临床儿科杂志 ›› 2014, Vol. 32 ›› Issue (11): 1052-.doi: 10.3969 j.issn.1000-3606.2014.11.013

• 综合报道 • 上一篇    下一篇

2007—2013 年上海南翔地区呼吸道感染儿童鼻咽部病毒病原学哨点监测及分析

严华杰1,盛军1,董蔚1,钱丹1,刘嘉2,姚福家2,邵洁3   

  1. 1. 上海市嘉定区南翔医院儿科( 上海 201802);2. 中国科学院上海巴斯德研究所病原诊断中心( 上海 200031);3. 上海交通大学医学院附属瑞金医院儿科( 上海 200020)
  • 收稿日期:2014-11-15 出版日期:2014-11-15 发布日期:2014-11-15
  • 通讯作者: 邵洁 E-mail:dr.shaojie@163.com
  • 基金资助:
    上海市卫生与计划生育委员会科研项目(No.20114132)

Sentinel surveillance and analyze for the detection of respiratory infection in children: nasopharyngeal viral etiology in Nanxiang, Shanghai during 2007 to 2013

YAN Huajie1, SHENG Jun1, DONG Wei1, QIAN Dan1, LIU Jia2, YAO Fujia2, SHAO Jie3   

  1. 1.Department of Pediatrics, Nanxiang Hospital in Jiading District, Shanghai 201802, China; 2.Pathogenic Diagnosis Center. Institute Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031,China; 3.Department of Pediatrics ,Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Received:2014-11-15 Online:2014-11-15 Published:2014-11-15

摘要: 目的 常年监测分析上海市南翔地区呼吸道感染儿童病毒病原学情况。方法 采集2007年1月至2013年9月门诊急性呼吸道感染患儿4 389例鼻咽分泌物,多重逆转录PCR法(Multiplex RT-PCR)检测9种呼吸道病毒,包括流感病毒(FLU)、副流感病毒(PIV)、呼吸道合胞病毒(RSV)、腺病毒(ADV)、人博卡病毒(HBOV)、人冠状病毒(Cov)、肠病毒(EV)、人偏肺炎病毒(HMPV)、鼻病毒(HRV)。同期采集无呼吸道感染症状儿童鼻咽分泌物标本123例,同时多重逆转录PCR法检测9种呼吸道病毒。结果 4 389例呼吸道感染患儿鼻咽分泌物标本中呼吸道病毒阳性检出率为34.8%(1526/4389),前3位病毒依次为FLU 10.3%(453/4389)、RSV 7.3%(320/4389)和PIV 6.2%(274/4389);2种及2种以上呼吸道病毒混合感染273例(6.2%)。不同年龄组病毒总检出率差异有统计学意义(χ2=41.91,P<0.001),学龄组儿童检出率最低为23.4%,其余3组检出率均≥35.0%;RSV、HRV在婴儿组检出率均较高;FLU在学龄组儿童中检出率较高为13.6%。儿童喘息性疾病中存在较高的病毒检出率,其中RSV检出率14.8%(30/204),其次为HBOV 13.8%(28/204)。同期采集无呼吸道感染症状儿童鼻咽分泌物标本123例,病毒检出率6.5%(8/123),与呼吸道感染组病毒检出率比较,差异有统计学意义(χ2=42.60,P<0.001)。结论 在连续7年的常年检测中,FLU、RSV在该地区儿童呼吸道感染性疾病中占重要地位。不同年龄组病毒检出率存在差异,婴幼儿呼吸道感染有较高的病毒检出率,RSV检出率较高;随年龄增长,总体病毒检出率下降,但流感病毒在大年龄组的检出率增高。

Abstract:  Objective To report the result of annual monitoring and analysis of nasopharyngeal virus in children with respiratory tract infections in Nanxiang, Shanghai District. Methods Nasopharyngeal secretions were collected from 4389 children with acute respiratory tract infection in outpatient department from January 2007 to September 2013, 9 common respiratory viruses were analyzed by Multiplex RT-PCR, including influenza virus (FLU), parainfluenza virus (PIV), respiratory syncytical virus (RSV) , adenovirus (ADV), human bocavirus(HBOV), human coronavirus(Cov), enterovirus(EV), human metapneumovirus(HMPV), and rhinovirus(HRV). The same analysis was done in 123 asymptomatic children during the same period. Results The positive rate of detected respiratory viruses in children with respiratory tract infections in nasopharyngeal secretions were 34.8% (1526/4389), including FLU 10.3% (453/4389), RSV 7.3% (320/4389), PIV 6.2% (274/4389), ADV 3.3% (146/4389), HBOV 2.7% (118/4389), EV 2.5% (110/4389), Cov 2.4% (105/4389), HRV 1.6% (72/4389), HMPV 1.5% (67/4389); two and more combined respiratory viral infection were found in 273 cases (6.2%). The virus detection rate between age groups was significantly different (χ2 = 41.91, P <0.001). The school-age group had the lowest positive rate of 23.4% and the positive rates in other three groups were all higher than 35.0%. The infant group had the higher positive rate of RSV and HRV. FLU detection rate in school-age group was 13.6%. Respiratory viruses in children with asthmatic disease has high detection rate. RSV infection rate was the highest 14.8% (30/204) in the asthmatic disease group, followed by HBOV 13.8% (28/204). In nasopharyngeal secretions of 123 asymptomatic children, virus-positive detection rate of 6.5% (8/123), which showed significant difference from that in respiratory virus infection group (χ2 = 42.60, P <0.001). Conclusions In seven consecutive years of testing, the influenza virus and respiratory syncytial virus play an important role in children with respiratory tract infections in this region. The detection rate of virus showed difference between different age groups and a higher detection rate of RSV in infants with respiratory tract infections was observed. The overall detection rate of virus was decreased with the increase of age excluding the influenza virus.