广州地区2017—2022年儿童呼吸道感染疾病负担及常见病原体流行特征  

Disease burden and epidemic characteristics of pathogens causing acute respiratory infection in children in Guangzhou City,2017-2022

作　　者：李静静[1] 黄建英[1] 刘妙玲[1] 肖苑红 王珂 邹晓妮[1] LI Jing-jing;HUANG Jian-ying;LIU Miao-ling;XIAO Yuan-hong;WANG Ke;ZOU Xiao-ni(Department of Healthcare-associated Infection Management,Guangdong Women and Children Hospital,Guangzhou 511442,China)

机构地区：[1]广东省妇幼保健院医院感染管理科,广东广州511442

出　　处：《中国感染控制杂志》2023年第1期44-51,共8页Chinese Journal of Infection Control

基　　金：广东省医学科研基金指令性课题项目(C2022039)。

摘　　要：目的分析与探讨广州地区儿童急性呼吸道感染的疾病负担与常见病原体流行特征。方法以2017—2022上半年广州市某院收治的18542例因急性呼吸道感染住院儿童为研究对象,采用间接免疫荧光法检测患儿血清中抗呼吸道合胞病毒(RSV)、腺病毒(ADV)、甲型流感病毒(IFV-A)、乙型流感病毒(IFV-B)、副流感病毒(PIV)、嗜肺军团菌(LP)、肺炎支原体(MP)及肺炎衣原体(CP)8项常见病原体IgM抗体。应用SPSS 22.0软件对数据进行统计分析。结果18542例急性呼吸道感染住院患儿平均住院7 d,平均住院总费用(中位数)为5870.93元,~1岁患儿的住院总费用较高。18542例患儿中,10214例至少感染一种病原体,检出率为55.09%。男童检出率(52.31%)低于女童(59.77%),2017—2019年总检出率及混合感染率高于2020—2021年,高年龄组患儿总检出率及混合感染率高于低年龄组。4973例为混合感染,以IFV-A+IFV-B+MP(1033例)及IFV-A+IFV-B(1022例)合并感染为主。病原体检出率前三分别为IFV-B(27.27%)、MP(25.47%)、IFV-A(21.24%)。RSV检出率随年龄增长逐渐降低,LP、CP及MP检出率随年龄增长逐渐升高;ADV在~3岁组检出率最高,IFV及PIV在~5岁组检出率最高。CP和RSV在夏秋季高发,其余6种病原体检出率无明显季节依赖性。结论广州地区急性呼吸道感染住院患儿病原体分布具有年龄和季节性特征,应采取措施降低低龄儿童肺炎发病率,减少儿童急性呼吸道感染的疾病负担。Objective To analyze the disease burden and epidemic characteristics of major pathogens causing acute respiratory infection(ARI)in children in Guangzhou City.Methods In 2017.01-2022.06,18542 hospitalized children with ARI in a hospital in Guangzhou City were taken as the research objects.Serum IgM antibodies against 8 common pathogens,including respiratory syncytial virus(RSV),adenovirus(ADV),influenza virus A(IFV-A),influenza virus B(IFV-B),parainfluenza virus(PIV),Legionella pneumophila(LP),Mycoplasma pneumo-niae(MP)and Chlamydia pneumoniae(CP),were detected by indirect immunofluorescence method.SPSS 22.0 software was used for statistical analysis.Results The average length of hospital stay of 18542 children with ARI was 7 days,and the median of total hospitalization expense was 5870.93 Yuan.The total hospitalization expense of children in the-1-year-old group was the highest.Among 18542 children,10214 were infected with at least one pathogen,with a detection rate of 55.09%.Detection rate in boys(52.31%)was lower than that in girls(59.77%).The total detection rate and co-infection rate in 2017-2019 were higher than those in 2020-2021,and those in elder group were higher than in younger group.4973 children were co-infected,mostly with IFV-A+IFV-B+MP(n=1033)and IFV-A+IFV-B(n=1022).The top three pathogens with the highest detection rates were IFV-B(27.27%),MP(25.47%)and IFV-A(21.24%).Detection rate of RSV decreased with the increase of age,and detection rate of LP,CP and MP increased with the increase of age.Detection rate of ADV peaked in children in the-3-year-old group,while detection rates of IFV and PIV were the highest in the-5-year-old group.CP and RSV occurred frequently in summer and autumn,however,detection rates of the other 6 pathogens showed no obvious seasonal dependence.Conclusion Pathogens causing ARI in children in Guangzhou City have different age di-stribution and seasonal epidemic characteristics.Measures should be taken to reduce the incidence of pneumonia in younger children,so as to ease the

关 键 词：急性呼吸道感染 病原体 疾病负担 流行特征 

分 类 号：R181.32[医药卫生—流行病学]