2012―2019年泰州市呼吸道感染性疾病综合监测结果分析

何义林; 张璇; 管沄浩; 李晨; 戴文军; 查杰; 张翔

doi:10.16462/j.cnki.zhjbkz.2021.09.014

2012―2019年泰州市呼吸道感染性疾病综合监测结果分析

doi: 10.16462/j.cnki.zhjbkz.2021.09.014

何义林¹,
张璇⁴,
管沄浩¹,
李晨¹,
戴文军²,
查杰³,
张翔^1, ,

1.
225300 泰州，泰州市疾病预防控制中心综合业务办
2.
225300 泰州，泰州市疾病预防控制中心急性传染病防制科
3.
225300 泰州，泰州市疾病预防控制中心微生物检验科
4.
233000 蚌埠，蚌埠医学院公共卫生学院

何义林和张璇为共同第一作者

基金项目:

泰州市科技支撑计划社会发展项目 TS202038

泰州市科技支撑计划社会发展项目 TS201720

泰州市“311工程”培养对象科研资助项目 RCPY201910

详细信息

通讯作者:
张翔，E-mail: 410176578@qq.com

中图分类号: R56;R181.8
计量
- 文章访问数: 299
- HTML全文浏览量: 187
- PDF下载量: 42
- 被引次数: 0
出版历程
- 收稿日期: 2020-11-27
- 修回日期: 2021-01-28
- 网络出版日期: 2021-10-23
- 刊出日期: 2021-09-10

Analysis of comprehensive surveillance results of respiratory tract infectious diseases in Taizhou, 2012-2019

1.
Integrated Business Management Office, Taizhou Center for Disease Control and Prevention, Taizhou 225300, China
2.
Department for Communicable Disease Control and Prevention, Taizhou Center for Disease Control and Prevention, Taizhou 225300, China
3.
Department of Microbiological Laboratory, Taizhou Center for Disease Control and Prevention, Taizhou 225300, China
4.
School of Public health, Bengbu Medical College, Bengbu 233000, China

HE Yi-lin and ZHANG Xuan contributed equally to this article

Funds:

Social development project of science and technology support plan of Taizhou TS202038

Social development project of science and technology support plan of Taizhou TS201720

Scientific Research Funding Project of Taizhou 311 Project Training Object RCPY201910

More Information

Corresponding author: ZHANG Xiang, E-mail: 410176578@qq.com

摘要

摘要: 目的了解泰州市流感样病例(influenza-like illness, ILI)和严重急性呼吸道感染(severe acute respiratory infection, SARI)病例的流行病学特征，为科学制定防控策略提供依据。方法收集哨点医院ILI病例和SARI病例基本信息并采集咽拭子标本，用PCR法开展13种呼吸道病原体检测，用χ²检验进行统计学分析。结果 2012年4月―2019年12月ILI就诊百分比(ILI%)和SARI就诊百分比(SARI%)分别为7.27%和2.44%，具有秋冬季流行高峰。共检测956例ILI病例和557例SARI病例的标本，二者的病原阳性检出率分别为50.84%(486/956)、39.14%(218/557)。肺炎链球菌(Streptococcus pneumoniae, SP)、流感病毒(influenza virus, Flu)、流感嗜血杆菌(Haemophilus influenzae, HI)、人鼻病毒(Human rhinovirus, HRV)为优势病原体，其检出率分别为14.81%、9.25%、9.39%、7.73%。总混合感染率为30.11%(212/704)，主要为SP合并其他病原体感染。低年龄组病原体检出阳性率高于高年龄组，0~ < 5岁儿童的检出率达34.83%(χ²=54.47, P < 0.001)。冠状病毒(human coronavirus, HCoV)的检出率为2.12%，以HCoV-OC43亚型为主(46.88%)，各亚型季节分布不明显。结论泰州市哨点医院呼吸道综合监测发病呈秋冬季的流行高峰，主要病原体为SP、Flu、HI、HRV，15岁以下年龄组检出率较高，应针对重点人群采取综合性呼吸道疾病防控措施。
- 呼吸道感染 /
- 病原学 /
- 监测 /
- 流行特征
Abstract: Objective To understand the epidemiological characteristics of influenza-like illness (ILI) cases and severe acute respiratory infection (SARI) cases in Taizhou, so as to provide a basis for scientific prevention and control strategies. Methods The basic information of ILI and SARI cases and throat swab specimens were collected from the sentinel hospital and 13 respiratory pathogens were detected by RT-PCR method.χ² test was used as statistical analysis method. Results From April 2012 to December 2019, with epidemic peaks in autumn and winter, the percentages of ILI visits (ILI%) and SARI visits (SARI%) were 7.27% and 2.44%, respectively. Finally, 956 ILI case specimens and 557 SARI case specimens were detected. The positive detection rates of the two types of cases were 50.84% (486/956) and 39.14% (218/557), separately. Streptococcus pneumoniae (SP), influenza virus (Flu), Haemophilus influenzae (HI) and Human rhinovirus (HRV) were the dominant pathogens in Taizhou city from April 2012 to December 2019, and their detection rates were 14.81%, 9.25%, 9.39% and 7.73%, respectively. The total mixed infection rate was 30.11% (212/704), which was mainly caused by SP complicated with other pathogenic infections. The positive rate of pathogen detection in the low-age group was higher than that in the high-age group, and the detection rate of children under 5 years old was 34.83% (χ²=54.47, P < 0.001). The detection rate of human coronavirus (HCoV) was 2.12%, with HCoV-OC43 subtype mainly (46.88%), and each subtype has no obvious seasonal distribution characteristics. Conclusions The incidence of comprehensive respiratory tract surveillance in sentinel hospitals in Taizhou City showed that the peak of the epidemic was in autumn and winter, and SP, Flu, HI, and HRV were main pathogens in this area. In the age group under 15 years old, the detection rate was higher. Comprehensive respiratory disease prevention and control measures should be taken for key populations.
- Respiratory infection /
- Pathogenic /
- Surveillance /
- Epidemic characteristics

