摘要
目的:描述2015年1月1日至2024年12月21日期间宁波市鄞州区肺炎患者22种常见呼吸道病原体的流行特征。方法:收集2015年1月1日至2024年12月21日期间鄞州区域健康信息平台中被诊断为肺炎或肺部感染的患者22种常见呼吸道病原体检验数据,计算阳性率、阳性人次和构成比,并从年度、性别、年龄组、季节、新型冠状病毒感染时期等亚组分别描述其流行特征。结果:共纳入77531例肺炎患者,进行呼吸道病原体检验492696人次。鄞州区肺炎患者呼吸道病原体检验和阳性人次呈上升趋势。34.63%肺炎患者检出至少1种病原体阳性,病原体未检出率由2015年的79.44%下降至2024年的58.38%。总体病原体阳性率为9.12%,新型冠状病毒感染期间阳性率有所下降,新型冠状病毒感染后尚未回升至新型冠状病毒感染前水平。6~17岁儿童阳性率最高(13.99%),60岁以上老年人最低(4.16%)。病原体阳性人次前3位为肺炎支原体、甲型流感病毒和乙型流感病毒;病原体检验阳性率前3位为肺炎支原体(25.26%)、鼻病毒(12.02%)和百日咳鲍特菌(11.66%)。男性病原谱构成比与女性基本相似,仅表现出更高的结核分枝杆菌感染和略低的肺炎支原体感染(P<0.001)。肺炎支原体、呼吸道合胞病毒和鼻病毒感染更多见于儿童,而流感病毒、结核分枝杆菌和溶血性链球菌则更多见于成人和老年人(P<0.001)。流感病毒和偏肺病毒多发于冬季,鼻病毒和百日咳鲍特菌多发于春季,肺炎支原体则相对多发于秋季(P<0.001)。新型冠状病毒感染后肺炎患者的鼻病毒、呼吸道合胞病毒、偏肺病毒感染构成比明显升高,分别达到7.53%、4.26%、2.25%,而乙型流感病毒和结核分枝杆菌感染构成比则分别降低至4.14%和2.80%(P<0.001)。结论:近十年间鄞州区肺炎人群呼吸道病原体感染规模明显扩大,并存在年度、性别、年龄、季节上的分布差异;新型冠状病毒感染后肺炎患者的呼吸道病原谱具有多样化趋势。
Objective:To describe the epidemiological characteristics of 22 common respiratory pathogens in patients with pneumonia in Yinzhou,Ningbo,from January 1,2015 to December 21,2024.Methods:The test data of 22 common respiratory pathogens in patients diagnosed with pneumonia or lung infection in the Yinzhou Regional Health Information Platform from January 1,2015 to December 21,2024 were collected.The positive cases,positive rates,and positive proportions were calculated.The epidemiological characteristics were described by the year,sex,age group,season,and coronavirus disease 2019(COVID-19)pandemic period.Results:A total of 77531 pneumonia patients were included,with 492696 respiratory pathogen tests performed.The number of respiratory pathogen tests and positive cases of pneumonia patients in Yinzhou showed an upward trend.In the study,34.63%of the pneumonia patients tested positive for at least one pathogen,and the pathogen non-detection rate decreased from 79.44%in 2015 to 58.38%in 2024.The overall pathogen positive rate was 9.12%,which decreased during the COVID-19 pandemic and had not returned to the historical level after the COVID-19 pande-mic.The positive rate was highest in children aged 6-17 years(13.99%),and lowest in the elderly over 60 years(4.16%).The top 3 highest number of positive cases was Mycoplasma pneumoniae,influenza A virus,and influenza B virus;the top 3 highest positive rates of pathogen tests were Mycoplasma pneumoniae(25.26%),rhinovirus(12.02%),and Bordetella pertussis(11.66%).The pathogen spectrum proportion in men was similar to that in women,only showing a higher ratio of Mycobacterium tuberculosis and a slightly lower ratio of Mycoplasma pneumoniae(P<0.001).Mycoplasma pneumoniae,respiratory syncytial virus,and rhinovirus infections were more common in children,while influenza virus,Mycobacterium tuberculosis,and Streptococcus pyogenes infections were more common in adults and the elderly(P<0.001).Influenza virus and human metapneumovirus infections were more common in winter,rhinovirus and Bordetella pertussis infections were more common in spring,and Mycoplasma pneumoniae infections were relatively more common in fall(P<0.001).After the COVID-19 pandemic,the proportions of rhinovirus,respiratory syncytial virus,and human metapneumovirus infections in the pneumonia patients increased signi-ficantly,reaching 7.53%,4.26%,and 2.25%,respectively,while the proportions of influenza B virus and Mycobacterium tuberculosis infections decreased to 4.14%and 2.80%,respectively(P<0.001).Conclusion:In the past decade,the scale of respiratory pathogen infection in the pneumonia population in Yinzhou had expanded significantly,and there were differences in distribution by the year,gender,age group,and season.The respiratory pathogen spectrum in pneumonia patients after the COVID-19 pandemic had a trend of diversification.
作者
杨子铭
李淑雅
李肖彤
沈鹏
孙烨祥
林鸿波
江志琴
詹思延
刘志科
YANG Ziming;LI Shuya;LI Xiaotong;SHEN Peng;SUN Yexiang;LIN Hongbo;JIANG Zhiqin;ZHAN Siyan;LIU Zhike(Department of Epidemiology and Biostatistics,Peking University School of Public Health,Beijing 100191,China;Key Laboratory of Epidemiology of Major Diseases(Peking University),Ministry of Education,Beijing 100191,China;Yinzhou District Center for Disease Control and Prevention of Ningbo,Ningbo 315199,Zhejiang,China;Research Center of Clinical Epidemiology,Peking University Third Hospital,Beijing 100191,China;Center for Intelligent Public Health,Institute for Artificial Intelligence,Peking University,Beijing 100871,China)
出处
《北京大学学报(医学版)》
北大核心
2025年第3期496-506,共11页
Journal of Peking University:Health Sciences
基金
国家自然科学基金(82330107,72361127500)。
关键词
肺炎
病原体
流行病学特征
公共卫生监测
Pneumonia
Pathogens
Epidemiological characteristics
Public health surveillance
