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安徽省2024年急性呼吸道感染病原谱特征分析
Analysis of pathogen spectrum characteristics of acute respiratory infections in Anhui Province in 2024
目的 了解安徽省2024年急性呼吸道感染(ARI)病例主要病原谱特征,为呼吸道感染防控提供依据。方法 收集2024年1—12月安徽省13家哨点医院和7家网络实验室上报的ARI病例资料和多病原检测结果,分析病原谱分布特征。结果 2024年全省共检测ARI病例样本4 129份,总检出率为50.64%(2 091/4 129),其中流感病毒(IFV)、流感嗜血杆菌(H.influenzae)、肺炎链球菌(S.pneumoniae)检出率居前3位,分别为16.54%(664/4 015)、11.30%(450/3 981)、8.52%(343/4 024)。<5岁、5~17岁、18~59岁和≥60岁群体病原体检出率分别为62.71%(723/1 153)、63.08%(745/1 181)、37.14%(387/1 042)和31.34%(236/753),差异有统计学意义(χ2=1 407.19,P<0.001)。不同病例类型(χ2=16.078,P<0.001)和不同样本类型(χ2=4.188,P=0.041)病原体检出率差异均具有统计学意义。IFV、H.influenzae和S.pneumoniae在各个年龄组人群的检出率均相对较高,肺炎克雷伯菌(K.pneumoniae)在≥60岁群体中检出率最高(5.62%,39/694)。ARI病例感染病原体季节特征热图显示,春季(3—5月)S.pneumoniae检出率最高,为34.78%(16/46),夏季(6—8月)和秋季(9—11月)检出率最高均为H.influenzae,分别为17.59%(38/216)、9.61%(212/2 205),冬季(12月至次年2月)IFV检出率最高,为30.49%(472/1 548)。在检出ARI病原体的2 091例病例中,单一感染占71.54%(1 496/2 091),混合感染占28.46%(595/2 091),混合感染中以双重感染为主,占78.32%(466/595),常见的混合感染为H.influenzae分别与IFV和S.pneumoniae的双重感染。结论 2024年安徽省ARI病例感染的病原体主要为IFV、H.influenzae和S.pneumoniae,儿童青少年群体检出率高于成人和老年人群体,2种及以上病原混合感染较为常见。
Objective To understand the main pathogen spectrum characteristics of acute respiratory infection (ARI) cases in Anhui Province in 2024,and to provide evidence for preventing and controlling respiratory infection. Methods The ARI case data and multi-pathogen detection results reported by 13 sentinel hospitals and 7 network laboratories in Anhui Province from January 2024 to December 2024 were collected,and the distribution characteristics of the pathogen spectrum were analyzed. Results A total of 4 129 ARI case samples were tested in Anhui Province in 2024,the overall detection rate was 50.64% (2 091/4 129).The top three pathogens detected were influenza virus (IFV),Haemophilus influenzae (H.influenzae),and Streptococcus pneumoniae (S.pneumoniae),with detection rates of 16.54% (664/4 015),11.30% (450/3 981),and 8.52% (343/4 024),respectively.The detection rates of pathogens in groups aged<5 years,5-17 years,18-59 years,and≥60 years were 62.71% (723/1 153),63.08% (745/1 181),37.14% (387/1 042),and 31.34% (236/753),respectively,with statistically significant differences (χ2=1 407.19,P<0.001).The differences in pathogen detection rates among different case types (χ2=16.078,P<0.001) and different sample types (χ2=4.188,P=0.041) were also statistically significant.The detection rates of IFV,H.influenzae and S.pneumoniae were relatively high in all age groups,and Klebsiella pneumoniae (K.pneumoniae) had the highest detection rate in people≥60 years old (5.62%,39/694).The seasonal characteristic heatmap of pathogens in ARI cases showed that the highest detection rate of S.pneumoniae was in spring (March to May),which was 34.78% (16/46).The highest detection rates in summer (June to August) and autumn (September to November) were both H.influenzae,which were 17.59% (38/216) and 9.61% (212/2 205),respectively.The highest detection rate of IFV was in winter (December to February of the following year),which was 30.49% (472/1 548).Among the 2 091 cases in which ARI pathogens were detected, single infection accounted for 71.54% (1 496/2 091), and mixed infection accounted for 28.46% (595/2 091).Double infection was the main type of mixed infection,accounting for 78.32% (466/595),and common double infections were H.influenzae co-infected with IFV or S.pneumoniae. Conclusion In 2024,the main pathogens detected in ARI cases in Anhui Province are IFV,H.influenzae and S.pneumoniae.The detection rate in children and adolescents is higher than that in adults and the elderly.Mixed infections with two or more pathogens are relatively common.
Acute respiratory infections / Pathogenic spectrum / Analysis of characteristics
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Respiratory syncytial virus (RSV) and human rhinovirus (HRV) are the most common viruses associated with acute respiratory tract infections in infancy. Viral interference is important in understanding respiratory viral circulation and the impact of vaccines.To study viral interference, we evaluated cases of RSV and HRV codetection by polymerase chain reaction in 2 prospective birth cohort studies (the Infant Susceptibility to Pulmonary Infections and Asthma Following RSV Exposure [INSPIRE] study and the Tennessee Children's Respiratory Initiative [TCRI]) and a double-blinded, randomized, controlled trial (MAKI), using adjusted multivariable regression analyses.Among 3263 respiratory tract samples, 24.5% (798) and 37.3% (1216) were RSV and HRV positive, respectively. The odds of HRV infection were significantly lower in RSV-infected infants in all cohorts, with adjusted odds ratios of 0.30 (95% confidence interval [CI],.22-.40 in the INSPIRE study, 0.18 (95% CI,.11-.28) in the TCRI (adjusted for disease severity), and 0.34 (95% CI,.16-.72) in the MAKI trial. HRV infection was significantly more common among infants administered RSV immunoprophylaxis, compared with infants who did not receive immunoprophylaxis (OR, 1.65; 95% CI, 1.65-2.39).A negative association of RSV on HRV codetection was consistently observed across populations, seasons, disease severity, and geographical regions. Suppressing RSV infection by RSV immunoprophylaxis might increase the risk of having HRV infection.© The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
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This investigation aims to understand the role and burden of viral co-infections for acute respiratory illnesses in children. Co-infection can be either viral-viral or viral-bacterial and with new technology there is more information on the role they play on the health of children.With the proliferation of multiplex PCR for rapid diagnosis of multiple viruses as well as innovations on identification of bacterial infections, research has been attempting to discover how these co-infections affect each other and the host. Studies are aiming to discern if the epidemiology of viruses seen at a population level is related to the interaction between different viruses on a host level. Studies are also attempting to discover the burden of morbidity and mortality of these viral-viral co-infections on the pediatric population. It is also becoming important to understand the interplay of certain viruses with specific bacteria and understanding the impact of viral-bacterial co-infections. RSV continues to contribute to a large burden of disease for pediatric patients with acute respiratory illnesses. However, recent literature suggests that viral-viral co-infections do not add to this burden and might, in some cases, be protective of severe disease. Viral-bacterial co-infections, on the other hand, are most likely adding to the burden of morbidity in pediatric patients because of the synergistic way they can infect the nasopharyngeal space. Future research needs to focus on confirming these conclusions as it could affect hospital cohorting, role of molecular testing, and therapeutic interventions.
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