<b>2020</b>—<b>2023</b>年浙江省绍兴市老年急性上呼吸道感染患者病原学流行特征

章正浩; 叶珂雯; 阮四维

doi:10.19428/j.cnki.sjpm.2024.23887

2020—2023年浙江省绍兴市老年急性上呼吸道感染患者病原学流行特征

Pathogen epidemic characteristics of acute upper respiratory tract infection among the elderly patients in Shaoxing City， Zhejiang Province from 2020 to 2023

摘要

摘要:
目的监测分析2020—2023年浙江省绍兴市老年急性上呼吸道感染病例病原体流行特征，以指导老年人急性上呼吸道病原体感染的合理防治。
方法采集2020年1月—2023年12月因急性上呼吸道感染在绍兴市传染病监测哨点医院传染病门诊就诊的老年患者的鼻咽拭子标本，采用多重核酸检测法检测甲型流感病毒（Flu A）、乙型流感病毒（Flu B）、呼吸道合胞病毒（RSV）、人鼻病毒（HRV）、腺病毒（ADV）和肺炎支原体（MP），对以上6种病原体进行流行病学分析。统计学分析采用χ²检验。
结果共采集年龄60~89岁的老年患者急性上呼吸道感染鼻咽拭子样本3 670份，检测结果显示阳性2 330例，阳性检出率为63.49%。2 293例为单一病原体感染（简称“单一感染”），包括Flu A阳性1 255例，Flu B阳性356例，ADV阳性63例，RSV阳性76例，HRV阳性363例，MP阳性180例。Flu A、Flu B、ADV、RSV、HRV、MP的检出率分别为34.20%、9.70%、1.72%、2.07%、9.89%和4.90%。2种及以上病原体混合感染37例，阳性检出率为1.01%。混合感染重症率高于单一感染（χ²=24.468，P<0.001）。单一感染病例中，重症率最高为ADV感染，达4.76%；其次是Flu A和RSV，分别为3.19%和2.63%；重症率最低的是MP感染，为0.56%。上述6种呼吸道病原体感染重症病例分布均与其流行高峰相对应。
结论老年急性上呼吸道感染与不同呼吸道病原体感染密切相关，且多种呼吸道病原体混合感染可能提高老年患者呼吸道疾病重症率。

Abstract:
Objective To monitor and analyze the epidemiological characteristics of viral pathogens among elderly patients with acute upper respiratory tract infections in Shaoxing City from 2020 to 2023, to guide prevention and treatment.
Methods Nasopharyngeal swab samples were collected from elderly patients at the Infectious Disease Outpatient Department of Shaoxing infectious disease surveillance sentinel hospital for acute upper respiratory tract infections between January 2020 and December 2023. The multiple nucleic acid detection method was used to detect the influenza A virus (Flu A), influenza B virus (Flu B), respiratory syncytial virus (RSV), human rhinovirus (HRV), adenoviruses (ADV), and Mycoplasma pneumoniae (MP). Epidemiological analysis was conducted on the six pathogens mentioned above. χ2 test was used for statistical analysis.
Results Of the 3 670 nasopharyngeal swab samples collected from the elderly patients with acute upper respiratory tract infections aged 60-89,2 330 were positive, with a detection rate of 63.49%. Among these, 2 293 were single pathogen infections, including 1 255 Flu A, 356 Flu B, 63 ADV, 76 RSV, 363 HRV, and 180 MP cases, with positive rates of 34.20%, 9.70%, 1.72%, 2.07%, 9.89%, and 4.90%, respectively. A total of 37 cases were mixed infections with two or more pathogens, with a positive detection rate of 1.01%. The rate of severe cases was significantly higher in patients with mixed infections compared to single pathogen infections (χ2=24.468, P<0.001). Among the single pathogen infections, ADV had the highest rate of severe cases at 4.76%, followed by Flu A at 3.19% and RSV at 2.63%. The lowest rate of severe cases was caused by MP infection at 0.56%. The distribution of severe cases of the six respiratory pathogen infections corresponded to their epidemic peaks.
Conclusion Acute upper respiratory tract infections in the elderly are closely related to different respiratory pathogens, and mixed respiratory pathogen infections may increase the severity of respiratory cases in elderly patients.

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