台州地区2378例流感样病例呼吸道感染病毒病原学分析
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摘要
目的了解台州地区流感样病例(ILI)呼吸道病毒的病原特征及流行趋势,为临床诊疗和防控策略的制订提供病原学依据。方法采用多重实时荧光定量RT-PCR法同时检测2 378份咽拭子标本人流感病毒、呼吸道合胞病毒、腺病毒、副流感病毒、鼻病毒、人偏肺病毒、人博卡病毒、人冠状病毒等常见呼吸道病毒核酸并分析。结果 2 378份标本中共检出阳性标本644份,流感病毒检出率最高,其次为鼻病毒;台州地区各年龄段患者流感病毒、鼻病毒、人偏肺病毒、副流感病毒3型、呼吸道合胞病毒以及人偏肺病毒的阳性率有显著差异,且病毒流行呈现一定的季节性。结论台州地区流感样病例呼吸道病毒感染以流感病毒和鼻病毒为主,并呈现季节性和年龄段偏好性。快速发现呼吸道感染的病原体,不仅对流感样病例的早期诊断有指导价值,同时可以为掌握疾病的流行特征提供依据。
Objective To understand the pathogenic characteristics and epidemic trends of respiratory viruses among influenza-like illness(ILI) cases in Taizhou, so as to provide etiological basis for clinical diagnosis, treatment and control strategies. Methods Multiple real-time RT-PCR was applied to simultaneously detect 2 378 throat swab specimens. Human influenza virus, respiratory syncytial virus, adenovirus, parainfluenza virus, rhinovirus, human metapneumovirus, human Boca virus and human coronavirus were analyzed. Results Totally, 644 positive results were detected among 2 378 samples, with the highest positive rate of influenza virus, followed by rhinovirus. The positive rates of influenza virus, hRV, hMPV, PIV3, RSV and hBoV viruses in different age groups in Taizhou were significantly different, but the virus epidemic showed a certain seasonality. Conclusion Respiratory virus infection in ILI cases in Taizhou were mainly influenza and rhinoviruses, showing seasonality and age preference. The rapid discovery of respiratory infection pathogens not only had guiding value for the early diagnosis of influenza-like cases, but also provided a basis for mastering the epidemiological characteristics of the disease.
Objective To understand the pathogenic characteristics and epidemic trends of respiratory viruses among influenza-like illness(ILI) cases in Taizhou, so as to provide etiological basis for clinical diagnosis, treatment and control strategies. Methods Multiple real-time RT-PCR was applied to simultaneously detect 2 378 throat swab specimens. Human influenza virus, respiratory syncytial virus, adenovirus, parainfluenza virus, rhinovirus, human metapneumovirus, human Boca virus and human coronavirus were analyzed. Results Totally, 644 positive results were detected among 2 378 samples, with the highest positive rate of influenza virus, followed by rhinovirus. The positive rates of influenza virus, hRV, hMPV, PIV3, RSV and hBoV viruses in different age groups in Taizhou were significantly different, but the virus epidemic showed a certain seasonality. Conclusion Respiratory virus infection in ILI cases in Taizhou were mainly influenza and rhinoviruses, showing seasonality and age preference. The rapid discovery of respiratory infection pathogens not only had guiding value for the early diagnosis of influenza-like cases, but also provided a basis for mastering the epidemiological characteristics of the disease.
引文
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[7] 杨丽华, 张清慧, 吴毅凌, 等. 上海市松江地区急性上呼吸道感染患儿呼吸道病毒感染研究[J]. 国际病毒学杂志, 2017, 24(6): 388-393.
[8] Kodani M, Yang G, Conklin LM, et al. Application of TaqMan low-density arrays for simultaneous det-ection of multiple respiratory pathogens[J]. J Clin Microbiol, 2011, 49(6): 2175-2182.
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[11] 常玥, 翁坚, 张宗祥, 等. 2010-2013年浙江省台州市监测哨点医院流行性感冒流行特征分析[J]. 疾病监测, 2014, 29(11): 888-892.
[12] Morikawa S, Hiroi S, Kase T. Detection of respiratory viruses in gargle specimens of healthy children[J]. J Clin Virol, 2015, 64: 59-63.
[13] 陈鲲, 郑威. 武汉市青山区呼吸道疾病患者病原学及流行病学研究[J]. 中国预防医学杂志, 2016, 17(6): 472-474.
[14] Nascimento AC, Vilas AL, Fontoura MH, et al. Respiratory viruses among children with non-severe community-acquired pneumonia: A prospective cohort study[J]. J Clin Virol, 2018, 105: 77-83.
[15] 刘营, 宋绍霞, 王伟, 等. 济南市社区居民急性上呼吸道感染与流感样病例发病及其疫苗接种情况[J]. 中国预防医学杂志, 2015, 49(12): 1032-1035.
