年(NPIs实施中),2023年1-12月(NPIs实施后)。结果纳入呼吸道感染成人患者33068例,8种成人感染呼吸道病原体2017-2019年总流行率(26.95%)高于2020-2022年(8.70%),差异有统计学意义(P<0.05)。在NPIs实施的前、中、后3个时段中,不同性别、年龄和季节的病原体流行率比较,差异有统计学意义(P<0.05)。NPIs实施前,呼吸道病原体流行的季节高峰出现在每年的1-3月。随着NPIs的实施,流行季节高峰分别出现在2020年1-3月(10.09%)、2021年10-12月(9.32%)、2022年7-9月(15.23%)。NPIs实施后,病原体流行的季节高峰出现在2023年10-12月(21.20%)。8种病原体中,甲型流感病毒H1N1(2009)的流行率变化最为明显,NPIs实施前、中、后流行率分别为17.42%、0.00%、6.99%。结论2017-2023年由于NPIs等因素的影响,呼吸道病原体流行情况改变了原有特征。关注病原体流行率的新特征,对于预防、诊断和控制突发公共卫生事件中的呼吸道感染疾病具有重要意义。

湖南省细菌耐药监测网2012—2021年呼吸道分离菌耐药性监测

目的了解2012—2021年湖南省细菌耐药监测网呼吸道分离菌的分布和耐药性变迁。方法细菌鉴定和药敏试验统一按全国细菌耐药监测网(CARSS)细菌耐药监测技术方案执行,剔除重复菌株。按照美国临床实验室标准化协会(CLSI)2022年标准判断细菌对抗菌药物的敏感性,应用WHONET 5.6软件进行统计描述。结果2012—2021年湖南省细菌耐药监测网呼吸道标本共分离976984株细菌,其中革兰阳性菌185642株(19.0%),革兰阴性菌791342株(81.0%)。分离自成人患者呼吸道标本排名前五位的细菌是肺炎克雷伯菌(25.2%)、铜绿假单胞菌(17.0%)、鲍曼不动杆菌(14.6%)、大肠埃希菌(6.7%)和金黄色葡萄球菌(5.8%)。分离自儿童患者呼吸道标本排名前五位的细菌是金黄色葡萄球菌(17.7%)、肺炎链球菌(15.6%)、大肠埃希菌(13.5%)、肺炎克雷伯菌(13.1%)和流感嗜血杆菌(10.8%)。肺炎克雷伯菌、大肠埃希菌和阴沟肠杆菌对替加环素、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、碳青霉烯类、阿米卡星耐药率较低(<15%)。肺炎克雷伯菌对亚胺培南、美罗培南的耐药率分别从2012—2013年的3.5%、4.2%逐渐上升至2020—2021年的9.5%、11.5%,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星、妥布霉素、环丙沙星和左氧氟沙星的耐药率呈上升趋势。大肠埃希菌和阴沟肠杆菌对氨曲南、氨基糖苷类和氟喹诺酮类的耐药率呈下降趋势。铜绿假单胞菌对多黏菌素耐药率较低(<6%),鲍曼不动杆菌对替加环素和多黏菌素耐药率较低(<6%)。铜绿假单胞菌对β-内酰胺类、氨基糖苷类和氟喹诺酮类耐药率下降。鲍曼不动杆菌对头孢哌酮/舒巴坦的耐药率从18.0%上升至43.7%,对哌拉西林/他唑巴坦、亚胺培南、氟喹诺酮类和米诺环素的耐药率呈上升趋势。未发现对万古霉素、替考拉宁和利奈唑胺耐药的金黄色葡萄球菌。成人和儿童患者耐甲氧西林金黄色葡萄球菌(MRSA)检出率分别为37.8%(14208/37594)、22.7%(10874/47882)。结论湖南省2012—2021年呼吸道分离细菌以革兰阴性菌为主,成人和儿童患者分离的优势细菌并不相同。大肠埃希菌、阴沟肠杆菌和铜绿假单胞菌对部分抗菌药物的耐药率不断下降。肺炎克雷伯菌对碳青霉烯类耐药率逐渐上升。应持续高效做好细菌耐药监测,为临床使用抗菌药物提供数据支持。

