2022—2023年承德市呼吸道合胞病毒的暴发流行及其临床特征研究  被引量:3

Outbreak and clinical features of respiratory syncytial virus in Chengde from 2022 to 2023

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作  者:马倩格 高姝畅 郭心悦 严梦瑶 户祖熙 谢广成[2] 李涛 Ma Qiange;Gao Shuchang;Guo Xinyue;Yan Mengyao;Hu Zuxi;Xie Guangcheng;Li Tao(Department of Pediatrics,the Second Clinical Medical School of Chengde Medical University,Chengde 067000,China;Department of Pathogenic Biology,Chengde Medical University,Chengde 067000,China)

机构地区:[1]承德医学院第二临床学院儿科,承德067000 [2]承德医学院病原生物学教研室,承德067000

出  处:《中华微生物学和免疫学杂志》2024年第2期155-161,共7页Chinese Journal of Microbiology and Immunology

基  金:国家重点研发计划(2022YFC3500802)。

摘  要:目的确定呼吸道合胞病毒(respiratory syncytial virus,RSV)在承德市的流行情况及临床特征。方法收集2022年8月—2023年6月因呼吸道感染在承德市中心医院儿科住院治疗的患儿咽拭子478份及其临床信息,实时定量PCR检测A亚型和B亚型RSV的分子流行情况,对RSV感染患者的临床特征进行分析。结果67.57%(323/478)的住院患儿为RSV阳性,RSV呈暴发流行且均为RSV-A型,2022年11—12月和2023年5—6月为RSV-A型的2次感染高峰。RSV-A型阳性患儿中,86.07%(278/323)为合并其他病原体检出病例,其中与细菌共检出的例数最多,以肺炎链球菌为主,肺炎克雷伯菌次之。流感病毒A型是最常见的共检出病毒。与RSV-A型共检出患儿组相比,RSV-A型单独检出组的乳酸脱氢酶(Z=2.396,P=0.017)较高,且高于正常高值;RSV-A型共检出组的白细胞计数(Z=2.417,P=0.016)、中性粒细胞比例(Z=3.218,P=0.001)、C-反应蛋白(Z=1.998,P=0.046)和肌酐(Z=2.107,P=0.035)较高,淋巴细胞比例(Z=3.205,P=0.001)较低,但位于正常值范围。RSV-A型合并检出细菌或其他病毒的患儿临床特征无差异(P均>0.05)。结论RSV-A型是承德市2022—2023年呼吸道感染患儿的主要病原体,且多与细菌共检出。RSV-A型检测阳性患儿的临床特征与RSV-A型是否合并其他呼吸道病原体情况相关。Objective To analyze the prevalence and clinical features of respiratory syncytial virus(RSV)in Chengde city.Methods From August 2022 to June 2023,throat swabs and clinical data of 478 hospitalized children with respiratory tract infection in the Chengde Central Hospital were collected.Real-time quantitative PCR was used to detect the molecular epidemiology of RSV-A and RSV-B subtypes and analyze the clinical features of patients with RSV infection.Results Among the hospitalized children,67.57%(323/478)tested positive for RSV.The outbreak of RSV infection was caused by RSV-A subtype.The peaks of RSV-A infection occurred from November to December,2022 and May to June,2023.There were 86.07%(278/323)of the RSV-A-positive cases had mixed infection with other pathogens,primarily bacterial pathogens with Streptococcus pneumoniae being the most common,followed by Klebsiella pneumoniae.Influenza virus A was the most common viral pathogens causing mixed infection.The level of lactate dehydrogenase was higher in the patients with single RSV-A infection than in those with mixed infection(Z=2.396,P=0.017),and higher than the normal upper limit.Compared with the single infection group,the mixed infection group had higher white blood cell count(Z=2.417,P=0.016),neutrophil ratio(Z=3.218,P=0.001),C-reactive protein level(Z=1.998,P=0.046)and creatinine level(Z=2.107,P=0.035),and lower lymphocyte ratio(Z=3.205,P=0.001),but they were all within the normal range.There were no significant differences in the clinical features between RSV-A-positive patients co-infected with bacteria or other viruses(all P>0.05).Conclusions RSV-A is the leading cause of respiratory tract infection in children in Chengde from 2022 to 2023,and often co-detected with bacteria.The mixed infection with other respiratory pathogens is related to the clinical features of patients with RSV-A infection.

关 键 词:呼吸道合胞病毒 流行特征 临床特征 儿童 

分 类 号:R725.6[医药卫生—儿科]

 

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