HTML全文

图 1 2012―2019年泰州市呼吸道感染性疾病综合监测优势病原体逐月分布

Figure 1. Monthly distribution of dominant pathogens in the comprehensive monitoring of respiratory tract infectious diseases in Taizhou from 2012 to 2019

下载: 全尺寸图片幻灯片

图 2 2012―2019年泰州市冠状病毒及各亚型时间分布

Figure 2. Time distribution of coronavirus and its subtypes in Taizhou from 2012 to 2019

下载: 全尺寸图片幻灯片

表 1 2012―2019年泰州市呼吸道感染性疾病综合监测病原体检出情况分布

Table 1. Distribution of pathogens detected in comprehensive surveillance of respiratory tract infectious diseases in Taizhou from 2012 to 2019

病原体类型	ILI病例		SARI病例
病原体类型	阳性数(例)	检出率(%)	阳性数(例)	检出率(%)
SP	169	17.68	55	9.87
Flu	107	11.19	33	5.92
HI	102	10.70	40	7.18
HRV	92	9.62	25	4.49
ADV	64	6.69	10	1.80
HSV	39	4.08	27	4.85
RSV	29	3.03	20	3.59
PIV	26	2.72	17	3.05
HCoV	25	2.62	7	1.26
HMPV	11	1.15	6	1.08
HBV	9	0.94	6	1.08
MP	9	0.94	33	5.92
CPN	2	0.21	4	0.72
合计	684	71.57	283	50.81

下载: 导出CSV

表 2 2012―2019年泰州市呼吸道感染性疾病综合监测病原体分年度构成(%)

Table 2. Annual composition of pathogens in the comprehensive monitoring of respiratory tract infectious diseases in Taizhou from 2012 to 2019 (%)

病原体类型	2012年	2013年	2014年	2015年	2016年	2017年	2018年	2019年	χ²值^a	P值
Flu	24.68	7.27	33.22	16.20	5.48	4.59	19.44	17.67	0.074	1.000
PIV	6.56	2.77	6.40	11.85	7.08	0.42	2.78	4.43
RSV	0.32	3.82	14.03	17.96	4.49	2.83	13.40	3.50
ADV	2.24	10.56	8.25	7.41	10.51	10.88	2.12	0.72
HRV	15.91	17.27	6.79	5.56	8.60	7.59	12.25	5.68
HMPV	0.64	0.00	5.78	6.85	0.00	2.77	2.94	2.17
HCoV	2.16	3.90	0.00	0.00	3.96	4.95	6.45	0.72
HBV	3.99	0.00	0.00	2.50	0.00	0.85	4.25	1.65
HSV	11.83	2.21	0.00	10.56	11.28	3.19	10.62	5.35
SP	23.19	45.60	10.49	16.76	17.44	40.16	11.52	14.86
HI	6.32	0.56	15.04	1.85	23.84	17.07	12.83	27.78
CPN	1.52	2.21	0.00	2.50	1.22	0.00	0.00	0.00
MP	0.64	3.82	0.00	0.00	6.10	4.69	1.39	15.46
合计	100.00	100.00	100.00	100.00	100.00	100.00	100.00	100.00
注：^a表示χ²值为2012―2019年间进行构成比比较的结果。