急性下呼吸道感染患儿支气管肺泡灌洗液病原菌特征分析

目的研究急性下呼吸道感染患儿病原菌特点,探讨支气管肺泡灌洗液荧光PCR检测对儿童急性呼吸道感染病原学的诊断价值。方法选择2018年6月至2019年5月吉林大学第一医院收治的急性呼吸道感染住院患儿172例为研究对象,收集其支气管肺泡灌洗液,通过多重实时荧光定量PCR检测其病原体。结果本研究中172例支气管肺泡灌洗液样本致病菌检出有106例,阳性率为61.63%(106/172);排在前三位的病原菌检出率依次为肺炎链球菌26.74%(46/172),流感嗜血杆菌17.44%(30/172),百日咳鲍特菌8.14%(14/172),且不同年龄组的病原菌检出率存在差异,P<0.01。结论急性下呼吸道感染患儿支气管肺泡灌洗液中肺炎链球菌检出率最高,依次为流感嗜血杆菌、百日咳鲍特菌、卡他莫兰汉菌、金黄色葡萄球菌。急性下呼吸道感染患儿的病原菌检出率在不同年龄段分组中存在差异。

蚌埠市6~15岁儿童急性呼吸道感染病原谱检测分析

目的:分析蚌埠市6~15岁儿童急性呼吸道感染病原谱特征,为制定有效防控措施提供依据。方法:2022年1—8月,采集蚌埠市流感监测哨点医院流感样病例咽拭子标本1 625份,其中6~15岁儿童标本233份,每月抽取10例左右6~15岁儿童病例标本,共抽取80例。使用荧光定量PCR法进行流感病毒和新冠病毒核酸检测,应用FilmArray多重巢式PCR检测技术检测22种病原体。分析流感、新冠病毒实时荧光定量PCR检测结果,以及蚌埠市6~15岁儿童急性呼吸道感染病原体种类、不同月份急性呼吸道感染病原体构成、不同年龄段及性别急性呼吸道感染病原体检出情况、病原体检出特征。结果:1 625份送检标本,新冠检测全部阴性;流感检出阳性242例(14.89%),其中甲型季节性H3亚型阳性133例(8.18%),B型Victoria系阳性109例(6.71%)。233份6~15岁儿童标本,流感检出阳性23例(9.87%),其中甲型季节性H3亚型阳性4例(1.72%),B型Victoria系阳性19例(8.15%)。6~15岁儿童与全部人群的流感及亚型检出率比较差异无统计学意义(P>0.05)。80份呼吸道咽拭子标本中检出病原体28份(35.00%);检出7种病原体共32株,其中人鼻病毒/肠道病毒(37.50%)、B型流感病毒(34.38%)占比较高。2022年1—2月是B型流感流行高峰,其他病原体检测阳性率不同月份间比较,差异均无统计学意义(P>0.05)。不同年龄段、性别急性呼吸道感染病原体检出阳性率比较,差异无统计学意义(P>0.05)。28例检测阳性病例标本中,单一感染25例(89.29%),双重感染2例(7.14%),三重感染1例(3.57%),单一感染占比最高(P<0.001);检出病毒感染26例(92.86%),细菌2例(7.14%)。结论:人鼻病毒/肠道病毒和流感病毒是蚌埠市6~15岁儿童主要的急性呼吸道感染病原体,除流感病毒外,人鼻病毒等其他病原体不同时期检测阳性率比较,差异均无统计学意义。

