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北京地区2023—2024年秋冬季急性呼吸道感染疾病的病原体流行情况分析：以北京协和医院5556例患者为例

Epidemiological Analysis of Pathogens in Acute Respiratory Infections During the 2023—2024 Autumn-Winter Season in Beijing: A Case Series of 5556 Patients at Peking Union Medical College Hospital

    摘要
  • 摘要:
    目的 分析北京地区秋冬季急性呼吸道感染的流行特征，为急性呼吸道感染疾病的防控和诊治提供依据。
    方法 采用便利抽样法，以北京协和医院2023年9月—2024年2月因急性呼吸道感染就诊的患者为研究对象。采集患者鼻咽拭子标本，采用荧光定量PCR法检测6种常见呼吸道病原体包括甲型流感病毒(influenza A virus，FluA)、乙型流感病毒(influenza B virus，FluB)、人鼻病毒(human rhinovirus，HRV)、肺炎支原体(Mycoplasma pneumoniae，MP)、呼吸道合胞病毒(respiratory syncytial virus，RSV)、腺病毒(adenovirus，ADV)和新型冠状病毒感染情况，对病原体感染分布特征进行分析。
    结果 共入选符合标准的患者5556例，6种常见呼吸道病原体总体阳性率为63.7%，单一病原体阳性率为54.0%，2种病原体阳性率为8.9%，3种及以上病原体阳性率为0.7%。整体检出病原体以FluA和RSV为主，阳性率依次为16.1%和15.7%；ADV、MP、HRV和FluB阳性率接近，分别为11.1%、11.1%、10.0%和10.0%。病原体总体阳性率在性别间无显著性差异，但在秋冬季节间(χ2=34.617, P＜0.001)以及儿童、中青年和老年患者间(χ2=422.38, P＜0.001)存在统计学差异。其中，MP(χ2=8.647, P=0.003)、FluA(χ2=131.932, P＜0.001)和HRV(χ2=174.199, P＜0.001)在秋季的阳性率显著高于冬季，而FluB在冬季的阳性率显著高于秋季(χ2=287.894, P＜0.001)；儿童组MP、RSV、HRV和ADV的阳性率均显著高于中青年和老年患者(P均＜0.001)，而FluB在中青年患者中的阳性率则显著高于儿童和老年患者(P均＜0.001)。6种常见呼吸道病原体在新型冠状病毒感染流行时期阳性率明显下降，表现为非同步季节性模式。
    结论 北京地区呼吸道病原体流行情况与年龄、季节有关，需在不同季节、针对不同重点人群开展有针对性的预防措施。

     

    Abstract:
    Objective To analyze the epidemiological characteristics of acute respiratory infections (ARIs) during the autumn-winter season in Beijing, providing evidence for the prevention, control, diagnosis, and treatment of ARIs.
    Methods A convenience sampling method was employed, enrolling patients who visited Peking Union Medical College Hospital (PUMCH) between September 2023 and February 2024 due to ARIs. Nasopharyngeal swabs were collected, and real-time fluorescence quantitative PCR was used to detect six common respiratory pathogensinfluenza A virus (FluA), influenza B virus (FluB), human rhinovirus (HRV), Mycoplasma pneumoniae(MP), respiratory syncytial virus (RSV), and adenovirus(ADV), as well as SARS-CoV-2 infection. The distribution patterns of pathogen infections were analyzed.
    Results A total of 5556 eligible patients were included. The overall positivity rate for the six common respiratory pathogens was 63.7%, with single-pathogen positivity at 54.0%, dual-pathogen positivity at 8.9%, and triple or more pathogen positivity at 0.7%. The predominant pathogens detected were FluA(16.1%) and RSV(15.7%), followed by ADV(11.1%), MP(11.1%), HRV(10.0%), and FluB(10.0%).No significant difference in overall pathogen positivity was observed between genders.However, significant differences were found between autumn and winter(χ2=34.617, P < 0.001) and among pediatric, young/middle-aged, and elderly patients(χ2=422.38, P < 0.001).Specifically, MP(χ2=8.647, P=0.003), FluA(χ2=131.932, P < 0.001), and HRV(χ2=174.199, P < 0.001) exhibited significantly higher positivity rates in autumn than in winter, whereas FluB was more prevalent in winter(χ2=287.894, P < 0.001). In pediatric patients, MP, RSV, HRV, and ADV positivity rates were significantly higher than in young/middle-aged and elderly patients(all P < 0.001), whereas FluB was more common in young/middle-aged patients(both P < 0.001). The positivity rates of the six common respiratory pathogens significantly declined during the SARS-CoV-2 epidemic period, exhibiting an asynchronous seasonal pattern.
    Conclusions The prevalence of respiratory pathogens in Beijing is associated with age and season. Targeted preventive measures should be implemented in different seasons and for key populations.

     

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