摘要
目的分析2024年上海市杨浦区哨点医院急性呼吸道传染病的流行特征及病原谱分布,为传染病精准防控提供科学依据。方法收集2024年1月1日至12月31日上海市杨浦区哨点医院监测采样的门急诊流感样病例(ILI)和住院严重急性呼吸道感染(SARI)病例的临床和实验室数据,通过描述性统计分析急性呼吸道传染病的流行病学特征和病原体季节性流行规律,采用χ^(2)检验和Fisher确切概率法分析组间差异。结果共纳入2514例病例(门急诊ILI患者1360例,住院SARI患者1154例),总体病原体检出率为46.5%(1168/2514);主要临床症状为发热(99.4%,2500/2514)和咳嗽(93.4%,2348/2514)。病原谱分布显示,肺炎支原体(10.3%,259/2514)、腺病毒(7.2%,180/2514)和新型冠状病毒(SARS-CoV-2;6.8%,171/2514)为检出率最高的3种病原体。门急诊ILI患者中,60岁以上老年人病原体检出率最高(61.4%,51/83),以SARS-CoV-2感染为主(38.6%,32/83);住院SARI患者中,>4~15岁儿童病原体检出率最高(46.1%,166/360),以肺炎支原体感染为主(36.9%,133/360)。人冠状病毒HKU1与人冠状病毒NL63共感染(44例,41.9%)、肠道病毒与人鼻病毒共感染(34例,32.4%)是最常见的多重感染组合。季节性流行特征分析表明,腺病毒感染在夏季(5-8月)高发,流感病毒感染在冬季(1-2月和12月)流行,SARS-CoV-2感染在冬春之交(2-3月)和夏季(6-8月)形成双峰,肺炎支原体感染在住院SARI患者中全年持续流行。结论上海市杨浦区2024年急性呼吸道传染病呈现显著年龄与季节差异,建议实施差异化公共卫生防控策略,重点加强15岁及以下儿童腺病毒感染和60岁以上老年人SARS-CoV-2感染的针对性防控以及住院SARI患者肺炎支原体感染的管理。
Objective To analyze the epidemiological characteristics and pathogen spectrum of acute respiratory infections in sentinel hospitals in Yangpu District,Shanghai,2024,and to provide evidence for the development of precise prevention and control strategies.Methods Clinical and laboratory data were collected from outpatient/emergency influenza-like illness(ILI)cases and hospitalized severe acute respiratory infection(SARI)cases in sentinel hospitals of Yangpu District between Jan.1 and Dec.31,2024.Epidemiological characteristics and seasonal epidemic patterns of pathogens of acute respiratory infections were analyzed using descriptive statistics,and intergroup differences were analyzed usingχ^(2)test and Fisher exact test.Results A total of 2514 cases were enrolled,including 1360 outpatient/emergency ILI cases and 1154 hospitalized SARI cases,with an overall pathogen detection rate of 46.5%(1168/2514).The most common clinical manifestations were fever(99.4%,2500/2514)and cough(93.4%,2348/2514).The top 3 pathogens were Mycoplasma pneumoniae(10.3%,259/2514),adenovirus(7.2%,180/2514),and severe acute respiratory syndrome coronavirus 2(SARS-CoV-2;6.8%,171/2514).Among outpatient/emergency ILI cases,the elderly aged>60 years had the highest detection rate of pathogens(61.4%,51/83),with SARS-CoV-2 being the predominant(38.6%,32/83).Among hospitalized SARI cases,children aged>4-15 years had the highest detection rate of pathogens(46.1%,166/360),with Mycoplasma pneumoniae as the primary pathogen(36.9%,133/360).The most common mixed infections were coinfection with human coronavirus HKU1 and human coronavirus NL63(44 cases,41.9%)and coinfection with enterovirus and human rhinovirus(34 cases,32.4%).Seasonal trends showed that adenovirus infection peaked in summer(May to Aug.),influenza virus infection in winter(Jan.to Feb.and Dec.),SARS-CoV-2 infection exhibited bimodal peaks in late winter to spring(Feb.to Mar.)and in summer(Jun.to Aug.),while Mycoplasma pneumoniae infection persisted epidemic throughout the year among hospitalized SARI patients.Conclusion Acute respiratory infections demonstrate distinct age and seasonal variations in Yangpu District,Shanghai,2024.Tailored public health prevention and control interventions should be implemented,including adenovirus infection control for children aged≤15 years and SARS-CoV-2 infection prevention for the elderly aged>60 years,as well as enhancing the management of Mycoplasma pneumoniae infection in hospitalized SARI patients.
作者
乔鹏
方乐天
刘文斌
肖建伟
谢茜茹
柏佳宁
曹广文
QIAO Peng;FANG Letian;LIU Wenbin;XIAO Jianwei;XIE Qianru;BAI Jianing;CAO Guangwen(Yangpu District Center for Disease Control and Prevention(Yangpu District Health Supervision Institute),Shanghai 200090,China;Department of Epidemiology,Faculty of Naval Medicine,Naval Medical University(Second Military Medical University),Shanghai Key Laboratory of Medical Bioprotection,Key Laboratory of Biological Defense,Ministry of Education,Shanghai 200433,China)
出处
《海军军医大学学报》
北大核心
2026年第4期518-525,共8页
Academic Journal of Naval Medical University
基金
上海市公共卫生研究专项面上项目(2024GKM08)
上海市公共卫生重点学科建设项目(GWVI-11.1-0)。
关键词
急性呼吸道传染病
哨点监测
病原谱
流感样病例
严重急性呼吸道感染
acute respiratory tract infection
sentinel surveillance
pathogen spectrum
influenza-like illness
severe acute respiratory infection
