２０２３—２０２４ 年西安市某医院儿童呼吸道病原体流行病学特征分析

Objective To investigate the Status and epidemiological characteristics of suspected acute respiratory tract infection (ARIS) in children at The First Affiliated Hospital of Xi'an Jiaotong University from July 2023 to June 2024, so as to provide evidence for the prevention and treatment of children in this area. Methods A total of 12 169 throat swab samples were collected from children with ARIS during this period, including 6 535 male children and 5 634 female children, with an age of M (Q,, Q,,) of 6(3,9) years old. Six types of respiratory pathogens were detected by multiple real-time fluorescence quantitative PCR. The children were grouped aecording to sex and age. Differences among groups were analyzed by X2 test, and epidemic characteristics of respiratory pathogens were explored from the perspectives of time dimension and infection type. Results Among the 12 169 samples, 8 241 were positive for six respiratory pathogens with a positive rate of 67.72% of which 6 823 (56.07%) were detected with Single infection and 1 418 (11.65%) were detected with multiple infection. The detection rate of mycoplasma pneumonia (MP) ranked first (21.81%). Among the six pathogens, only human rhinovirus (HRV) showed statistically significant differences in gender (P = 0.003). There were significant differences in the pathogens detection rate between the age groups (P<0.001), with the highest pathogens detection rate in the 6 — 14 years of age group (72.49%). In terms of monthly pathogen detection rate, there showed Statistical differences between different months (P<0.001); except HRV, which had two peak detection rates throughout the year, the other five pathogens had only one peak detection rate and the peak months were not completely overlapping. The monthly pathogen detection rate in each age group showed a trend consistent with the overall trend, but in all months of the year, adenovirus (ADV) and MP showed higher detection rates in the age group of 3—14 years, while respiratory syncytial virus (RSV) showed higher detection rates in the age group of <3 years. Among 8 241 children infected with respiratory pathogens, the proportion of fifteen types of dual infections showed significant Statistical differences (P<0.001) and ADV + MP co-infection accounted for the highest proportion (4.02%). There were significant differences in the proportion of dual infection types among different age groups. HRV+RSV co-infection was the highest pattern in the <1 year group (1.55%) and the 1 —<3 years group (1.77%). while ADV+MP was the most common type of co-infection in 3 — <6 years group (2.94%) and 6 — 14 years group (5.26%). Conclusion Between 2023 and 2024, the pathogen patterns of respiratory tract infection of children in Xi'an were mainly Single infection type and the detection rate of MP was the highest. With the increase of age, the detection rates of ADV, influenza virus B and MP increased, but RSV decreased. Except HRV, which had two peak detection rates in spring and autumn, the other five pathogens showed a trend of "staggered outbreaks" in winter and spring. While the multiple infection types were mostly dual infection, HRV+RSV co-infection was the dominant infection type in infants «3 years), while ADV+MP co-infection was the dominant infection type in school-age children (3 — 14 years).