2015-2019年北京市肺炎衣原体流行特征分析  

Epidemiological characteristics of Chlamydia pneumoniae in cases with acute respiratory infection in Beijing,2015-2019

作　　者：罗明[1] 龚成[1] 罗琴 李爱华[1] 王雪 李茂中[1] 谢会 王怡婷 张合润[1] 黄芳[1] Luo Ming;Gong Cheng;Luo Qin;Li Aihua;Wang Xue;Li Maozhong;Xie Hui;Wang Yiting;Zhang Herun;Huang Fang(Department of Immunization,Beijing Center for Disease Prevention and Control/Beijing Research Center for Preventive Medicine,Beijing 100013,China;School of Public Health,Capital Medical University,Beijing 100069,China)

机构地区：[1]北京市疾病预防控制中心免疫预防所/北京市预防医学研究中心,100013 [2]首都医科大学公共卫生学院,北京100069

出　　处：《中华流行病学杂志》2021年第8期1466-1474,共9页Chinese Journal of Epidemiology

基　　金：急性呼吸道传染病病原谱和流行规律及重要病原变异变迁特征研究(2017ZX10103004)。

摘　　要：目的分析北京市2015-2019年急性呼吸道感染患者中肺炎衣原体感染者的流行特征。方法利用北京市呼吸道病原体监测系统,收集全市35家哨点医院就诊的急性呼吸道感染患者流行病学资料,采集临床标本开展肺炎衣原体检测,并对阳性标本ompA基因的VD4区序列做进化分析。结果2015-2019年,北京市急性呼吸道感染就诊患者中肺炎衣原体总体阳性率为0.34%(129/37460),肺炎衣原体阳性率在每年3月升高,5月达到峰值,7月回落,持续时间约5-8个月,不同年份流行季可能提前或推迟1-2个月;每年流行季肺炎衣原体月阳性率均≥0.30%。5-44岁人群高发,其中10-14岁组肺炎衣原体阳性率最高;<25岁患者中,随年龄增加,感染肺炎衣原体的风险增加,≥25岁患者,随年龄增加,感染肺炎衣原体的风险降低;男、女性患者阳性率分别为0.33%(68/20830)和0.37%(61/16528),组间差异无统计学意义(χ^(2)=0.486,P=0.486);普通肺炎患者中的肺炎衣原体阳性率高于上呼吸道感染患者与重症肺炎患者(χ^(2)=36.797,P<0.01);40.31%(52/129)肺炎衣原体感染者标本中检出≥1种其他呼吸道病原体,排名前4位依次是:流感嗜血杆菌(15份)、肺炎链球菌(13份)、鼻病毒(8份)、嗜麦芽窄食单胞菌(7份);129份肺炎衣原体阳性标本中的101株经测序鉴定均为A型。结论北京市肺炎衣原体每年呈单峰流行模式,流行季一般为3-7月,流行季节特征可用于与其他呼吸道病原体的鉴别诊断,5-44岁人群好发,基因型以A型为主;如果连续2个月肺炎衣原体核酸阳性率超过0.30%,可初步认为进入肺炎衣原体高流行期;肺炎衣原体感染发生肺炎后进展为重症肺炎的概率较高。Objective To analyze the epidemiological characteristics of Chlamydia pneumoniae infection among patients with acute respiratory infection in Beijing from 2015 to 2019.Methods The epidemiological data of acute respiratory infection patients from 35 sentinel hospitals in Beijing were collected by the respiratory pathogen surveillance system in Beijing.The clinical samples were collected to detect Chlamydia pneumoniae,and the sequence of the VD4 region of the ompA gene in positive samples was analyzed.Results From January 2015 to December 2019,the overall positive rate of Chlamydia pneumoniae among patients with acute respiratory infection in Beijing was 0.34%(129/37460).The positive rate of Chlamydia pneumoniae generally increased in March,reaching the peak in May,and started to drop in July,with a duration of about 5-8 months.The epidemic season in different years fluctuated by 1-2 months.The positive monthly rate of Chlamydia pneumoniae was no less than 0.30%in every epidemic season.The positive rate of Chlamydia pneumoniae was the highest in the 5-44 years old group and the highest in 10-14 year-olds.The risk of Chlamydia pneumoniae infection increased with age in patients younger than 25 years old and decreased in those older one aged than 25 years of age.The positive rates in male and female patients were 0.33%(68/20830)and 0.37%(61/16528),respectively,and there was no significant difference between the two groups(χ^(2)=0.486,P=0.486).The positive rate of Chlamydia pneumoniae in patients with common pneumonia was higher than that in patients with upper pneumonia and severe pneumonia(χ^(2)=36.797,P<0.01).Other respiratory pathogens were also detected in the Chlamydia pneumoniae samples,and the top four pathogens appeared as Haemophilus influenzae(15 cases),Streptococcus pneumoniae(13 cases),Rhinovirus(8 cases),and Stenotrophomonas maltophilia(7 cases).101 strains of 129 Chlamydia pneumoniae positive samples were identified as type A by sequencing.Conclusions The annual epidemic pattern of Chlamydia pneumonia

关 键 词：急性呼吸道感染 肺炎衣原体 流行特征 基因型 

分 类 号：R563.1[医药卫生—呼吸系统] R181.3[医药卫生—内科学]