目的 了解三门峡地区儿童急性呼吸道感染(ARI)的病毒病原学构成,指导临床诊断与治疗。方法 采集578例ARI住院患儿的鼻咽拭子,采用直接免疫荧光法检测7种病毒即呼吸道合胞病毒(RSV)、腺病毒(ADV)、副流感病毒Ⅰ、Ⅱ、Ⅲ(PIVⅠ～Ⅲ)、流感病毒A、B型(IVA、IVB)。结果 儿童ARI的病毒总检出率为61.59%,混合感染占45.22%。病毒总检出率冬季最高(77.35%)、夏季最低(25.00%)。下呼吸道感染的病毒总检出率高于上呼吸道感染。RSV、PIVⅢ、IVA的检出率位居前三位,分别为30.62%、28.89%、21.97%。RSV及PIVⅢ在秋冬季、下呼吸道感染、3岁以下患儿中检出率较高;IVA在冬季、上呼吸道感染患儿中检出率较高。结论 RSV 、PIVⅢ、IVA是三门峡地区儿童急性呼吸道感染的主要病毒病原。RSV 、PIVⅢ是秋冬季节婴幼儿下呼吸道感染的主要病原;IVA是冬季各年龄患儿上呼吸道感染的主要病原。通过检测儿童ARI的病毒病原,对尽早明确病毒病原,避免滥用抗生素具有重要意义。
Abstract
Objective To understand the viral pathogen of children with acute respiratory infection(ARI) in Sanmenxia,and to provide guidance for direct clinical diagnosis and treatment. Methods Nasopharyngeal swabs were collected from 578 inpatient children diagnosed with ARI,and respiratory syncytial virus (RSV),adenovirus(ADV),parainfluenza virus Ⅰ,Ⅱ,Ⅲ (PIV Ⅰ～Ⅲ),influenza virus A,B (IVA,IVB) were detected by direct immunofluorescence. Results The total positive rate of virus pathogen of children with ARI was 61.59%.45.22% of the positive specimens were mixed infection.The total positive rate of virus pathogen was the highest in winter (77.35%) and the lowest in summer(25.0%).The total virus detection rate of lower respiratory tract infection was higher than that of upper respiratory tract infection.The detection rates of RSV,PIV Ⅲ and IVA ranked the top three,with 30.62%,28.89% and 21.97%,respectively.The detection rates of RSV and PIV Ⅲ were higher in lower respiratory tract infections in children under 3 years of age during the fall and winter.IVA had a higher detection rate in children with upper respiratory tract infection in winter. Conclusions RSV,PIV Ⅲ,IVA are main pathogens of acute respiratory tract infections in children from Sanmenxia area.RSV and PIV Ⅲ are the main pathogens of lower respiratory tract infections in children under 3 years old in autumn and winter.IVA is the main pathogen of upper respiratory tract infection in children of all ages in winter.It is of great significance to early diagnose virus pathogen and to avoid antibiotics abuse to detect viral pathogens in ARI children.
关键词
急性呼吸道感染 /
病毒 /
儿童
Key words
acute respiratory infection /
virus /
children
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参考文献
[1] Bryce J,Boschi-Pinto C,Shihuya K,et al.WHO egtimates of the causes of death in children[J].Lancet,2005,365(9465):1147.
[2] Bicer S,Giray T,Col D,et al.Virological and clinical characterizations of respiratory in fections in hospitalized chidren[J].Ital J Pediatar,2013,39:22.
[3] Yuzaburo I,Naoki S.Epidemiology of virus-induced wheezing/asthm a in children[J].Front Microbiol,2013,4(12):1-5.
[4] Gao R,Cao B,Hu Y,et al.Human infection with a novel avian-origin influenza A(H7N9) virus[J].N Engl J Med,2013,368(20):1888-1897.
[5] Dobbs TD,Barber ZE,Squier WL,et al.Cerebral venous sinus thrombosis complicating traumatic head injury[J].J Clin Neurosci,2012,19(7):1058-1059.
[6] 朱美华,周志刚,温红艳,等.广州地区儿童呼吸道病毒感染流行情况及混合感染调查[J].中国妇幼保健,2013,28(18):2953.
[7] 丁金龙,应群华,楼秀敏.儿童7项呼吸道病毒感染的病原学分析[J].中国卫生检验杂志,2013,23(15):3131-3132.
[8] 吕晓娟,徐丹,陈志敏.杭州地区儿童常见呼吸道病毒感染流行病学特征分析[J].中华流行病学杂志,2008,29(8):847.
[9] 许晶,张蕾,史伟,等.西安市儿童呼吸道病毒感染谱分析[J].中华疾病控制杂志,2015,19(7):663-665.
[10] 李权恒,高文杰,李金英,等.5150例急性下呼吸道感染儿童呼吸道病毒检测结果分析[J].中国当代儿科杂志,2016,18(1):51-52.
[11] 俞涟芳,张晨美,邵媛仙,等.呼吸道病毒感染患儿的临床分析[J].中华医院感染学杂志,2016,26(12):2846-2847.
[12] 朱益飞,张晨美,周招美.小儿急性上呼吸道病毒感染病原学与临床特征研究[J].中华医院感染学杂志,2015,25(23):5473-5474.
[13] Khamis FA,Al-KobaisiMF,Al-Areimi WS,et al.Epidemiology of respiratory virus infections among infants and young children admitted to hospital in Oman[J].Med Virol,2012,84(8):1323.
[14] Mahony JB.Nuclei acid amplification-based diagnosis of respiratory virus infections[J].Expert Rev Anti Infect Ther,2010,8(11):1273-1292.
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