学龄前呼吸道感染患儿8种呼吸道病原体的流行病学特征

目的 了解呼吸道感染常见8种病原体在四川绵阳地区学龄前患儿中的流行病学特征,为临床诊断治疗及相关疾病的预防控制提供参考依据。方法 收集2018年1月—2018年12月因呼吸道感染住院治疗的学龄前患儿基本信息,以及在住院期间采用间接免疫荧光法检测血清呼吸道合胞病毒（RSV）、腺病毒（ADV）、甲型流感病毒（FluA）、乙型流感病毒（FluB）、副流感病毒（PFlu）、肺炎支原体（MP）、肺炎衣原体（CP）和嗜肺军团菌（LPS）等8种常见呼吸道病原体IgM抗体结果,并对结果进行统计学分析。结果 2 963例样本中8种呼吸道病原体IgM抗体阳性1 857例,总阳性率62.7%;单一抗体阳性率从高到低依次是：MP(33.9%)、 FluB(28.3%)、 FluA(26.3%)、RSV(9.1%)、PFlu(2.4%)、ADV(1.9%)、CP(1.3%)和LP(0.7%),混合感染占总阳性的45.2%,多为MP混合感染;男性患儿阳性率61.5%,女性患儿阳性率64.5%,差异无统计学意义（P>0.05）;不同年龄组呼吸道病原体阳性率不同,差异有统计学意义（P<0.05）,其中1~2岁阳性率最高 (80.0%);不同季节呼吸道病原体阳性率不同,差异有统计学意义（P<0.05）,冬季阳性率最高（68.9%）。结论 绵阳地区学龄前住院患儿呼吸道感染的主要病原体是MP、FluB和FluA,其感染与年龄、季节相关,1~2岁儿童感染率最高,在冬季流行,建议有针对性地加强儿童呼吸道疾病的预防控制工作。

Epidemiological characteristics of 8 respiratory pathogens in children with preschool respiratory infection

Objective To understand the epidemiological characteristics of 8 common respiratory pathogens in preschool children in this area,and provide reference for clinical diagnosis and treatment and related diseases prevention and control. Methods Collection of basic information on preschool children hospitalized for respiratory infections from January to December 2018,and detection of eight common respiratory pathogen IgM antibodies in serum by indirect immunofluorescence,including respiratory syncytial virus (RSV),adenovirus (ADV),influenza A virus (FluA),influenza B virus (FluB),parainfluenza virus (PFlu),Mycoplasma pneumoniae (MP),Chlamydia pneumoniae (CP),and Legionella pneumophila ( LPS), and statistical analysis of the results.Results Among the 2 963 samples,1 857 cases were positive for IgM antibodies against 8 respiratory pathogens,with a total positive rate of 62.7%．The positive rate of single antibody was MP (33.9%),FluB (28.3%),FluA (26.3%),RSV (9.1%),PFlu (2.4%),ADV (1.9%),CP (1.3%) and LP (0.7%) in order from high to low．The mixed infection accounted for 45.2% of the total positives,mostly MP mixed infection．The positive rate of male and female children was 61.5% and 64.5%,respectively（P>0.05）;positive rate of respiratory pathogens was different in different age groups,and the difference was statistically significant（P<0.05）．The highest positive rate was found in 1 to 2 years old(80.0%);positive rate of respiratory pathogens was different in different seasons groups,and the difference was statistically significant (P<0.05),and the highest in winter (66.1%).Conclusion MP, FluB and FluA are the main pathogen of respiratory tract infection in preschool hospitalized children in Mianyang area．Its infection is related to age and season．The infection rate of children aged 1-2 is the highest．It is prevalent in winter．It is suggested to purposefully strengthen the prevention and control of respiratory tract diseases in children．