2014-2017年北京市怀柔区急性呼吸道病毒感染病例流行病学分析
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摘要
目的了解怀柔地区呼吸道病毒感染的病原学和流行病学特征,为临床诊断和治疗提供参考。方法选取2014年8月至2017年12月北京怀柔医院就诊的门诊或住院呼吸道感染患者的咽拭子,应用实时荧光PCR方法对8种呼吸道病毒(包括亚型共14种)进行检测和分析。结果对911份样本进行检测,检出阳性样本244例,阳性率26.78%;病毒感染率前五位的依次为季节性甲型H3N2流感病毒71份(7.79%)、乙型流感病毒34份(3.73%)、副流感病毒31份(3.40%)、鼻病毒25份(2.74%)、呼吸道合胞病毒23份(2.52%)。≤14岁儿童中呼吸道病毒阳性检出率较高,其中2～岁组阳性率最高,为35.66%,不同年龄组人群呼吸道病毒检出率差异有统计学意义(χ~2=21.31,P=0.00)。不同季节吸道病毒检出率不同(χ~2=43.96,P<0.01),冬季最高(42.41%),其次是春季和秋季。流感病毒、RSV和人偏肺病毒感染主要发生在每年的冬春季,PIV感染主要发生在夏秋季。呼吸道病毒在上呼吸道感染病例(31.76%)中的检出率高于下呼吸道感染病例(24.71%)(χ~2=4.44,P=0.04)。结论 14岁及以下儿童呼吸道病毒感染率较高,是防控的重点人群;呼吸道病毒感染呈现一定的季节性特征,冬春季高发。
Objective To understand the epidemiological and etiological characteristics of acute respiratory viral infections in Huairou district of Beijing. Methods Nasopharyngeal swabs were collected from outpatients and inpatients with respiratory infections in Beijing Huairou hospitals from August 2014 to December 2017.Real-time PCR was applied to detect 8 types of respiratory viruses(14 subtypes). Results A total of 911 samples were collected and tested, 244 samples were positive with the positive rate of 26.78%.The top five common viruses identified were FluA(H3 N2)(7.79%, 71/911), FluB(3.73%, 34/911), PIV(3.40%, 31/911), RV(2.74%, 25/911) and RSV(2.52%, 23/911).The positive rate of respiratory viruses varied significantly among subjects in different age group(χ~2=21.31, P=0.00) with the highest of 35.66% in children of 2-4 years old.It also varied significantly in different season(χ~22=43.96, P<0.01) with the highest of 42.41% in winter.Cases with influenza virus, RSV and hMPV infections mainly appeared in winter and spring, while those with PIV infection usually appeared in summer and autumn.The positive rate of respiratory viruses in patients of upper airway infection was higher than that in patients of lower airway infection(31.76% vs 24.71%; χ~2=4.44, P=0.04). Conclusions Children under 15 years old are more susceptible to respiratory viruses with higher infection rate.The incidence of respiratory viral infection is higher in winter and spring.
Objective To understand the epidemiological and etiological characteristics of acute respiratory viral infections in Huairou district of Beijing. Methods Nasopharyngeal swabs were collected from outpatients and inpatients with respiratory infections in Beijing Huairou hospitals from August 2014 to December 2017.Real-time PCR was applied to detect 8 types of respiratory viruses(14 subtypes). Results A total of 911 samples were collected and tested, 244 samples were positive with the positive rate of 26.78%.The top five common viruses identified were FluA(H3 N2)(7.79%, 71/911), FluB(3.73%, 34/911), PIV(3.40%, 31/911), RV(2.74%, 25/911) and RSV(2.52%, 23/911).The positive rate of respiratory viruses varied significantly among subjects in different age group(χ~2=21.31, P=0.00) with the highest of 35.66% in children of 2-4 years old.It also varied significantly in different season(χ~22=43.96, P<0.01) with the highest of 42.41% in winter.Cases with influenza virus, RSV and hMPV infections mainly appeared in winter and spring, while those with PIV infection usually appeared in summer and autumn.The positive rate of respiratory viruses in patients of upper airway infection was higher than that in patients of lower airway infection(31.76% vs 24.71%; χ~2=4.44, P=0.04). Conclusions Children under 15 years old are more susceptible to respiratory viruses with higher infection rate.The incidence of respiratory viral infection is higher in winter and spring.
引文
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[15] 毛晓健,曾其毅,陈焕辉,等.2005-2007 年广州地区住院肺炎患儿呼吸道合胞病毒感染分析[J].实用儿科临床杂志,2009,24(10):745-747.
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[19] 冯录召,赖圣杰,李夫,等.2009-2012年我国6省(市)5岁以下儿童住院肺炎病例的病毒病原学分析[J].中华流行病学杂志,2014,35(6):646-649.
[20] 许晶,张蕾,史伟,等.西安市儿童呼吸道病毒感染谱分析[J].中华疾病控制杂志,2015,19(7):663-666.
