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基于甘肃省哨点医院的 2011-2015 年急性呼吸道感染患者的病毒病因学和流行病学。

Viral etiologies and epidemiology of patients with acute respiratory infections based on sentinel hospitals in Gansu Province, Northwest China, 2011-2015.

机构信息

Institution of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Gansu Province, P.R. China.

Centers' for Disease Control and Prevention, Gansu Province, P.R. China.

出版信息

J Med Virol. 2018 May;90(5):828-835. doi: 10.1002/jmv.25040. Epub 2018 Feb 22.

Abstract

Understanding etiological role and epidemiological profile is needed to improve clinical management and prevention of acute respiratory infections (ARIs). A 5-year prospective study about active surveillance for outpatients and inpatients with ARIs was conducted in Gansu province, China, from January 2011 to November 2015. Respiratory specimens were collected from patients and tested for eight respiratory viruses using polymerase chain reaction (PCR) or reverse transcription polymerase chain reaction (RT-PCR). In this study, 2768 eligible patients with median age of 43 years were enrolled including pneumonia (1368, 49.2%), bronchitis (435, 15.7%), upper respiratory tract infection or URTI (250, 9.0%), and unclassified ARI (715, 25.8%). Overall, 29.2% (808/2768) were positive for any one of eight viruses, of whom 130 cases were identified with two or more viruses. Human rhinovirus (HRV) showed the highest detection rate (8.6%), followed by influenza virus (Flu, 7.3%), respiratory syncytial virus (RSV, 6.1%), human coronavirus (hCoV, 4.3%), human parainfluenza (PIV, 4.0%), adenovirus (ADV, 2.1%), human metapneumovirus (hMPV, 1.6%), and human bocavirus (hBoV, 0.7%). Compared with URTI, RSV was more likely identified in pneumonia (χ  = 12.720, P < 0.001) and hCoV was more commonly associated with bronchitis than pneumonia (χ  = 15.019, P < 0.001). In patients aged less than 5 years, RSV showed the highest detection rate and hCoV was the most frequent virus detected in adults and elderly. The clear epidemical seasons were observed in HRV, Flu, and hCoV infections. These findings could serve as a reference for local health authorities in drawing up further plans to prevent and control ARIs associated with viral etiologies.

摘要

了解病因学作用和流行病学特征对于改善急性呼吸道感染(ARI)的临床管理和预防至关重要。本研究在中国甘肃省进行了一项为期 5 年的前瞻性研究,对门诊和住院 ARI 患者进行主动监测。研究于 2011 年 1 月至 2015 年 11 月期间采集患者的呼吸道标本,采用聚合酶链反应(PCR)或逆转录聚合酶链反应(RT-PCR)检测 8 种呼吸道病毒。本研究共纳入 2768 例符合条件的患者,中位年龄为 43 岁,包括肺炎(1368 例,49.2%)、支气管炎(435 例,15.7%)、上呼吸道感染或 URTI(250 例,9.0%)和未分类 ARI(715 例,25.8%)。总体而言,2768 例患者中 29.2%(808 例)检测到 8 种病毒中的任何一种,其中 130 例为两种或两种以上病毒感染。人鼻病毒(HRV)的检出率最高(8.6%),其次是流感病毒(Flu,7.3%)、呼吸道合胞病毒(RSV,6.1%)、人冠状病毒(hCoV,4.3%)、人副流感病毒(PIV,4.0%)、腺病毒(ADV,2.1%)、人偏肺病毒(hMPV,1.6%)和人博卡病毒(hBoV,0.7%)。与 URTI 相比,RSV 在肺炎中更易被检出(χ ²=12.720,P<0.001),hCoV 更常见于支气管炎而非肺炎(χ ²=15.019,P<0.001)。年龄小于 5 岁的患者中 RSV 检出率最高,而 hCoV 是成人和老年人中最常见的病毒。HRV、Flu 和 hCoV 感染均呈现明确的流行季节。这些发现可为当地卫生部门制定进一步的病毒性呼吸道感染防控计划提供参考。

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