摘要
目的建立资阳地区近年急性呼吸道传染病病原谱,研究其引起的传染病流行特征及防控策略。方法收集2021年1月至2023年12月,资阳市2家流感哨点医院和1家三乙县级非哨点综合医院的呼吸道感染患者的咽拭子标本(不含新冠病毒感染和流感病毒感染病例标本,其病原谱数据依据新冠和流感专项监测结果另计)。利用实时荧光PCR技术,检测26种呼吸道感染病原。利用一代、二代基因测序技术,对肺炎支原体、百日咳、腺病毒进行基因测序,将获得的序列与美国国立生物信息中心(NCBI)的GenBank数据库比对,确定病原型别及其进化关系。采用SPSS 26.0软件进行描述性统计分析,率的比较采用χ^(2)检验,以P<0.05为差异有统计学意义。结果共收集429例咽拭子标本,总阳性率为37.30%,检出呼吸道病原排名前3的分别为流感嗜血杆菌、肺炎链球菌和铜绿假单胞菌。同期专项监测显示本地区存在新冠病毒和流感病毒感染,阳性率分别为12.77%和14.39%。429例咽拭子标本中检出阳性占比靠前的病原体,肺炎支原体以秋季检出为主,腺病毒以春季检出为主。流感嗜血杆菌、肺炎链球菌、鼻病毒、肺炎支原体、腺病毒和人类偏肺病毒检出年龄分布差异均有统计学意义(P均<0.05),其中肺炎链球菌检出率最高的人群是65岁及以上老年人群,流感嗜血杆菌、肺炎支原体检出率最高的人群是5~<18岁人群,鼻病毒、腺病毒、人类偏肺病毒检出率最高的人群是5岁以下的幼儿。铜绿假单胞菌、金黄色葡萄球菌、肺炎克雷伯菌检出年龄分布差异均无统计学意义。不同性别感染病原情况差异无统计学意义。经基因测序获得肺炎支原体有效序列2条,分析得知有同源性;获得腺病毒有效序列2条,无同源性。结论2021—2023年本地区呼吸道病原谱22种,提示应重点加强当地新冠病毒、流感病毒、流感嗜血杆菌、肺炎链球菌、铜绿假单胞菌、腺病毒、肺炎支原体和百日咳等病原引起的急性呼吸道传染病的防控,特别是冬春季须加强流感病毒、腺病毒感染防控,秋季须加强肺炎支原体感染防控。
Objective To establish the pathogen spectrum of acute respiratory infectious diseases in Ziyang area in recent years,and to study the epidemiological characteristics and control strategies of the infectious diseases caused by these pathogens.Methods Throat swab samples were collected from patients with respiratory tract infection from two influenza sentinel hospitals and one nonsentinel general hospital in Ziyang City from January 2021 to December 2023(excluding novel coronavirus infection and influenza virus infection case specimens,whose pathogen spectrum data were analyzed based on the special monitoring results of new coronavirus and influenza).Real-time fluorescence PCR(polymerase chain reaction)was used to detect 26 pathogens of respiratory infections.Using the first and second generation gene sequencing technology,the gene sequencing of Mycoplasma pneumoniae,pertussis and adenovirus was carried out,and the obtained sequences were compared with the GenBank database of the National Center for Biological Information(NCBI)to determine the disease prototype and its evolutionary relationship.Descriptive statistical analysis was performed by SPSS 26.0 software,and rates were compared byχ^(2) test,with P<0.05considered as statistically significant.Results A total of 429 throat swab samples were collected,with a total positive rate of 37.30%.The top 3 respiratory pathogens detected were Haemophilus influenzae,Streptococcus pneumoniae and Pseudomonas aeruginosa,During the same period,the special monitoring showed that there were novel coronavirus and influenza virus infections in this region,and the positive rate was 12.77%and 14.39%,respectively.In 429 throat swab samples with positive pathogens,Mycoplasma pneumoniae was mainly detected in autumn and adenovirus was mainly detected in spring.There were significant differences in the detection age distribution of Haemophilus influenzae,Streptococcus pneumoniae,rhinovirus,Mycoplasma pneumoniae,adenovirus and human metapulmonary virus(all P<0.05).Among them,the Streptococcus pneumoniae detection rate was the highest in people aged 65 years and above.The detection rates of Haemophilus influenzae and Mycoplasma pneumoniae were the highest in people aged 5-<18 years.And the detection rates of rhinovirus,adenovirus and human metapulmonary virus were the highest in children under 5 years old.There was no significant difference in the detection age distribution of Pseudomonas aeruginosa,Staphylococcus aureus and Klebsiella pneumoniae.There was no significant difference in the etiology of infection between different genders.Two valid sequences of Mycoplasma pneumoniae were obtained by gene sequencing,and they were homologous after analysis.Two valid sequences of adenovirus were obtained without homology.Conclusions There were 22 kinds of respiratory pathogens in the region from 2021 to 2023,which indicated that the prevention and control work should be strengthened and focused on the local acute respiratory infectious diseases caused by coronavirus,influenza virus,Haemophilus influenzae,Streptococcus pneumoniae,Pseudomonas aeruginosa,adenovirus,Mycoplasma pneumoniae and pertussis,especially influenza virus and adenovirus infections in winter and Mycoplasma pneumoniae infection in autumn.
作者
高小洁
彭沛
张涛
胡杰
张梅
刘陈欣
毕成金
张丹宜
吴华英
贾勇
颜雯雯
GAO Xiaojie;PENG Pei;ZHANG Tao;HU Jie;ZHANG Mei;LIU Chenxin;BI Chengjin;ZHANG Danyi;WU Huaying;JIA Yong;YAN Wenwen(Ziyang Center for Disease Control and Prevention,Ziyang 641300,Sichuan Province,China)
出处
《预防医学情报杂志》
2025年第12期1664-1671,1680,共9页
Journal of Preventive Medicine Information
基金
资阳市科技计划项目(项目编号:Zykjjsc20-yyjc-2022-01)。
关键词
急性呼吸道感染
病原谱
多重实时荧光PCR
基因测序
acute respiratory tractinfection
pathogen spectrum
multiplexreal-timefluorescentPCR
gene sequencing
