2024－2025年常州5岁以下儿童下呼吸道感染病原学及RSV亚型分布

Epidemiological characteristics of pathogen spectrum of lower respiratory tract infection and RSV subtypes in children under five years old in Changzhou from 2024 to 2025

    摘要
  • 摘要:
    目的  分析2024－2025年常州5岁以下儿童下呼吸道感染病原谱及呼吸道合胞病毒（RSV）亚型的流行特征。
    方法 收集2024年2月－2025年1月于常州市儿童医院呼吸科住院的5岁以内下呼吸道感染患儿的痰液标本，对13种病原进行核酸检测，分析各年龄段患儿、各季节检出病原菌情况。
    结果  2 172例标本病原检出率为81.08%。单一病原检出率为45.49%，混合病原检出率为35.59%，差异有统计学意义（P＜0.001）。细菌性病原检出率为41.94%（911/2 172），非细菌性病原检出率为66.11%（1436/2172），差异有统计学意义（P＜0.001）。非细菌性病原中检出率前三位：RSV、肺炎支原体（MP）、鼻病毒（HRV）。各年龄组的总体病原检出率差异无统计学意义。3～5岁年龄组MP、腺病毒（ADA）、副流感病毒（PIV）检出率较高，1～＜3岁组RSV-A/B、冠状病毒（CoV）、百日咳检出率较高（P＜0.05）。不同季节的呼吸道病原检出率不同，秋冬季病原检出率高于春夏季（P=0.004）。HRV、PIV以秋季流行，RSV、肺炎链球菌以冬春季为主，流感病毒（IFV）冬季多发，ADV、CoV、MP、百日咳夏季检出率较高，流感嗜血杆菌（Hi）春季检出率最高。RSV-B型（81.46%）检出率高于RSV-A型（19.72%），有5例为混合RSV-A、RSV-B感染。
    结论 2024－2025年常州地区儿童下呼吸道感染中RSV、MP、HRV是主要的非细菌性病原体，RSV和百日咳的感染高峰出现在1～＜3岁年龄组，RSV和IFV以冬季流行为主，而MP和ADV则在夏季较为活跃。RSV亚型中RSV-B型占主导地位。

     

    Abstract:
    OBJECTIVE  To analyze the epidemiological characteristics of the pathogen spectrum of lower respiratory tract infection and respiratory syncytial virus (RSV) subtypes in children under 5 years old in Changzhou from 2024 to 2025.
    METHODS  Sputum specimens were collected from children under 5 years old with lower respiratory tract infection admitted to the Respiratory Department of Changzhou Children's Hospital from Feb. 2024 to Jan. 2025. Nucleic acid testing was conducted for 13 pathogens, and the detection rates of pathogenic bacteria in children of different age groups and seasons was analyzed.
    RESULTS  The pathogen detection rate was 81.08% in 2 172 specimens. The detection rate of single pathogens was 45.49%, while that of mixed pathogens was 35.59%, showing a statistically significant difference (P＜0.001). The detection rate of bacterial pathogens was 41.94% (911/2 172), and non-bacterial pathogens was 66.11% (1 436/2 172), with a statistically significant difference (P＜0.001). The top three non-bacterial pathogens in terms of detection rate were RSV, Mycoplasma pneumoniae (MP) and human rhinovirus (HRV). There was no statistically significant difference in the overall pathogen detection rate among different age groups. The detection rates of MP, adenovirus (ADV) and parainfluenza virus (PIV) were higher in the 3−5 years age group, while the detection rates of RSV-A/B, coronavirus (CoV) and pertussis were higher in the 1−＜3 years age group (P＜0.05). The detection rates of respiratory pathogens varied across seasons, with higher rates in autumn and winter than in spring and summer (P=0.004). HRV and PIV were prevalent in autumn, while RSV and Streptococcus pneumoniae were predominant in winter and spring. Influenza virus (IFV) was more common in winter, whereas ADV, CoV, MP and pertussis had higher detection rates in summer. Haemophilus influenzae (Hi) had the highest detection rate in spring. The detection rate of RSV-B (81.46%) was higher than that of RSV-A (19.72%), with 5 cases of mixed RSV-A and RSV-B infection.
    CONCLUSIONS  RSV, MP and HRV are the main non-bacterial pathogens causing lower respiratory tract infection in children in Changzhou from 2024 to 2025. The peak infection periods for RSV and pertussis occur in the 1−＜3 years age group. RSV and IFV are predominantly prevalent in winter, while MP and ADV are more active in summer. Among RSV subtypes, RSV-B is predominant.

     

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