下载: 导出CSV

表 3 2012―2019年泰州市呼吸道感染性疾病综合监测病原体分年度构成(%)

Table 3. Annual composition of pathogens in the comprehensive monitoring of respiratory tract infectious diseases in Taizhou from 2012 to 2019 (%)

病原体	年龄组						χ²值	P值
病原体	0~＜5岁(n=700)	5~＜15岁(n=473)	15~＜25岁(n=46)	25~＜60岁(n=122)	≥60岁(n=172)	合计	χ²值	P值
Flu-A	44(6.29)	32(6.77)	3(6.52)	7(5.74)	12(6.98)	98(6.48)	1.48	0.836
Flu-B	10(1.43)	26(5.50)	0(0.00)	2(1.64)	4(2.33)	42(2.78)	19.27	< 0.001
PIV-I	5(0.71)	1(0.21)	2(4.35)	0(0.00)	0(0.00)	8(0.53)	8.26	0.044
PIV-II	1(0.14)	0(0.00)	1(2.17)	0(0.00)	0(0.00)	2(0.13)	7.14	0.098
PIV-III	19(2.71)	4(0.85)	1(2.17)	1(0.82)	3(1.74)	28(1.85)	6.06	0.152
PIV-IV	3(0.43)	2(0.42)	0(0.00)	0(0.00)	0(0.00)	5(0.33)	1.01	1.000
RSV	41(5.86)	6(1.27)	0(0.00)	1(0.23)	1(0.58)	49(3.24)	32.09	< 0.001
ADV	37(5.29)	32(6.77)	2(4.35)	0(0.00)	3(1.74)	74(4.89)	20.52	< 0.001
HRV	75(10.71)	33(6.98)	2(4.35)	2(1.64)	5(2.91)	117(7.73)	25.5	< 0.001
HMPV	9(1.29)	6(1.27)	0(0.00)	0(0.00)	2(1.16)	17(1.12)	1.14	0.863
HCoV	21(3.00)	7(1.48)	1(2.17)	1(0.82)	2(1.16)	32(2.12)	4.49	0.303
HBV	13(1.86)	1(0.21)	0(0.00)	1(0.82)	0(0.00)	15(0.99)	8.77	0.041
HSV	24(3.43)	20(4.23)	2(4.35)	11(9.02)	9(5.23)	66(4.36)	6.79	0.172
SP	124(17.71)	77(16.28)	4(8.70)	9(7.38)	10(5.81)	224(14.81)	23.23	< 0.001
HI	78(11.14)	46(9.73)	2(4.35)	6(4.92)	10(5.81)	142(9.39)	10.52	0.038
CPN	1(0.14)	3(0.63)	0(0.00)	0(0.00)	2(1.16)	6(0.40)	4.65	0.249
MP	22(3.14)	18(3.81)	1(2.17)	1(0.82)	0(0.00)	42(2.78)	14.14	< 0.001
合计	527(34.83)	314(20.75)	23(1.52)	42(2.78)	63(4.16)	969(64.04)	54.47	< 0.001

下载: 导出CSV

表 4 2012―2019年泰州市ILI病例和SARI病例混合感染的主要类型

Table 4. The main types of co-infection of ILI cases and SARI cases in Taizhou from 2012 to 2019

混合感染类型	例数(例)	构成比(%)
SP+HRV	20	9.43
SP+Flu-A	16	7.55
SP+ADV	15	7.08
SP+HI	15	7.08
SP+HSV	7	3.30
SP+HSV+HI	7	3.30
SP+HCoV	7	3.30
SP+HI+Flu-B	5	2.36
其他	120	56.60
合计	212	100.00

下载: 导出CSV

参考文献(11)