[16] 徐文彩, 王珺, 张海艳. 2013-2015年北京市东城区流感样病例暴发疫情流行病学特征分析[J]. 现代预防医学, 2016, 43(10): 1760-1762.
[17] 张辉, 王春娟, 雷超, 等. 2006-2016年西安市学校流感样病例暴发疫情流行病学特征分析[J]. 现代预防医学, 2017, 44(17): 3085-3088.
[18] Cinemre H, Karacer C, Yücel M, et al. Viral etiology in adult influenza-like illness/acute respiratory infection and predictivity of C-reactive protein[J]. J Infect Dev Ctries, 2016, 10(7): 741-746.
[19] van Beek J, Veenhoven RH, Bruin JP, et al. Influenza-like illness incidence is not reduced by influenza vaccination in a cohort of older adults, despite effectively reducing laboratory-confirmed influenza virus infections[J]. J Infect Dis, 2017, 216(4): 415-424.
[2] 沈军, 朱启镕, 俞蕙, 等. 急性下呼吸道感染住院儿童病原及临床流行病学分析[J]. 中华传染病杂志, 2009, 27(11): 668-672.
[3] 陈恩富, 谢淑云, 卢亦愚, 等. 浙江首例人禽流感确诊病例流行病学调查[J]. 浙江预防医学, 2007, 19(11): 16-17.
[4] 王丽萍, 曾令佳, 任翔. 中国2013年报告法定传染病发病及死亡特征分析[J]. 中华流行病学杂志, 2015, 36(3): 194-198.
[5] Schnell D, Gits-Muselli M, Canet E, et al. Burden of respiratory viruses in patients with acute respiratory failure[J]. J Med Virol, 2014, 86(7): 1198-1202.
[6] WHO. Antimicrobial resistance[EB/OL](2018-2-15)[2018-6-1]. http://www.who.int/mediacentre/factsheets/fs194/en/.
[7] 杨丽华, 张清慧, 吴毅凌, 等. 上海市松江地区急性上呼吸道感染患儿呼吸道病毒感染研究[J]. 国际病毒学杂志, 2017, 24(6): 388-393.
[8] Kodani M, Yang G, Conklin LM, et al. Application of TaqMan low-density arrays for simultaneous det-ection of multiple respiratory pathogens[J]. J Clin Microbiol, 2011, 49(6): 2175-2182.
[9] 张媛媛. 淮安市儿童急性呼吸道感染病原学分析[J]. 中国现代医学杂志, 2017, 27(23): 95-99.
[10] Huo X, Qin Y, Qi X, et al. Surveilance of 16 respiratory viruses in patients with influenza-like illness in Nanjing, China[J]. J Med Virol, 2012, 84(12): 1980-1984.
[11] 常玥, 翁坚, 张宗祥, 等. 2010-2013年浙江省台州市监测哨点医院流行性感冒流行特征分析[J]. 疾病监测, 2014, 29(11): 888-892.
[12] Morikawa S, Hiroi S, Kase T. Detection of respiratory viruses in gargle specimens of healthy children[J]. J Clin Virol, 2015, 64: 59-63.
[13] 陈鲲, 郑威. 武汉市青山区呼吸道疾病患者病原学及流行病学研究[J]. 中国预防医学杂志, 2016, 17(6): 472-474.
[14] Nascimento AC, Vilas AL, Fontoura MH, et al. Respiratory viruses among children with non-severe community-acquired pneumonia: A prospective cohort study[J]. J Clin Virol, 2018, 105: 77-83.
[15] 刘营, 宋绍霞, 王伟, 等. 济南市社区居民急性上呼吸道感染与流感样病例发病及其疫苗接种情况[J]. 中国预防医学杂志, 2015, 49(12): 1032-1035.
[16] 徐文彩, 王珺, 张海艳. 2013-2015年北京市东城区流感样病例暴发疫情流行病学特征分析[J]. 现代预防医学, 2016, 43(10): 1760-1762.
[17] 张辉, 王春娟, 雷超, 等. 2006-2016年西安市学校流感样病例暴发疫情流行病学特征分析[J]. 现代预防医学, 2017, 44(17): 3085-3088.
[18] Cinemre H, Karacer C, Yücel M, et al. Viral etiology in adult influenza-like illness/acute respiratory infection and predictivity of C-reactive protein[J]. J Infect Dev Ctries, 2016, 10(7): 741-746.
[19] van Beek J, Veenhoven RH, Bruin JP, et al. Influenza-like illness incidence is not reduced by influenza vaccination in a cohort of older adults, despite effectively reducing laboratory-confirmed influenza virus infections[J]. J Infect Dis, 2017, 216(4): 415-424.