发热伴呼吸道症候群儿童呼吸道病原谱分析  

作　　者：林先耀 赵仕勇 郑绪阳[2] 王华平 李雯 

机构地区：[1]杭州市儿童医院,310014 [2]杭州市第一人民医院,310003

出　　处：《浙江临床医学》2024年第10期1516-1518,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨新型冠状病毒肺炎后发热伴呼吸道症候群患儿呼吸道病原谱的变迁。方法纳入2020年12月至2022年4月于杭州市儿童医院及杭州市第一人民医院住院的发热伴呼吸道症候群患儿280例,男136例、女144例。行咽拭子SARS-CoV-2核酸检测筛查及呼吸道13种病原体核酸检测及临床特征分析。结果所有入组患儿咽拭子SARS-CoV-2核酸检测均阴性,咽拭子呼吸道13项病原体核酸的阳性检出率为69.64%,其中混合感染22例,占7.86%。病原谱检出前5位分别为:鼻病毒(16.43%)、呼吸道合胞病毒(14.29%)、偏肺病毒(13.21%)、副流感病毒(12.14%)、乙型流感病毒(6.07%)。其中家庭聚集性病例12起,密切接触的24例成人中呼吸道病原体核酸阳性17例(70.83%),大部分无明显发热及呼吸道症状或仅有轻微上呼吸道症状,病原以鼻病毒、呼吸道合胞病毒及乙型流感病毒为主。鼻病毒分型均为CA型(53/53),呼吸道合胞病毒均为BA型(42/42),乙型流感病毒均为Victoria系(23/23),腺病毒有3例为B组,6例为C组。结论新型冠状病毒肺炎疫情防控措施遏制了儿童常见呼吸道病原体的社会群体聚集性传播,发病方式转向以散发及家庭聚集性传播。Objective To explore the changes of respiratory pathogenic spectrum of children with fever and respiratory syndrome in the post epidemic era of COVID-19.Methods Children with fever and respiratory symptoms admitted to Hangzhou Children's Hospital and Hangzhou First People's Hospital affiliated to Zhejiang University from December 2020 to April 2022 were included in the study.They underwent throat swab SARSCoV-2 nucleic acid testing screening and 13 respiratory pathogen nucleic acid testing.Clinical characteristics were analyzed.Results All enrolled children had negative throat swab SARS-CoV-2 nucleic acid test results.The positive detection rate of 13 respiratory pathogens in throat swabs was 69.64%,including 22 cases of mixed infection,accounting for 7.86%.The top five pathogens detected were:rhinovirus 16.43%,respiratory syncytial virus 14.29%,parainfluenza virus 13.21%,parainfluenza virus 12.14%,and influenza B virus 6.07%.Among them,there were 12 family cluster cases,and 17 of the 24 adults in close contact were positive for respiratory pathogens(70.83%).Most of them had no obvious fever or respiratory symptoms,or only mild upper respiratory symptoms.The pathogens were mainly rhinovirus,respiratory syncytial virus,and influenza B virus.All rhinoviruses were CA type(53/53),respiratory syncytial viruses were BA type(42/42),influenza B viruses were Victoria series(23/23),adenoviruses were group B in 3 cases and group C in 6 cases.Conclusion The prevention and control measures of novel coronavirus pneumonia curb the social mass transmission of common respiratory pathogens in children.The mode of onset has shifted to sporadic and family cluster transmission as the main characteristics.

关 键 词：儿童 新型冠状病毒肺炎 发热呼吸道症候群 家庭聚集性 病原谱 

分 类 号：R725.6[医药卫生—儿科]