2012 - 2015年华北地区不同医院环境下急性呼吸道感染患者呼吸道病毒流行率的比较
Comparison of the prevalence of respiratory viruses in patients with acute respiratory infections at different hospital settings in North China, 2012-2015.
作者信息
Yu Jianxing, Xie Zhengde, Zhang Tiegang, Lu Yanqin, Fan Hongwei, Yang Donghong, Bénet Thomas, Vanhems Philippe, Shen Kunling, Huang Fang, Han Jinxiang, Li Taisheng, Gao Zhancheng, Ren Lili, Wang Jianwei
机构信息
MOH Key Laboratory of Systems Biology of Pathogens and Christophe Mérieux Laboratory, IPB, CAMS-Fondation Mérieux, Institute of Pathogen Biology (IPB), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, Beijing, 100730, People's Republic of China.
Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics (Capital Medical University), Ministry of Education, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, No. 56 Nan-li-shi Road, Beijing, 100045, People's Republic of China.
出版信息
BMC Infect Dis. 2018 Feb 8;18(1):72. doi: 10.1186/s12879-018-2982-3.
BACKGROUND
Acute respiratory infections (ARIs) are a great public health challenge globally. The prevalence of respiratory viruses in patients with ARIs attending at different hospital settings is fully undetermined.
METHODS
Laboratory-based surveillance for ARIs was conducted at inpatient and outpatient settings of 11 hospitals in North China. The first 2-5 patients with ARIs were recruited in each hospital weekly from 2012 through 2015. The presence of respiratory viruses was screened by PCR assays. The prevalence of respiratory viruses was determined and compared between patients at different hospital settings.
RESULTS
A total of 3487 hospitalized cases and 6437 outpatients/Emergency Department (ED) patients were enrolled. The most commonly detected viruses in the hospitalized cases were respiratory syncytial virus (RSV, 33.3%) in children less than two years old, adenoviruses (13.0%) in patients 15-34 years old, and influenza viruses (IFVs, 9.6%) in patients ≥65 years. IFVs were the most common virus in outpatient/ED patients across all age groups (22.7%). After controlling for the confounders caused by other viruses and covariates, adenoviruses (adjusted odds ratio [aOR]: 3.97, 99% confidence interval [99% CI]: 2.19-7.20) and RSV (aOR: 2.04, 99% CI: 1.34-3.11) were independently associated with increased hospitalization in children, as well as adenoviruses in adults (aOR: 2.14, 99% CI: 1.19-3.85). Additionally, co-infection of RSV with IFVs was associated with increased hospitalization in children (aOR: 12.20, 99% CI: 2.65-56.18).
CONCLUSIONS
A substantial proportion of ARIs was associated with respiratory viruses in North China. RSV, adenoviruses, and co-infection of RSV and IFVs were more frequent in hospitalized children (or adenoviruses in adults), which might predict the severity of ARIs. Attending clinicians should be more vigilant of these infections.
背景
急性呼吸道感染（ARIs）是全球公共卫生面临的重大挑战。在不同医院环境就诊的急性呼吸道感染患者中呼吸道病毒的流行情况尚未完全明确。
方法
在中国北方11家医院的住院部和门诊部开展基于实验室的急性呼吸道感染监测。2012年至2015年期间，每周在每家医院招募前2至5例急性呼吸道感染患者。通过聚合酶链反应（PCR）检测法筛查呼吸道病毒的存在情况。确定不同医院环境患者中呼吸道病毒的流行情况并进行比较。
结果
共纳入3487例住院病例和6437例门诊/急诊科患者。住院病例中最常检测到的病毒为：2岁以下儿童中的呼吸道合胞病毒（RSV，33.3%）、15至34岁患者中的腺病毒（13.0%）以及65岁及以上患者中的流感病毒（IFV，9.6%）。IFV是所有年龄组门诊/急诊科患者中最常见的病毒（22.7%）。在控制了由其他病毒和协变量引起的混杂因素后，腺病毒（调整优势比[aOR]：3.97，99%置信区间[99%CI]：2.19至7.20）和RSV（aOR：2.04，99%CI：1.34至3.11）与儿童住院率增加独立相关，腺病毒在成人中也如此（aOR：2.14，99%CI：1.19至3.85）。此外，RSV与IFV的合并感染与儿童住院率增加相关（aOR：12.20，99%CI：2.65至56.18）。
结论
在中国北方，相当一部分急性呼吸道感染与呼吸道病毒有关。RSV、腺病毒以及RSV与IFV的合并感染在住院儿童中（或成人中的腺病毒）更为常见，这可能预示着急性呼吸道感染的严重程度。主治医生应对这些感染更加警惕。
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