2020—2021年武汉市596例急性呼吸道感染患者病原谱研究  

Pathogenic spectrums of 596 patients with acute respiratory tract infections in Wuhan City,2020-2021

作　　者：吴奕璇 李瑶 孔雯骅[1] 张祎婕 刘满清[1] WU Yixuan;LI Yao;KONG Wenhua;ZHANG Yijie;LIU Manqing(Wuhan Municipal Center for Disease Control and Prevention,Wuhan,Hubei 430021,China)

机构地区：[1]武汉市疾病预防控制中心,湖北武汉430021

出　　处：《实用预防医学》2024年第7期805-810,共6页Practical Preventive Medicine

摘　　要：目的在新冠感染疫情暴发一年后,明确非药物干预措施下武汉冬季呼吸道感染患者病原谱的构成,为呼吸道感染性疾病的防治提供病原学依据。方法收集2020年12月28日—2021年2月14日武汉8家大型医院发热门诊急性呼吸道感染(acute respiratory tract infection,ARTI)病例咽拭子样本,经全自动核酸提取仪提取核酸后,采用实时荧光定量PCR技术进行23种常见呼吸道病原体检测。采用Excel 2016软件对数据进行录入、整理,建立数据库,用SPSS 20.0软件进行统计学分析。结果共收集596例ARTI病例,其中男性335例,女性261例,男女比例1.28∶1。年龄最小患者为5月龄,最大为91岁。23种呼吸道病原体中共13种病原体检出阳性,总阳性率86.24%(514/596),排在前3位的病原体分别为肺炎链球菌(Streptococcus pneumoniae,SPN)占比30.47%(323/1060)、肺炎克雷伯菌(Klebsiella pneumoniae,KPN)占比24.25%(257/1060)和流感嗜血杆菌(Haemophilus influenzae,HIN)占比19.43%(206/1060)。514例检测阳性的病例中混合感染共331例,占比64.40%(331/514),其中细菌之间的混合感染占比54.68%(181/331)高于细菌和病毒的混合感染45.01%(149/331)。331例混合感染病例中,仅检出1例病毒之间的混合感染,占比0.30%(1/331),为人偏肺病毒(human metapneumovirus,HMPV)和呼吸道合胞病毒(respiratory syncytial virus,RSV)共感染。HIN、KPN、SPN、HMPV、RSV、呼吸道腺病毒(respiratory adenovirus,RA)、人博卡病毒(human bocavirus,HBoV)和肠道病毒(human enterovirus,HEV)在不同年龄段的患者中检出率差异有统计学意义,HIN、KPN、SPN、HMPV和RSV在不同体温患者中的检出率差异有统计学意义,不同性别患者之间所有病原体的检出率差异无统计学意义。国家级和非国家级流感监测哨点医院之间A族链球菌(group A streptococcus,GAS)和RSV的检出率差异有统计学意义。结论非药物干预措施下武汉冬季呼吸道病原以SPN、KPN、HIN、HMPV和金黄色�Objective One year after the outbreak of the SARS-CoV-2 infection,the composition of pathogenic spectrums of patients with respiratory tract infections in Wuhan in winter was clarified under non-drug intervention measures,and the etiological basis for prevention and treatment of respiratory tract infectious diseases was provided.Methods We collected throat swab samples from acute respiratory tract infection(ARTI)cases in fever clinics of eight large hospitals in Wuhan from December 28,2020 to February 14,2021.Nucleic acid extraction was performed using an automatic nucleic acid extractor,and real-time fluorescence quantitative PCR technology was used to detect 23 respiratory pathogens.Microsoft Office Excel 2016 was used to input and organize the data,and then a database was established.Statistical analysis was performed with SPSS 20.0 software.Results A total of 596 ARTI cases were collected,including 335 males and 261 females,with a male-to-female ratio of 1.28:1.The youngest was 5 months old and the oldest 91 years old.The total positive rate of 23 respiratory pathogens was 86.24%(514/596),and a total of 13 pathogens of 23 respiratory pathogens were positive.The top three pathogens were Streptococcus pneumoniae(SPN)(30.47%,323/1,060),Klebsiella pneumoniae(KPN)(24.25%,257/1,060)and Haemophilus influenzae(HIN)(19.43%,206/1,060).Among the 514 positive cases,331 were mixed infections,accounting for 64.40%(331/514).The proportion of mixed infection between bacteria(54.68%,181/331)was higher than that of bacteria and virus(45.01%,149/331).Among the 331 cases of mixed infections,only one case of mixed infection between human metapneumovirus(HMPV)and respiratory syncytial virus(RSV)was detected,accounting for 0.30%(1/331).There were statistically significant differences in the detection rates of HIN,KPN,SPN,HMPV,RSV,respiratory adenovirus(RA),human bocavirus(HBoV)and human enterovirus(HEV)in patients of different ages as well as in the detection rates of HIN,KPN,SPN,HMPV and RSV in patients of different body temperatu

关 键 词：急性呼吸道感染 非药物干预措施 呼吸道病原体 病原谱 监测与预防 

分 类 号：R56[医药卫生—呼吸系统]