2023年湖北省某妇幼保健院住院儿童呼吸道腺病毒感染流行病学及临床特征

Epidemiological and clinical characteristics of respiratory adenovirus infection in hospitalized children of a maternal and child health hospital in Hubei Province in 2023

    摘要
  • 摘要:
    目的 分析住院儿童呼吸道腺病毒(ADV)感染的分型、临床及流行病学特征，为呼吸道ADV的防治提供科学依据。
    方法 收集湖北省妇幼保健院2023年1月-2023年12月15 315例住院患儿呼吸道样本，采用病原体靶向高通量测序技术(tNGS)/多重呼吸道病毒检测试剂盒对呼吸道病原体进行检测；回顾性分析患者的临床和实验室特征、ADV分型及流行病学特征。
    结果 15 315份样本中436份被确定为ADV阳性，总检出率为2.85%，夏季是ADV呼吸道感染的高发季节，检出人数达峰值1.46%(224/15 315)，春、秋、冬季节检出率(0.43%、0.41%、0.54%)。2~ < 6岁儿童检出率最高(3.24%，247/7 621)，不同年龄段患儿ADV检出率差异具有统计学意义(P < 0.05)。436份样本中包含4个种(B、C、D、E)以及7个型别(ADV-1~7)。ADV-B3和ADV-B7亚型是占比最多的基因型占据了总体的73.62%。ADV阳性患儿的主要临床症状为咳嗽、发烧、扁桃体肿大伴脓性分泌物、腹痛。436例ADV阳性住院患儿中，296例(67.89%)为ADV单一感染，140例(32.11%)为合并其他呼吸道病原体感染。混合感染组患儿发热、高热、热程、咳嗽、呼吸短促、轻、重度肺炎比例以及住院时间高于单一感染组(P < 0.05)。
    结论 ADV检出率与年龄和季节有关，常见临床表现为咳嗽、发热、扁桃体肿大伴脓性渗出及腹痛；ADV-3和ADV-7是诊断为呼吸道感染儿童中最常见的检测类型。

     

    Abstract:
    OBJECTIVE To analyze the subtyping, clinical and epidemiological characteristics of respiratory adenovirus (ADV) infections in hospitalized children, and to provide a scientific basis for the prevention and treatment of respiratory ADV infections.
    METHODS Respiratory samples from 15, 315 hospitalized children in Hubei Maternal and Child Health Care Hospital from Jan. to Dec. 2023 were collected. Pathogen-targeted high-throughput sequencing technology (tNGS)/multiplex respiratory virus detection kits were used to detect respiratory pathogens in the samples. A retrospective analysis was conducted on the clinical and laboratory characteristics of the patients, as well as the subtypes and epidemiological features of adenovirus (ADV).
    RESULTS Of the 15, 315 samples, 436 were confirmed to be ADV-positive, with an overall detection rate of 2.85%. Summer was the peak season for ADV respiratory infections, with the highest detection rate of 1.46% (224/15, 315). The detection rates in spring, autumn and winter were 0.43%, 0.41% and 0.54%, respectively. The detection rate was highest among children aged 2 to < 6 years (3.24%, 247/7, 621). The ADV detection rates differed significantly among different age groups (P < 0.05). The 436 samples contained 4 species (B, C, D and E) and 7 serotypes (ADV-1 ~7), and the ADV-B3 and ADV-B7 subtypes accounted for the majority of genotypes, accounting for 73.62% of the total. The main clinical symptoms of ADV-positive children were cough, fever, tonsillar enlargement with purulent secretions and abdominal pain. Among the 436 ADV-positive hospitalized children, 296 (67.89%) had single ADV infection, while 140 (32.11%) had co-infection with other respiratory pathogens. Children in the coinfection group had higher proportions of fever, high fever, fever duration, cough, shortness of breath, mild to severe pneumonia and longer hospital stays compared to the single infection group (P < 0.05).
    CONCLUSIONS The detection rate of ADV is associated with age and season. Common clinical manifestations are cough, fever, tonsillar enlargement with purulent exudates and abdominal pain. ADV-3 and ADV-7 are the most commonly detected types in children diagnosed with respiratory infections.

     

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