江苏省2014-2023年儿童呼吸道合胞病毒感染流行特征及临床特征  

Epidemiological and clinical characteristics of respiratory syncytial virus infections in children in Jiangsu Province,2014-2023

作　　者：谷文欣 许可[2] 王慎骄[2] 邓斐[2] 戴启刚[2] 邹鑫 尚庆香 陈立凌[4] 夏瑜[4] 戴文军[5] 查杰[5] 丁松宁[6] 何敏[6] 鲍倡俊 Gu Wenxin;Xu Ke;Wang Shenjiao;Deng Fei;Dai Qigang;Zou Xin;Shang Qingxiang;Chen Liling;Xia Yu;Dai Wenjun;Zha Jie;Ding Songning;He Min;Bao Changjun(School of Public Health,Nanjing Medical University,Nanjing 211166,China;Jiangsu Provincial Center for Disease Control and Prevention,Nanjing210009,China;Department of Infectious Diseases,First Affiliated Hospital,Army Medical University,Chongqing400038,China;Suzhou Center for Disease Control and Prevention,Suzhou215000,China;Taizhou Center for Disease Control and Prevention,Taizhou225300,China;Nanjing Center for Disease Control and Prevention,Nanjing210003,China)

机构地区：[1]南京医科大学公共卫生学院,南京211166 [2]江苏省疾病预防控制中心,南京210009 [3]陆军军医大学第一附属医院感染科,重庆400038 [4]苏州市疾病预防控制中心,苏州215000 [5]泰州市疾病预防控制中心,泰州225300 [6]南京市疾病预防控制中心,南京210003

出　　处：《中华流行病学杂志》2024年第11期1537-1543,共7页Chinese Journal of Epidemiology

基　　金：江苏省卫生健康委员会重点项目(ZD2021037);江苏省“十四五”流行病学重点学科(ZDXK202250)。

摘　　要：目的分析江苏省2014-2023年儿童呼吸道合胞病毒(RSV)感染流行特征及临床特征。方法研究对象来源于江苏省南京市、苏州市和泰州市各2家监测哨点医院,于2014年7月1日至2023年12月31日门/急诊或住院0~14岁儿童急性呼吸道感染病例,对研究对象进行RSV核酸检测,采用WHO流感流行阈值法评估RSV流行强度,收集病例个案信息和临床资料。采用χ^(2)检验比较组间差异,采用Bonferroni法进行多组间两两比较。结果在4946例急性呼吸道感染儿童病例中,RSV阳性率为8.21%(406/4946),年龄M(Q1,Q3)为1(0,3)岁。2014-2019年和2019-2023年流行季的RSV阳性率分别为10.92%(258/2362)和6.06%(118/1948),差异有统计学意义(χ^(2)=31.74,P<0.001)。2014-2019年RSV流行期为每年10月至次年3月,流行高峰为12月,流行强度为中度及以上;2019-2023年RSV季节性流行特征消失,流行期分散,流行强度以低度流行为主。0~岁年龄组儿童RSV阳性率最高(17.85%,151/846),阳性率随着儿童年龄增长而逐渐下降(χ^(2)=184.51,P<0.001)。住院病例RSV阳性率(9.84%,244/2480)高于门/急诊病例RSV阳性率(6.57%,162/2466)(χ^(2)=17.54,P<0.001)。在有完整临床资料的儿童RSV感染病例155例中,临床症状主要为咳嗽(99.35%,154/155)、发热(55.48%,86/155)、呼吸急促(45.16%,70/155),其中<6月龄儿童出现发热的比例较低,但出现呼吸短促、转入重症加强护理病房和接受氧气治疗的比例较高(均P<0.05)。<6月龄和患有基础疾病的儿童容易发生重症RSV感染(均P<0.05)。结论江苏省儿童RSV感染在2014-2019年具有以冬季为主的季节性流行特征。2020年以来,季节性流行特征有所改变,流行期分散且流行强度降低。<1岁婴儿是RSV感染的高危人群,<6月龄和患基础疾病者容易发生重症感染。Objective To analyze the epidemiological and clinical characteristics of respiratory syncytial virus(RSV)infection in children in Jiangsu Province from 2014 to 2023.Methods The acute respiratory infection cases in children aged 0-14 years were selected from outpatient/emergency or inpatient departments in 2 surveillance sentinel hospitals,respectively,in Nanjing,Suzhou and Taizhou of Jiangsu from 1 July 2014 to 31 December 2023,and RSV nucleic acid test was conducted and the intensity of the RSV infection was accessed by WHO influenza epidemiological threshold method,and case information and clinical data were collected.χ^(2) test was used to compare the differences between groups,and the Bonferroni method was used for pairwise comparisons between groups.Results In 4946 cases of acute respiratory infections,the RSV positive rate was 8.21%(406/4946),and the age M(Q 1,Q 3)of the cases was 1(0,3)years.The RSV positive rate was 10.92%(258/2362)during 2014-2019 and 6.06%(118/1948)during 2019-2023,the difference was significant(χ^(2)=31.74,P<0.001).RSV infection mainly occurred from October to March during 2014-2019,with the incidence peak in December and moderate or higher intensity.The seasonality of RSV infection was not obvious during 2019-2023,with low intensity.The RSV positive rate was highest in children in age group 0-years(17.85%,151/846),and the positive rate declined gradually with age(χ^(2)=184.51,P<0.001).The RSV positive rate was higher in inpatient cases(9.84%,244/2480)than in outpatient/emergency cases(6.57%,162/2466)(χ^(2)=17.54,P<0.001).In the 155 RSV infection cases with complete clinical data,the clinical symptoms mainly included cough(99.35%,154/155),fever(55.48%,86/155),and shortness of breath(45.16%,70/155).In the cases aged<6 months,the proportion of those with fever was low,but the proportion of those with shortness of breath,transferred to intensive care units,and receiving oxygen therapy were higher(all P<0.05).Children aged<6 months and those with underlying diseases were more likely to

关 键 词：呼吸道合胞病毒 儿童 流行特征 临床特征 

分 类 号：R725.6[医药卫生—儿科] R181.3[医药卫生—临床医学]