广东省2023年8—12月流感样疾病病例和严重急性呼吸道感染病例病原体感染情况的对比分析  

Comparative analysis of etiological characteristics of influenza-like illness and severe acute respiratory infection in Guangdong Province from August to December 2023

作　　者：王蕾 庾健祥 谢家敏 张欢[1] 郭前方 王海燕[1] 李振翠 李柏生[1] 邹丽容[1] Wang Lei;Yu Jianxiang;Xie Jiamin;Zhang Huan;Guo Qianfang;Wang Haiyan;Li Zhencui;Li Bosheng;Zou Lirong(Guangdong Provincial Key Laboratory of Pathogen Detection for Emerging Infectious Disease Response,Guangdong Provincial Center for Disease Control and Prevention,Guangzhou 511430,China;Shenzhen Futian Center for Chronic Disease Control,Shenzhen 518048,China)

机构地区：[1]广东省疾病预防控制中心,广东省新发传染病应急检测技术研究与应用重点实验室,广州511430 [2]深圳市福田区慢性病防治院,深圳518048

出　　处：《中华微生物学和免疫学杂志》2025年第1期26-33,共8页Chinese Journal of Microbiology and Immunology

基　　金：国家自然科学基金(22178070)。

摘　　要：目的比较广东省门、急诊流感样疾病(influenza-like illness,ILI)病例和住院严重急性呼吸道感染(sever acute respiratory infection,SARI)病例的多重病原体检测结果,为呼吸道感染疾病的诊治和防控提供依据。方法对广东省2023年8—12月收集的6090份ILI和SARI病例标本进行实验室呼吸道多重病原体检测和数据统计,并采用卡方检验分析阳性率差异。结果病原体总阳性率为49.5%(3016/6090),ILI病例阳性率为54.5%(2260/4145),SARI病例阳性率为38.9%(756/1945)。在各性别、各年龄组和省内大部分地市中ILI病例的病原体总检出率均高于SARI病例,差异有统计学意义(P<0.05)。病原体总阳性率在不同性别之间的差异无统计学意义,但在不同年龄组之间的差异有统计学意义(P<0.001),以5~14岁年龄组最高(57.2%,957/1673)。ILI病例感染的主要病原体为流感病毒、人鼻病毒/肠道病毒、肺炎链球菌,SARI病例感染的主要病原体为肺炎支原体、人鼻病毒/肠道病毒、流感病毒。腺病毒、人副流感病毒、新型冠状病毒、普通冠状病毒、流感病毒、肺炎链球菌等病原体在ILI病例中的阳性率显著高于SARI病例,而肺炎支原体在SARI病例中的阳性率较高,差异有统计学意义(P<0.05)。此外,与SARI病例相比,ILI病例的呼吸道病原体混合感染风险更高,尤其是男性和25~59岁年龄组患者。结论广东省ILI和SARI病例之间病原体检出情况和病原谱构成存在差异,应根据病例特征做好相应的呼吸道感染防治工作。ObjectiveTo compare the etiological characteristics between influenza-like illness(ILI)cases in outpatient and emergency departments and those with severe acute respiratory infection(SARI)in Guangdong Province,hoping to provide scientific evidence for the treatment,prevention,and control of respiratory infectious diseases.MethodsLaboratory testing for multiple respiratory pathogens was conducted on 6090 specimens collected from ILI and SARI cases in Guangdong Province from August to December 2023.Chi-square test was used to analyze the differences in positive rates.ResultsThe overall positive rate of respiratory pathogens was 49.5%(3016/6090).The positive rate was 54.5%(2260/4145)in ILI cases and 38.9%(756/1945)in SARI cases.The overall positive rate was higher in ILI cases than in SARI cases across all genders and age groups,and in most cities of the province,with statistically significant differences(P<0.05).No significant difference was found in the overall positive rate between different genders.However,the difference between different age groups was statistically significant(P<0.001),with the highest rate identified in children aged 5-14 years(57.2%,957/1673).The main pathogens detected in ILI cases were influenza virus,human rhinovirus/enterovirus,and Streptococcus pneumoniae,while in SARI cases they were Mycoplasma pneumoniae,human rhinovirus/enterovirus,and influenza virus.The positive rates of adenovirus,human parainfluenza virus,SARS-CoV-2,human coronavirus,influenza virus,and Streptococcus pneumoniae were significantly higher in ILI cases than in SARI cases,while the positive rate of Mycoplasma pneumoniae was significantly higher in SARI cases(P<0.05).Moreover,ILI cases were characterized by a higher risk of coinfection compared with SARI cases,especially in males or those aged 25-59 years.ConclusionsThere are differences in the detection rates and spectrum of respiratory pathogens between ILI and SARI cases in Guangdong Province.Case features should be considered when developing strategies for prevent

关 键 词：呼吸道感染 流感样病例 严重急性呼吸道感染 呼吸道多重病原体检测 

分 类 号：R511.7[医药卫生—内科学] R56[医药卫生—临床医学]