<b>2021</b>—<b>2023</b>年苏州市住院患儿部分呼吸道病毒感染的流行病学特征

赵旭; 洪礼义; 高涵昌; 王清华

doi:10.19428/j.cnki.sjpm.2024.24076

2021—2023年苏州市住院患儿部分呼吸道病毒感染的流行病学特征

Epidemiological characteristics of respiratory virus infection among hospitalized children in Suzhou City， 2021‒2023

摘要

摘要:
目的分析2021—2023年苏州市因急性呼吸道感染（ARTI）住院中儿童常见非细菌性病原体的分布特征，为儿童ARTI防治工作提供相应依据。
方法回顾性选取2021年9月—2023年7月于苏州大学附属儿童医院内科病房治疗的ARTI住院患儿14 953例，运用实时荧光定量聚合酶链反应（RTFQ⁃PCR）与毛细管电泳联用技术检测咽拭子标本中的13种呼吸道病原体，分析不同病原体的分布特征。
结果 ARTI住院患儿呼吸道病原体总体检出率为76.23%（11 398/14 953），其中单一感染检出率为75.10%（8 560/11 398），混合感染检出率为24.90%（2 838/11 398）。病原体检出率排名前3位的病原体依次为鼻病毒23.35%（3 492/14 953）、呼吸道合胞病毒（RSV）19.53%（2 920/14 953）、肺炎支原体（MP）13.31%（1 990/14 953）。男童中人博卡病毒、鼻病毒检出率高于女童（P=0.008，P<0.01），但MP检出率低于女童（P<0.001）。年龄<1岁患儿RSV、CP检出率最高，1~岁患儿副流感病毒、人博卡病毒、鼻病毒、腺病毒、冠状病毒检出率最高，3~岁患儿甲型流感病毒、甲型H1N1流感病毒、甲型H3N2流感病毒、人偏肺病毒检出率最高；6~岁患儿乙型流感病毒、MP检出率最高。春季（3—5月）甲型流感病毒、甲型H1N1流感病毒、RSV检出率最高；夏季（6—8月）甲型H3N2流感病毒、MP检出率最高；秋季（9—11月）副流感病毒、人博卡病毒、鼻病毒、人偏肺病毒检出率最高；冬季（12—次年2月）乙型流感病毒检出率最高。不同疾病类型呼吸道病毒检出率不同（χ²=220.280，P<0.001），差异有统计学意义。其中支气管炎、支气管肺炎患儿呼吸道病毒检出率较高，分别达79.15%和78.83%。支气管炎、支气管肺炎和重症肺炎患儿检出病原体最多的均是鼻病毒（42.71%、22.58%、23.19%）。
结论苏州地区近年儿童呼吸道感染主要以病毒感染为主，其中鼻病毒、RSV、MP为主要感染病原体，呼吸道病原体检出率呈一定年龄、季节特征。

Abstract:
Objective To analyze the distribution characteristics of common non-bacterial pathogens in hospitalized children with acute respiratory tract infection(ARTI) in Suzhou from 2021 to 2023, and to provide a basis for the prevention and treatment of children with ARTI.
Methods A total of 14 953 patients with ARTI admitted to the internal medicine ward of the Children’s Hospital of Soochow University from September 2021 to July 2023 were retrospectively selected. Multiple RTFQ-PCR and capillary electrophoresis were used to detect 13 respiratory pathogens from throat swab samples, and the pathogen distribution was analyzed.
Results The total detection rate of respiratory virus in the 14 953 hospitalized children with ARTI was 76.23% (11 398/14 953). Single infection accounted for 75.10% (8 560/11 398), while mixed infection accounted for 24.90% (2 838/11 398). The top three pathogens detected were rhinovirus (23.35%, 3 492/14 953), respiratory syncytial virus (19.53%, 2 920/14 953), and Mycoplasma pneumoniae(MP) (13.31%, 1 990/14 953). The detection rate of human Bocavirus and rhinovirus were higher in boys than that in girls (P=0.008, P<0.001), while the detection rate of MP was higher in girls than that in boys (P<0.01). The detection rates of RSV and Chlamydia pneumoniae (CP) were the highest in children under 1 year of age. Parainfluenza virus human, Bocavirus, rhinovirus, adenovirus and coronavirus were most commonly detected in children aged between 1‒3 years. The detection rates of influenza A virus, influenza A (H1N1) virus, influenza A (H3N2) virus and metapenu⁃movirus were the highest in children aged between 3‒6 years. The detection rates of influenza B virus and MP were the highest in children older than 6 years. The detection rates of influenza A virus, influenza A (H1N1) virus and RSV were the highest in spring. The detection rates of influenza A (H3N2) virus and MP were the highest in summer. The detection rates of parainfluenza virus, human Bocavirus, rhinovirus and metapenu-movirus were the highest in autumn. The detection rate of influenza B virus was the highest in winter. The detection rate of respiratory tract viruses varied by type of disease, and the difference is statistically significant (χ²=220.280, P<0.001). The positive rate of respiratory tract virus was 79.15% and 78.83% in patients with bronchitis and bronchopneumonia, respectively. Rhinovirus was the most commonly detected pathogen in patients with bronchitis (42.71%), bronchopneumonia (22.58%), and severe pneumonia (23.19%).
Conclusion In recent years, respiratory tract infections in children in the Suzhou area have primarily been viral infections, with rhinovirus, RSV and MP being the main pathogens. The detection rates of respiratory pathogens vary by age and season.

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