2009-2021年中国60岁及以上老年人发热呼吸道症候群病例的病原构成及流行特征分析  

Analysis of the pathogen composition and epidemiological characteristics of febrile respiratory syndrome cases in the elderly aged 60 years and above in China from 2009 to 2021

作　　者：李开明 吴彦霖 连怡遥 郭玉清 张嘉洢 蔡立 郑建东[1] 王丽萍[1] Li Kaiming;Wu Yanlin;Lian Yiyao;Guo Yuqing;Zhang Jiayi;Cai Li;Zheng Jiandong;Wang Liping(National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases,Division of Infectious Disease,Chinese Center for Disease Control and Prevention,Beijing 102206,China;National Institute for Nutrition and Health,Chinese Center for Disease Control and Prevention,Beijing 100050,China)

机构地区：[1]传染病溯源预警与智能决策全国重点实验室,中国疾病预防控制中心传染病管理处,北京102206 [2]中国疾病预防控制中心营养与健康所,北京100050

出　　处：《中华流行病学杂志》2025年第4期619-629,共11页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(82320108018);国家科技重大专项(2018ZX10713001);公共卫生应急反应机制运行项目。

摘　　要：目的了解我国≥60岁老年人发热呼吸道症候群(FRS)病原构成及流行特征,为老年FRS的科学和精准防控提供参考依据。方法基于国家科技重大专项传染病监测技术平台信息管理系统FRS病例监测数据,监测病原包括8种病毒(流感病毒、呼吸道合胞病毒、腺病毒、副流感病毒、偏肺病毒、冠状病毒、博卡病毒和鼻病毒)、7种细菌(肺炎链球菌、金黄色葡萄球菌、肺炎克雷伯菌、铜绿假单胞菌、A组乙型链球菌、流感嗜血杆菌、嗜肺军团菌)以及肺炎衣原体和肺炎支原体。采用描述流行病学方法分析2009-2021年全国≥60岁老年FRS病例的病原构成及流行特征。结果我国≥60岁FRS病例的病毒病原谱主要包括流感病毒(42.42%)、鼻病毒(16.71%)、副流感病毒(11.53%)、冠状病毒(9.52%)和呼吸道合胞病毒(7.75%),合计占比87.93%;细菌病原谱主要包括肺炎链球菌(25.71%)、铜绿假单胞菌(24.97%)、肺炎克雷伯菌(22.47%)、流感嗜血杆菌(12.23%)、金黄色葡萄球菌(9.22%),合计占比94.60%。2009-2021年,流感病毒一直位居病毒病原谱首位,铜绿假单胞菌、肺炎克雷伯菌和肺炎链球菌位居细菌病原谱的前列,鼻病毒、副流感病毒、呼吸道合胞病毒、肺炎克雷伯菌和流感嗜血杆菌分别在病毒和细菌病原谱的占比呈波动上升趋势。门/急诊病例的任一病原阳性率(32.83%)高于住院病例(27.26%)(χ^(2)=125.89,P<0.001)。60~74岁年龄组病例的流感病毒阳性率较高(13.66%),≥90岁年龄组与北方地区的铜绿假单胞菌(10.71%与8.32%)和肺炎克雷伯菌阳性率(9.40%与7.30%)较高。冬季FRS病例的任一病原阳性率(33.82%)高于其他季节(χ^(2)=212.03,P<0.001);冬季的流感病毒(22.87%)和秋季的鼻病毒(5.98%)阳性率较高,夏季的铜绿假单胞菌和肺炎克雷伯菌阳性率较高(8.11%和8.30%)。结论2009-2021年我国≥60岁老年FRS病例感染的病毒和细菌病原谱居前三位的病原体分别�Objective To understand the pathogenic composition and epidemiological characteristics of febrile respiratory syndrome(FRS)in elderly people aged 60 and above in China,and to provide a reference basis for the scientific and precise prevention and control of FRS in the elderly.Methods Based on FRS cases surveillance data from information management system of National Technical Platform for Infectious Disease Surveillance,National Science and Technology Major Project of China,the surveillance pathogens included 8 viruses,including influenza virus(IFV),respiratory syncytial virus(RSV),adenovirus(HAdV),parainfluenza virus(HPIV),metapneumovirus(HMPV),coronavirus(HCoV),bocavirus and rhinovirus(HRV);7 bacterias,namely Streptococcus pneumoniae(S.pneumoniae),Staphylococcus aureus(S.aureus),Klebsiella pneumoniae(K.pneumoniae),Pseudomonas aeruginosa(P.aeruginosa),Group A Streptococcus(GAS),Haemophilus influenzae(H.influenzae)and Legionella pneumophila(L.pneumophila),in addition to Chlamydia pneumoniae(C.pneumoniae)and Mycoplasma pneumoniae(M.pneumoniae).A descriptive epidemiological approach was used to analyze the pathogenic composition and major epidemiological characteristics of FRS cases aged 60 years and older nationwide from 2009 to 2021.Results The predominant viruses of FRS cases aged≥60 years accounted for 87.93%of the pathogen spectrum in China,including IFV(42.42%),HRV(16.71%),HPIV(11.53%),HCoV(9.52%),and RSV(7.75%),while the pathogen spectrum of the major bacteria accounted for 94.60%,including S.pneumoniae(25.71%),P.aeruginosa(24.97%),K.pneumoniae(22.47%),H.influenzae(12.23%),and S.aureus(9.22%).Influenza viruses have always been at the top of the viral pathogen spectrum,and P.aeruginosa,K.pneumoniae and S.pneumoniae,ranked high in the bacterial pathogen spectrum.Among them,the proportions of HRV,HPIV,RSV,K.pneumoniae,and H.influenzae fluctuated and increased during the 13 years of observation.The positive rate of any pathogen in FRS cases was higher in out patient emergencies(32.83%)than in hospitalized case

关 键 词：发热呼吸道症候群 老年人 病原谱 流行特征 

分 类 号：R56[医药卫生—呼吸系统]