2022—2024年上海市虹口区急性呼吸道感染监测病例病原特征分析

任小凡; 王海燕; 姚红; 忻郦菁; 杨吉星

doi:10.19428/j.cnki.sjpm.2026.250454

2022—2024年上海市虹口区急性呼吸道感染监测病例病原特征分析

Analyses of Etiological characteristics of surveillance cases with acute respiratory infection in Hongkou District of Shanghai from 2022 to 2024

摘要

摘要: 【目的】分析2022—2024年上海市虹口区急性呼吸道感染监测病例病原特征，为呼吸道传染病防控及临床诊断治疗提供依据。【方法】采集在2022—2024年虹口区3家哨点医院就诊的1 471名急性呼吸道感染监测病例呼吸道样本，采用多重实时荧光聚合酶链反应技术对31种呼吸道感染病原体开展核酸检测，并对结果进行分析。【结果】 1 471例急性呼吸道感染监测病例的病原体检出率为39.97%（588/1471），病原体以病毒为主，其中检出率最高的为新型冠状病毒（13.94%，205/1471）、流感病毒（13.12%，193/1471）和副流感病毒（2.52%，37/1471）。2022年后病原体检出率有明显上升，且检出病原体种类数逐年增加，冬季病原体的检出率最高（46.48%，165/355）。流感样病例（ILI）的检出率（50.68%，387/764）高于严重急性呼吸道感染（SARI）病例（28.43%，201/707）(χ²=75.59，P<0.001)。新型冠状病毒(χ²=25.53，P<0.001)、流感病毒(χ²=71.64，P<0.001)及腺病毒(χ²=7.65，P=0.006)的检出率在ILI中更高，而肺炎克雷伯菌(χ²=10.08，P=0.002)、肺炎支原体(χ²=5.50，P=0.019)的检出率在SARI病例中更高。未成年组的检出率（56.00%，28/50）在全年龄组中最高。2种及以上病原体混合检出43例，占全部阳性检出的7.31%，以病毒细菌混合检出占比最高（55.81%，24/43），多数为2种病原体的混合检出。【结论】流感病毒和新型冠状病毒是2022—2024年虹口区急性呼吸道感染监测病例的主要流行病原体，不同病原体在不同病例类型、季节和年龄中存在差异，应当持续开展急性呼吸道感染监测病例的病原学监测和分析工作。

Abstract: Objective To analyze the etiological characteristics of surveillance cases with acute respiratory infections in Hongkou District of Shanghai from 2022 to 2024, and to provide a basis for the prevention and control of respiratory infectious diseases as well as clinical diagnosis and treatment. Methods Respiratory samples were collected from 1 471 acute respiratory infection surveillance cases who visited 3 sentinel hospitals in Hongkou District from 2022 and 2024. Nucleic acid detection of 31 types of respiratory pathogens was performed using multiplex real-time fluorescence polymerase chain reaction (RT-PCR) technology, and the results were analyzed. Results The overall pathogen detection rate among the 1 471 cases was 39.97%, with viruses being the predominant pathogens and the highest detection rates for SARS-CoV-2 (13.94%, 205/1471), influenza virus (13.12%, 193/1471) and parainfluenza virus (2.52%, 37/1471). The detection rate rose markedly from 2022 onwards, with the number of pathogen types detected showing a year-on-year increase. The pathogen detection rate was the highest in winter (46.48%, 165/355). The detection rate was significantly higher in influenza-like illness cases (50.68%，387/764) than in severe acute respiratory infection cases (28.43%，201/707) (χ²=75.59，P<0.001). Higher detection rates in ILI cases were observed for SARS-CoV-2 (χ²=25.53, P<0.001), influenza virus (χ²=71.64, P<0.001), and adenovirus (χ²=7.65, P=0.006). In contrast, Klebsiella pneumoniae (χ²=10.08, P=0.002) and Mycoplasma pneumoniae (χ²=5.50, P=0.019) had higher detection rates among SARI cases. The minor age group had the highest detection rate (56.00%,28/50) among all age groups. A total of 43 cases of co-detection with two or more pathogens were identified, accounting for 7.31% of all positive cases. Among these cases, viral-bacterial co-detection accounted for the highest proportion (55.81%, 24/43), and most of them were co-detections with two pathogens. Conclusion Influenza virus and SARS-CoV-2 were the main epidemic pathogens for acute respiratory infection cases in Hongkou District from 2022 to 2024. Pathogen distribution varied across case types, seasons, and age groups. Continuous etiological monitoring and analyses for ARI cases should be carried out.

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