2023年北京市朝阳区5家哨点医院呼吸道多病原监测分析

目的分析2023年北京市朝阳区5家哨点医院呼吸道多病原监测结果,及时掌握朝阳区呼吸道感染性疾病的流行特征。方法收集2023年1月至12月北京市朝阳区5家哨点医院1321例呼吸道患者,所有患者均采集咽拭子,使用多重荧光定量聚合酶链反应(PCR)进行检测甲型流感病毒、季节性甲3型流感病毒、新型甲型H1N1流感病毒、乙型流感病毒、乙型流感病毒BV系、乙型流感病毒BY系、新冠病毒N基因、新冠病毒ORF1ab基因、肺炎支原体、呼吸道合胞病毒、腺病毒、鼻病毒、副流感1型、副流感2型、副流感3型、副流感4型、人偏肺病毒、肠道病毒、冠状病毒HKU1、冠状病毒229E、冠状病毒OC43、冠状病毒NL63和肺炎衣原体。结果多病原检查结果显示,单一病原检测阳性标本633例,复合感染(≥2种病原体)检出76例。不同性别患者病原检出率相比较差异均无统计学意义(P>0.05);不同年龄患者腺病毒、呼吸道合胞病毒、肺炎支原体、新型冠状病毒、乙型流感病毒BV系、季节性甲3型流感病毒和人偏肺病毒相比较差异有统计学意义(P<0.05);不同季度鼻病毒、人偏肺病毒、肠道病毒和副流感2型检出率相比较差异无统计学意义(P>0.05),其他病原检出率相比较差异有统计学意义(P<0.05)。不同季节间年龄构成比相比较差异有统计学意义(P<0.05)。不同病例类型冠状病毒229E、季节性甲3型流感病毒、乙型流感病毒BV系和腺病毒检出率相比较差异有统计学意义(P<0.05),均容易引发急性上呼吸道感染。结论2023年北京市朝阳区呼吸道感染患者,病原检出率前5位是季节性甲3型流感病毒、肺炎支原体、呼吸道合胞病毒、新冠病毒和腺病毒,性别对病原检出率无显著影响,病原检出具有明显的年龄、季度和病例类型等相关特征。

住院儿童急性呼吸道感染常见病原体分布及流行病学特征分析

目的分析住院儿童急性呼吸道感染常见病原体在不同年龄阶段的感染情况及流行病学特征,为本地区ARI患儿的防治提供依据。方法收集2023年4月至2023年8月衢州市人民医院住院的ARI患儿鼻咽拭子标本1650份,采用实时荧光多重逆转录聚合酶链反应(RT-PCR)法进行6种常见呼吸道病原体检测。收集患儿一般信息,按性别和年龄(0~<12个月、1~<4岁、4~<7岁、7~14岁)分组,并分析病原体分布及流行特点。结果1650例患儿样本中有874例检出≥1种呼吸道病原体,检出率为53.0%。各病原体检出率:肺炎支原体(MP)28.1%、呼吸道合胞病毒(RSV)20.3%、人鼻病毒(HRV)4.7%、腺病毒(ADV)2.1%、甲型流感病毒(FluA)0.4%、乙型流感病毒(FluB)0.1%。有60例患儿以多重感染形式(≥2种病原体检出),多重感染最多的是RSV+HRV(30.0%),三重感染2例(3.3%)。不同年龄组间病原体检出差异有统计学意义(P<0.01)。7~14岁年龄段病原体检出率最高(63.7%),各年龄组间病原体检出率差异明显。单一病原体感染中,RSV以1~<4岁组患儿检出率最高(27.7%),MP以7~14岁组患儿检出率最高(57.7%),四组患儿间MP、RSV差异有统计学意义(P<0.05)。各类常见病原体在每月均有检出。结论MP、RSV是导致ARI住院儿童的主要病原体,且不同病原体检出率与住院患儿年龄密切相关。病原体的存在形式以单纯感染为主,多重感染中以双重感染为主。加强对呼吸道病原体的监测和扩大监测范围对儿童ARI防治至关重要。