[1]	杨娟, 郑亚明, 刘欣欣, 等. 中国哨点监测住院严重急性呼吸道感染病例经济负担分析[J]. 国际病毒学杂志, 2015, 22(6): 361-366. DOI: 10.3760/cma.j.issn.1673-4092.2015.06.001. Yang J, Zheng YM, Liu XX, et al. Analysis on the economic burden of severe acute respiratory infection inpatients from sentinel hospitals in China[J]. Int J Virol, 2015, 22(6): 361-366. DOI: 10.3760/cma.j.issn.1673-4092.2015.06.001.
[2]	顾文超, 唐海丰, 李晓君, 等. 上海市普陀区515例住院严重急性呼吸道感染病例监测结果分析[J]. 职业与健康, 2020, 36(11): 1492-1495. DOI: 10.13329/j.cnki.zyyjk.2020.0395. Gu WC, Tang HF, Li XJ, et al. Analysis on surveillance results of 515 inpatients with severe acute respiratory infection in Putuo District of Shanghai[J]. Occup Heal, 2020, 36(11): 1492-1495. DOI: 10.13329/j.cnki.zyyjk.2020.0395.
[3]	马文瑛, 张慧, 姜中毅, 等. 兰州市2009—2013年住院病例中严重急性呼吸道感染病毒病原学监测研究[J]. 中国病毒病杂志, 2015, 5(4): 281-286. DOI: 10.16505/j.2095-0136.2015.04.011. Ma WY, Zhang H, Jiang ZY, et al. Viral etiology and clinical features of severe acute respiratory infection (SARI) among hospitalized patients in Lanzhou City of China from 2009 to 2013[J]. Chin J Viral Dis, 2015, 5(4): 281-286. DOI: 10.16505/j.2095-0136.2015.04.011.
[4]	唐海丰, 李晓君, 胡焰, 等. 上海市普陀区监测点医院697例急性上呼吸道感染病例监测结果研究[J]. 现代医药卫生, 2020, 36(1): 47-49, 52. DOI: 10.3969/j.issn.1009-5519.2020.01.015. Tang HF, Li XJ, Hu Y, et al. Study on surveillance results of 697 cases of acute upper respiratory tract infection in hospital of Shanghai Putuo District[J]. Mod Med Heal, 2020, 36(1): 47-49, 52. DOI: 10.3969/j.issn.1009-5519.2020.01.015.
[5]	李翔, 方斌, 叶国军, 等. 武汉市2012—2015年发热呼吸道症候群监测病例病毒检测结果分析[J]. 中华疾病控制杂志, 2018, 22(8): 833-836. DOI: 10.16462/j.cnki.zhjbkz.2018.08.017. Li X, Fang B, Ye GJ, et al. Analysis on the detection results of case surveillance of febrile respiratory syndrome in Wuhan City from 2012 to 2015[J]. Chin J Dis Control Prev, 2018, 22(8): 833-836. DOI: 10.16462/j.cnki.zhjbkz.2018.08.017.
[6]	中国疾病预防控制中心. 中国流感疫苗预防接种技术指南(2019—2020)[J]. 中国病毒病杂志, 2019, 9(6): 419-428. DOI: 10.16505/j.2095-0136.2019.0085. Chinese Center for Disease Control and Prevention. Technical guidelines for influenza vaccination in China, 2019-2020[J]. Chin J Viral Dis, 2019, 9(6): 419-428. DOI: 10.16505/j.2095-0136.2019.0085.
[7]	Shooraj F, Mirzaei B, Mousavi SF, et al. Clonal diversity of Haemophilus influenzae carriage isolated from under the age of 6 years children[J]. BMC Res Notes, 2019, 12(1): 565. DOI: 10.1186/s13104-019-4603-7.
[8]	吕志勇, 董方, 宋文琪, 等. 儿童感染肺炎链球菌的血清型和耐药性分析[J]. 中国感染与化疗杂志, 2020, 20(4): 417-422. DOI: 10.16718/j.1009-7708.2020.04.014. Lv ZY, Dong F, Song WQ, et al. Analysis of the serotype distribution and antimicrobial resistance of Streptococcus pneumoniae isolated from children[J]. Chin J Infect Chemother, 2020, 20(4): 417-422. DOI: 10.16718/j.1009-7708.2020.04.014.
[9]	Jacobs SE, Lamson DM, St George K, et al. Human rhinoviruses[J]. Clin Microbiol Rev. 2013, 26(1): 135-162. DOI: 10.1128/CMR.00077-12.
[10]	World Health Organization. WHO COVID-19 Dashboard[EB/OL]. (2020-08)[2020-08-27]. https://covid19.who.int/.
[11]	Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019[J]. N Engl J Med, 2020, 382(8): 727-733. DOI: 10.1056/nejmoa2001017.