急性呼吸道感染患者220例非细菌性病原体流行特征分析

目的了解2011年3月—2012年2月北京市丰台区急性呼吸道感染非细菌性病原谱构成及其流行特征,为该区呼吸道传染病的预防控制以及临床诊断、治疗提供实验室依据。方法随机采集哨点医院发热门诊就诊的急性呼吸道感染病例咽拭子标本220例,利用多重实时-聚合酶链反应、聚合酶链反应(RT-PCR、PCR)方法进行流行性感冒(流感)病毒、副流感病毒、呼吸道合胞病毒、肠道病毒、博卡病毒、偏肺病毒、冠状病毒、鼻病毒和腺病毒9种病毒性病原体的检测和支原体检测,并进行统计分析。结果从220份咽拭子标本中共检出125份阳性标本,阳性率为56.82%。其中有6份标本为双重感染,阳性率较高的为流感病毒(65/131,49.62%)、支原体和副流感病毒(均为26/131,19.85%)。其他病原体的检出率均小于5%。不同病原体检出在季节分布上存在差异:流感病毒冬季检出率最高,支原体秋季检出较多,而副流感病毒感染的高峰期发生在夏季,病原体检出率在季节分布上总体呈现冬季(12—2月)较高,夏季较低的特点。不同性别间病原体检出率无统计学差异。发病3 d内采集的标本流感病毒检出率高于3 d后采集的标本,而支原体相反。结论北京市丰台区急性呼吸道感染非细菌性病原体主要为流感病毒、支原体和副流感病毒。在对急性呼吸道感染病例的诊断治疗中应考虑到不同病原体的高发季节。

Analysis on epidemiological characteristics of non-bacterial pathogens in 220 cases of acute respiratory infection

[Objective]To understand the non-bacterial pathogen distribution and epidemiological characteristic of acute respiratory infection in Fengtai district of Beijing from March 2011 to February 2012,provide the experimental basis for prevention and control of respiratory infection,as well as clinical diagnosis and treatment.[Methods]220 throat swab samples were randomly collected from patients with cute respiratory infection in fever clinic of sentinel hospitals.Nine viral pathogens,including influenza（Flu） virus,parainfluenza virus,respiratory syncytial virus,enterovirus,Boka virus,metapneumovirus,coronavirus,rhinovirus and adenovirus,and mycoplasma were detected by multiplex real-time polymerase chain reaction（RT-PCR） and polymerase chain reaction（PCR）.The results were analyzed statistically.[Results]125 of 220 throat swab samples were positive,the positive rate was 56.82%,and 6 samples were double infection.The positive of influenza virus was the highest（65/131,49.62%）,followed by mycoplasma（26/131,19.85%） and parainfluenza（26/131,19.85%）.The detection rates of other pathogens were less than 5%.The detection rates of different pathogens were different in seasonal distribution.The detection rate of influenza virus in winner was the highest,that of mycoplasma in autumn was the highest,and the peak season of parainfluenza virus infection was summer.The detection rates of pathogens showed the characteristic of higher in winter（December to February） and lower in summer.There was no significant difference in detection rates of pathogens between males and females.The detection rate of influenza virus in samples collected within the first three days after the onset was higher than that after three days of the onset,while the detection rate of mycoplasma was reverse.[Conclusion]The main non-bacterial pathogens of acute respiratory infection in Fengtai district of Beijing are influenza virus,parainfluenza virus and mycoplasma.It is essential to pay attention to the peak season of different pathogens in the diagnosis and treatment of acute respiratory infection.