2012—2021年海南地区儿童常见呼吸道病原体流行情况分析

目的分析海南省儿童急性呼吸道感染(acute respiratory tract infections,ARTI)常见呼吸道病原体的流行病学特征,为预防和诊治儿童AR TI提供参考。方法选择2012年3月—2021年12月在海南省多家医院儿科住院治疗的ARTI患儿,采用间接免疫荧光法检测患儿血清甲型流感病毒(FluA)、乙型流感病(FluB)、呼吸道合胞病毒(RSV)、腺病毒(ADV)、副流感病毒(PIV)、肺炎支原体(Mp)、肺炎衣原体(Cp)、嗜肺军团菌(Lp)、Q热立克次体(COX)9种病原体的IgM抗体,某种病原体IgM抗体阳性定义为该种病原体感染,对呼吸道感染病例的流行病学和临床资料进行回顾性分析。结果本研究符合入选条件患儿共59312例,IgM阳性患儿检出率为37.69%(22357/59312)。FluA、FluB、RSV、ADV、PIV的IgM阳性占总阳性率的35.23%(9953/28255);前3位病原体Mp、FluB、PIV阳性占IgM总阳性率86.54%(24451/28255),其检出率分别为28.58%(16953/59312)、9.50%(5636/59312)、3.14%(1862/59312)。4039例检出双重病原体,最常见的组合为Mp+FluB。各季节间比较,FluA、FluB、ADV、Cp和Lp在春季检出率最高,在秋季检出率最低;PIV、Mp和COX在夏季检出率最高,在冬季检出率最低。RSV在夏季检出率最高,在秋季检出率最低。2012—2021年期间2013年IgM阳性检出率最高(78.65%),2021年最低(15.72%),10年间各年检出率差异有统计学意义(P<0.001)。结论海南地区呼吸道病原体的流行各有其季节性,可以针对其流行特征制订相应的防护措施,应对儿童高发季节的呼吸道病原体感染。

成人与儿童下呼吸道感染患者的病原菌分布及耐药性分析

目的分析不同年龄段下呼吸道感染患者的病原菌检测结果及耐药特征。方法将本院2019年7月—2022年7月收治的120例下呼吸道感染患者纳入研究,其中儿童(4~14岁)共50例,成人(18~65岁)共70例,对其进行痰液分泌物检测,观察病原菌分布,选取应用较为广泛的几种抗生素,分析耐药性。结果在成人下呼吸道感染的病原菌中,革兰阴性菌所占比例为74.0%,而革兰阳性菌所占比例为17.5%。在儿童下呼吸道感染的病原菌中,革兰阴性菌所占比例为70.0%,革兰阳性菌所占比例为23.0%。针对下呼吸道感染患者革兰阴性菌的耐药性分析显示,在成人患者中,肺炎克雷伯菌对氨曲南、头孢哌酮、头孢曲松、头孢唑林等药物的耐药率超过50.0%,而对其他药物的耐药率相对较低。铜绿假单胞菌对阿莫西林/克拉维酸、氨曲南、头孢哌酮等药物的耐药率超过50%,而对其他药物的耐药率较低。在儿童群体中,肺炎克雷伯菌和大肠埃希菌对头孢哌酮的耐药率超过50.0%,而对其他药物的耐药率相对较低。针对下呼吸道感染患者中革兰阳性菌的耐药性分析显示,在成人患者中,金黄色葡萄球菌对头孢唑林和左氧氟沙星的耐药率超过50.0%,而肺炎链球菌仅对头孢唑林的耐药率超过50.0%。儿童中,金黄色葡萄球菌和肺炎链球菌对头孢唑林的耐药率均超过50.0%,而对其他药物的耐药率则较低。结论成人及儿童感染的病原菌类型及耐药情况有一定的差异,通过对这些因素的研究,可帮助临床医师针对不同人群开展针对性用药,保证良好的疗效。