[21] 耿佳,郭万亮,张学兰.苏州儿童医院住院儿童呼吸道合胞病毒流行特点及与气候因素相关性研究[J].中国当代儿科杂志,2015,17(5):482-486.
[22] Yusuf S,Piedimonte G,Auais A,et al.The relationship of meteorological conditions to the epidemic activity of respiratory syncytial virus[J].Paediatric Res Rev,2007,135(7):1077-1090.
[23] du Prel J,Puppe W,Gr ndahl B,et al.Are meteorological parameters associated with acute respiratory tract infections?[J].Clin Infect Dis,2009,49(6):861-868.
[2] Weber MW,Mulholland EK,Greenwood BM.Respiratory syncytial virus infection in tropical and developing countries[J].Trop Med Int Health,1998,3(4):268-280.
[3] Lowther SA,Shay DK,Holman RC,et al.Bronchiolitis-associated hospitalizations among American Indian and Alaska Native children[J].Pediatr Infect Dis J,2000,19(1):11-17.
[4] 吴茜,倪林仙,李杨芳,等.昆明地区2457例小儿急性下呼吸道感染病原学研究[J].中国小儿急救医学,2007,14(6):485-488.
[5] 雷小英.2009-2011年重庆地区儿童呼吸道病毒感染流行特征分析[D].重庆:重庆医科大学,2012.
[6] 张业成.2010-2015年武汉及周边地区发热呼吸道感染病毒病原学研究[D].武汉:武汉大学,2017.
[7] 王世斌,赵建忠,董晓根.北京市丰台地区呼吸道病毒感染病原学研究[J].蚌埠医学院学报,2013,38(8):1056-1059.
[8] Chan PK,Tam WW,Lee TC,et al.Hospitalization incidence,mortality,and seasonality of common respiratory viruses over a period of 15 years in a developed subtropical city[J].Medicine (Baltimore),2015,94(46):e2024.
[9] Weinberg GA,Hall CB,Iwane MK,et al.Parainfluenza virus infection of young children:estimates of the population-based burden of hospitalization[J].J Pediatr,2009,154(5):694-699.
[10] Fabbiani M,Terrosi C,Martorelli B,et al.Epidemiological and clinical study of viral respiratory tract infections in children from Italy[J].J Med Virol,2009,81(4):750-756.
[11] 何静,龚燕,张万菊,等.2009～2010年上海地区急性呼吸道感染病毒病原谱分析[J].微生物与感染,2011(2):90-96.
[12] Kliegman RM,Stanton BMD,Geme JS,et al.Nelson Textbook of Pediatrics[M].17th edition.Beijing:Peking University Medical Press,2007:1359-1365.
[13] 王莉佳,刘恩梅,赵晓东,等.重庆医科大学儿童医院急性呼吸道感染住院患儿病毒病原学分析[J].中国实用儿科杂志,2005,20(12):735-737.
[14] 曾玫,王晓红,俞蕙,等.上海地区儿童急性呼吸道病毒感染的流行特征[J].中华传染病杂志,2008,26(9):527-532.
[15] 毛晓健,曾其毅,陈焕辉,等.2005-2007 年广州地区住院肺炎患儿呼吸道合胞病毒感染分析[J].实用儿科临床杂志,2009,24(10):745-747.
[16] Nair H,Nokes DJ,Gessner BD,et al.Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children:a systematic review and meta-analysis[J].Lancet,2010,375(9725):1545-1555.
[17] Iwane MK,Edwards KM,Szilagyi PG,et al.Population-based surveillance for hospitalizations associated with respiratory syncytial virus,influenza virus,and parainfluenza viruses among young children[J].Pediatrics,2004,113(6):1758-1764.
[18] Huo X,Fang B,Liu L,et al.Clinical and dpidemiologic characteristics of respiratory syncytial virusInfection among children aged <5 years,jingzhou city,China,2011[J].The J Infec Dis,2013,208(3):S184-S188.
[19] 冯录召,赖圣杰,李夫,等.2009-2012年我国6省(市)5岁以下儿童住院肺炎病例的病毒病原学分析[J].中华流行病学杂志,2014,35(6):646-649.
[20] 许晶,张蕾,史伟,等.西安市儿童呼吸道病毒感染谱分析[J].中华疾病控制杂志,2015,19(7):663-666.
[21] 耿佳,郭万亮,张学兰.苏州儿童医院住院儿童呼吸道合胞病毒流行特点及与气候因素相关性研究[J].中国当代儿科杂志,2015,17(5):482-486.
[22] Yusuf S,Piedimonte G,Auais A,et al.The relationship of meteorological conditions to the epidemic activity of respiratory syncytial virus[J].Paediatric Res Rev,2007,135(7):1077-1090.
[23] du Prel J,Puppe W,Gr ndahl B,et al.Are meteorological parameters associated with acute respiratory tract infections?[J].Clin Infect Dis,2009,49(6):861-868.