摘要
目的分析2023年至2025年青岛地区5岁以下急性呼吸道感染住院患儿呼吸道合胞病毒(respiratory syncytial virus,RSV)感染的流行病学特征。方法采用横断面研究方法,对2023年5月1日至2025年6月30日期间因急性呼吸道感染在青岛市妇女儿童医院住院的5岁以下患儿进行6种呼吸道病原核酸检测。按年龄分为7组(0~28 d、29 d~<6月龄、6~<12月龄、1~<2岁、2~<3岁、3~<4岁、4~<5岁)。采用χ^(2)检验比较组间差异。对3个流行季节感染率峰值比较使用Bonferroni校正(校正后α=0.0167)。结果(1)在16613例患儿中,RSV阳性3280例(19.74%),阳性率居首位;(2)<1岁婴儿占RSV阳性患儿的56.37%(1849/3280),其中0~28 d、29 d~<6月龄和6~<12月龄组阳性率[分别为25.22%(286/1134)、26.66%(1072/4021)和24.92%(491/1970)]高于其他年龄组(χ^(2)=314.20,P<0.001);(3)混合感染率为13.66%(448/3280),主要混合感染病原体为鼻病毒(6.13%,201/3280),以及腺病毒和肺炎支原体(各3.35%,110/3280);(4)流行特征显示,2023年5至7月出现反季节流行(持续≥14周,峰值71.15%),2024年(持续20周,峰值52.55%)和2025年(持续24周,峰值46.49%)回归冬春季流行模式,2023年峰值显著高于后2年(两两比较,P值均<0.0167)。结论5岁以下急性呼吸道感染住院患儿中,RSV是主要病原体,<1岁婴儿特别是新生儿是高危人群;青岛地区RSV流行呈现由反季节高峰向冬春季长期流行的转变特征。
ObjectiveTo analyze the epidemiological characteristics of respiratory syncytial virus(RSV)infections in hospitalized children under five years of age with acute respiratory infections in Qingdao,China,from 2023 to 2025.MethodsThis cross-sectional study enrolled children under five years hospitalized with acute respiratory infections between May 1,2023,and June 30,2025.Nucleic acid testing was performed for six respiratory pathogens.Participants were stratified into seven age groups:0 to 28 days,29 days to<6 months,6 to<12 months,1 to<2 years,2 to<3 years,3 to<4 years,and 4 to<5 years.Intergroup differences were analyzed using Chi-square tests,with Bonferroni correction(adjustedα=0.0167)for peak rate comparisons across three epidemic seasons.ResultsAmong 16613 children,RSV was detected in 3280 cases(19.74%),representing the highest pathogen detection rate.Infants under one year accounted for 56.37%(1849/3280)of RSV-positive cases,with significantly higher positivity rates in the 0-28 days[25.22%(286/1134)],29 days to<6 months[26.66%(1072/4021)],and 6 to<12 months[24.92%(491/1970)]groups compared to other age groups(χ^(2)=314.20,P<0.001).Co-infections occurred in 13.66%(448/3280)of RSV-positive cases,primarily with rhinovirus(6.13%,201/3280),followed by adenovirus and Mycoplasma pneumoniae(3.35%each,110/3280).Epidemiological surveillance revealed an off-season outbreak from May to July 2023(duration≥14 weeks,peak positivity rate 71.15%),while both 2024(20 weeks,peak 52.55%)and 2025(24 weeks,peak 46.49%)exhibited typical winter-spring seasonal patterns.The 2023 peak rate significantly exceeded those of subsequent years(all pairwise P<0.0167).ConclusionRSV is the predominant pathogen among hospitalized children under five years with acute respiratory infections in Qingdao,with infants under one year representing the highest-risk population.The epidemiological pattern demonstrates a transition from post-pandemic off-season outbreaks to prolonged winter-spring epidemics,highlighting the need for continued surveillance and targeted prevention strategies.
作者
袁可
牟文凤
吕朦
杨玉萍
刘秀香
Yuan Ke;Mu Wenfeng;Lyu Meng;Yang Yuping;Liu Xiuxiang(Department of Neonatology,Qingdao Women and Children's Hospital,Qingdao 266000,China;Department of Clinical Laboratory,Qingdao Women and Children's Hospital,Qingdao 266000,China)
出处
《中华围产医学杂志》
北大核心
2025年第12期1035-1041,共7页
Chinese Journal of Perinatal Medicine
基金
青岛市医疗卫生重点学科建设项目。
关键词
呼吸道合胞病毒感染
呼吸道感染
流行病学研究
婴儿
住院病人
Respiratory syncytial virus infections
Respiratory tract infections
Epidemiological studies
Infant
Inpatients
