摘要
目的分析中国呼吸道病原体的流行病学特征和临床特点。方法本研究为横断面研究, 依托19家临床病原微生物网络核心单位, 建立三级临床病原监测系统, 于2024年1月至12月每2周从各单位采集30份呼吸道样本, 收集临床信息和病原体诊断信息。三级临床病原监测系统共检测11 864份样本。一级临床病原监测系统覆盖甲型流行性感冒病毒(Flu-A)、乙型流行性感冒病毒(Flu-B)、呼吸道合胞病毒(RSV)、新型冠状病毒。二级临床病原监测系统集中分析18种重点呼吸道病原体。三级临床病原监测系统进一步明确是否出现新发传染病。结果一级临床病原监测系统显示, Flu-A主要在12月流行, Flu-B主要在1月流行, 新型冠状病毒在3月和8月达到高峰, RSV则全年散发。同种病原体检出率变化趋势在我国七大地理区域间相似, 但12月Flu-A在东北[48.1%(111/231)]和华东[36.2%(148/409)]地区检出率较高, RSV主要在西北和华南地区1月至3月流行。二级临床病原监测系统显示, 肺炎链球菌、肺炎支原体、鼻病毒、腺病毒全年检出, 其中肺炎链球菌、鼻病毒检出率在8月至9月升高, 腺病毒检出率在1月达高峰。嗜肺军团菌全年无检出, 其他病原体检出率全年波动。儿童肺炎患者的主要病原体为肺炎支原体[35.0%(105/300)]、鼻病毒[25.7%(77/300)]、腺病毒[17.3%(52/300)], 成人肺炎患者则以肺炎链球菌[10.5%(29/277)]、金黄色葡萄球菌[6.9%(19/277)]、肺炎支原体[6.9%(19/277)]、Flu-A[6.1%(17/277)]为主。三级临床病原监测系统未发现新发呼吸道病原体。结论 2024年中国呼吸道病原体在时间和空间分布上表现出明显特征, 且在不同人群中存在差异。
Objective:To analyze the epidemiological and clinical characteristics of respiratory pathogens in China.Methods:This study was a cross-sectional study,which encompassed 19 core units of the clinical pathogen network and established a three-tiered clinical pathogen surveillance system.Thirty respiratory samples were collected every two weeks from various units from January to December 2024,and the clinical and pathogen diagnostic information were gathered.A total of 11864 samples were tested using this system.The tier-1 clinical pathogen surveillance system covered influenza A virus(Flu-A),influenza B virus(Flu-B),respiratory syncytial virus(RSV),and severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).The tier-2 clinical pathogen surveillance system focused on 18 key respiratory pathogens.The tier-3 clinical pathogen surveillance system further clarified whether any emerging infectious diseases had occurred.Results:The tier-1 clinical pathogen surveillance system showed Flu-A predominated in December,Flu-B predominated in January,SARS-CoV-2 peaked in March and August,whereas RSV circulated sporadically throughout the year.Geographic trends were broadly consistent across the seven major regions,although Flu-A detection in December was notably higher in Northeast China(48.1%(111/231))and East China(36.2%(148/409)),and RSV detection was concentrated in the Northwest and South China from January to March.Data from the tier-2 clinical pathogen surveillance system indicated that Streptococcus pneumoniae,Mycoplasma pneumoniae,rhinovirus,and adenovirus were detected year-round,of these,Streptococcus pneumoniae and rhinovirus showed elevated positive detection rates from August to September,while adenovirus peaked in January.Legionella pneumophila was not detected throughout the year,and other pathogens fluctuated throughout the year without a consistent pattern.The predominant etiologic agents of pediatric pneumonia were Mycoplasma pneumoniae(35.0%(105/300)),rhinovirus(25.7%(77/300)),and adenovirus(17.3%(52/300)),whereas adult pneumonia was mainly caused by Streptococcus pneumoniae(10.5%(29/277)),Staphylococcus aureus(6.9%(19/277)),Mycoplasma pneumoniae(6.9%(19/277)),and Flu-A(6.1%(17/277)).The tier-3 clinical pathogen surveillance system did not identify any emerging respiratory pathogens.Conclusion:Respiratory pathogens in China in 2024 exhibit distinct temporal and spatial distribution patterns and vary among different populations.
作者
艾静文
邓继岿
董民
高晓红
耿嘉蔚
胡晓丽
金柱
刘洪艳
李勇忠
刘曦
邱源旺
屈莉红
孙彬煌
宋玮
王红羽
王君平
王森
熊小明
杨道坤
张缭云
张彦亮
周向红
张文宏
Ai Jingwen;Deng Jikui;Dong Min;Gao Xiaohong;Geng Jiawei;Hu Xiaoli;Jin Zhu;Liu Hongyan;Li Yongzhong;Liu Xi;Qiu Yuanwang;Qu Lihong;Sun Binhuang;Song Wei;Wang Hongyu;Wang Junping;Wang Sen;Xiong Xiaoming;Yang Daokun;Zhang Liaoyun;Zhang Yanliang;Zhou Xianghong;Zhang Wenhong(Department of Infectious Diseases,National Medical Center for Infectious Diseases,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Infectious Diseases,Shenzhen Children's Hospital,Shenzhen 518038,China;Department of Infectious Diseases,Zaozhuang Municipal Hospital,Zaozhuang 277100,China;Department of Infectious Diseases,Yan'an University Affiliated Hospital,Yan'an 716099,China;Department of Infectious Diseases,Yunnan Provincial First People's Hospital,Kunming 650034,China;Department of Infectious Diseases,Heilongjiang Provincial Hospital,Harbin 150200,China;Department of Infectious Diseases,Yichang Third People's Hospital,Yichang 443008,China;Department of Infectious Diseases,Shenyang Sixth People's Hospital,Shenyang ll0006,China;Department of Infectious Diseases,Hunan Medical University General Hospital,Huaihua 418099,China;Department of Infectious Diseases,Sun Yat-sen University Fifth Afiliated Hospital,Zhuhai 519000,China;Department of Infectious Diseases,Wuxi Fifth People's Hospital,Wuxi 21401l,China;Department of Infectious Diseases,Shanghai Oriental Hospital.Shanghai 200120,China;Department of Infectious Diseases,Shanghai Jin Yang Community Hospital,Shanghai 200136,China;Department of Infectious Diseases,980 Hospital of the Joint Logistics Support Force,Shjazhuang O500ll,China;Department of Infectious Diseases,Jiujiang First People's Hospital,Jiujiang 332000,China;Department of Infectious Diseases,First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,China;Department of Infectious Diseases,First Hospital of Shanxi Medical University,Taiyuan030001,China;Department of Infectious Diseases,Nanjing Traditional Chinese Medicine Hospial,Nanjing 210022,China;Clinical Laboratory Center,Shanxi Provincial Children's Hospital,Taiyuan 030002 China)
出处
《中华传染病杂志》
北大核心
2025年第2期79-89,共11页
Chinese Journal of Infectious Diseases
基金
国家重点研发计划(2023YFC3043501)。
关键词
感染
呼吸道病原体
临床病原监测系统
流行特征
临床特征
Infections
Respiratory pathogens
Clinical pathogen surveillance system
Epidemiological characteristics
Clinical features
