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目的:探讨门诊和住院患儿急性呼吸道感染(ARIs)病毒病原特点和流行特征。方法:选取1 025例门诊和住院ARIs患儿,其中门诊564例,住院461例。采用咽拭子采集或一次性儿童吸疾管吸取咽部分泌物,采用逆转录-聚合酶链反应(RT-PCR)进行病毒核酸检测,分析门诊和住院不同病毒感染的分布特征。结果:检出至少1种病毒588例,总阳性检出率为57.37%。住院患儿病毒检出率为65.94%(304/461),明显高于门诊检出率50.35%(284/564),差异有统计学意义(P<0.01)。住院患儿中检出较高的有呼吸道合胞病毒(RSV)(31.67%)、人鼻病毒(HRV)(23.21%)和副流感病毒(PIV)(17.14%);门诊患儿中检出率较高的有流感病毒(IFV)(10.99%)、腺病毒(ADV)(10.82%)和PIV(10.28%)。2种以上病毒感染检出率达14.54%(149/1 025),住院患儿混合感染率24.51%(113/461)明显高于门诊患儿6.38%(36/564),差异有统计学意义(P<0.01)。住院患儿RSV检出率较高,门诊IFV检出率较高;住院患儿2种以上病毒混合感染明显高于门诊。结论:RSV和病毒混合感染可能增加急性呼吸道感染患儿住院风险。
Objective: To investigate the pathogenicity and epidemiology of acute respiratory infections (ARIs) in outpatients and inpatients. Methods: A total of 1 025 outpatients and hospitalized children with ARIs were selected, including 564 outpatients and 461 hospitalized patients. Pharyngeal secretions were taken by throat swab collection or one-time child suction tube, and the viral nucleic acid was detected by reverse transcription-polymerase chain reaction (RT-PCR). The distribution characteristics of outpatients and inpatients with different viral infections were analyzed. Results: 588 cases of at least one virus were detected, the total positive detection rate was 57.37%. The prevalence of inpatients was 65.94% (304/461), significantly higher than that of outpatients (50.35%, 284/564) (P <0.01). Respiratory syncytial virus (RSV) (31.67%), human rhinovirus (HRV) (23.21%) and parainfluenza virus (PIV) (17.14%) were higher in hospitalized children; Higher rates were influenza virus (IFV) (10.99%), adenovirus (ADV) (10.82%) and PIV (10.28%). The detection rate of two or more virus infections was 14.54% (149/1 025). The prevalence of mixed infection in hospitalized children was significantly higher than that of outpatients (24.51%, 113/461, 6.38%, 36/564) (P <0.01). The prevalence of RSV in hospitalized children was higher, and the detection rate of outpatient IFV was higher. The mixed infection rate of 2 or more inpatients was significantly higher than that of outpatients. Conclusions: Combined RSV and virus infection may increase hospitalization risk in children with acute respiratory infection.