2024年-2026年郑州人民医院急性下呼吸道感染患儿病原体检测及其流行病学特征分析

Analysis of Pathogen Detection and Epidemiological Characteristics in Children with Acute Lower Respiratory Tract Infections at Zhengzhou People’s Hospital, 2024–2026

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目的 分析2024年2月至2026年2月郑州人民医院收治的急性下呼吸道感染(ALRTI)患儿的病原体分布情况及其流行病学特征。方法 选取2024年2月—2026年2月于郑州人民医院就诊的193例ALRTI患儿为研究对象,采集患儿咽拭子样本,统计患儿病原体检测结果,比较不同性别、不同年龄段、不同发病季节患儿病原体分布情况。结果 193例患儿中,经病原体检测出阳性患儿165例,总阳性检出率85.49%,检出率最高的前三位为RSV(20.73%)、MP(19.69%)、HRV(15.54%);婴儿期患儿RSV感染占比(44.83%)最高,其次为HRV感染(20.69%),幼儿期患儿RSV、HRV、MP感染占比(17.31%、17.31%、19.23%)均较高,学龄前、学龄期患儿MP感染占比(33.33%、26.32%)最高,婴儿期患儿混合感染占比(6.90%)较低,学龄前患儿混合感染占比(20.00%)较高;春季时,各病原体分布较均衡,HRV、MP、SP感染占比(14.58%、12.50%、14.58%)均较高,夏季、秋季时,MP感染率(31.82%、28.85%)较高,冬季时,RSV感染率(55.10%)较高,四个季节中混合感染患儿占比较接近,其中秋季感染率(17.31%)相对较高。结论 2024年至2026年郑州人民医院收治的急性下呼吸道感染患儿病原体中,RSV、MP为主要病原体,各呼吸道病原体随患儿年龄段、季节变化存在不同发病高峰,临床应结合实际情况早期鉴别病原体,以指导临床制定针对性治疗方案,改善患儿预后。
Objective To analyze the distribution of pathogens and the epidemiological characteristics of children with acute lower respiratory tract infections (ALRTI) admitted to Zhengzhou People’s Hospital from February 2024 to February 2026. Methods: A total of 193 pediatric patients with ALRTI who visited Zhengzhou People’s Hospital between February 2024 and February 2026 were selected as study subjects. Throat swab samples were collected from the patients, and pathogen testing results were compiled to compare the distribution of pathogens across different genders, age groups, and seasons of onset. Results: Among the 193 children, 165 tested positive for pathogens, resulting in an overall positive detection rate of 85.49%. The top three most frequently detected pathogens were RSV (20.73%), MP (19.69%), and HRV (15.54%); RSV infection had the highest prevalence (44.83%) among infants, followed by HRV infection (20.69%). Among preschoolers, the prevalence of RSV, HRV, and MP infections (17.31%, 17.31%, and 19.23%, respectively) was relatively high. MP infections were most common among preschool and school-age children (33.33% and 26.32%, respectively); the proportion of mixed infections was lower among infants (6.90%) but higher among preschoolers (20.00%); In spring, the distribution of pathogens was relatively balanced, with high proportions of HRV, MP, and SP infections (14.58%, 12.50%, and 14.58%, respectively). In summer and fall, the MP infection rate was high (31.82% and 28.85%, respectively). In winter, the RSV infection rate (55.10%) was high. The proportion of children with mixed infections was relatively similar across the four seasons, with a relatively higher infection rate (17.31%) in autumn. Conclusion: Among the pathogens identified in children with acute lower respiratory tract infections admitted to Zhengzhou People’s Hospital from 2024 to 2026, RSV and MP were the primary pathogens. The incidence peaks of various respiratory pathogens varied according to the children’s age groups and seasons. Clinicians should conduct early pathogen identification based on actual conditions to guide the development of targeted treatment plans and improve patient outcomes.
论著

河源市源城区2 468例儿童呼吸道感染病原体核酸检测结果分析

Analysis of nucleic acid detection results of respiratory tract infection pathogens in 2 468 children in Yuancheng District of Heyuan City

:17-21
 
目的 分析不同年龄、不同季节河源市源城区呼吸道感染的病原学情况,指导临床用药。方法 回顾性研究2020年3月—2022年2月2 468例呼吸道感染的住院患儿,取咽部分泌物送广州达安临床检验中心进行呼吸道核酸六项检测并分析结果。包括:肺炎链球菌(Sp)、呼吸道合胞病毒(RSV)、卡他莫拉菌(MC)、流感嗜血杆菌(Hi)、肺炎支原体(LP)、腺病毒(ADV)。结果 (1)2 468例患儿的标本中阳性率52.8%,其中RSV最高,其他依次为Sp、Hi、MC、MP、ADV。而混合感染仅次于RSV。(2)婴儿组和幼儿组以RSV感染为主,在学龄前组和学龄组儿童中,以Sp感染为主,各病原体的混合感染组合很多,一种细菌合并一种病毒多见。(3)秋冬季是河源市源城区呼吸道感染的高发季节,RSV是秋冬季呼吸道感染最主要的病原体。结论 秋冬季节为河源市源城区呼吸道感染的高发季节,RSV为该季节的主要病原体。RSV也是婴幼儿组感染的主要致病菌,随着年龄增大,细菌感染导致的呼吸道疾病逐渐占优势。混合感染在各年龄组中均占比较高,值得临床诊疗的重视。
Objective To analyze the etiology of respiratory tract infection in Yuancheng District of Heyuan City ,which was in different ages and seasons,and to provide guidance of clinical drug usage.Methods Cases of 2 468 hospitalized children with respiratory tract infection from March 2020 to February 2022 were analyzed.The secretion from pharynx was collected and sent to Guangzhou Da’an Clinical Examination Center for six respiratory nucleic acid tests and then the results were analyzed,including Streptococcus pneumoniae(Sp),respiratory syncytial virus(RSV),Moraxella catarrhalis(MC),Haemophilus influenzae(Hi),Mycoplasma pneumonia(MP),adenovirus(ADV).Results The positive rate of 2 468 hospitalized children with respiratory tract infection was 52.8%,of which the highest was RSV,followed by Sp,Hi,MC,MP,ADV.Meanwhile the mixed infection rate was second to RSV.RSV infection was the main infection in infant group and early-aged children group,while in preschool group and school-aged group,Sp infection was the main infection.There were many mixed infection of pathogen,and one bacteria combined with one virus was more common.Respiratory tract infection had high incidence in autumn and winter in Yuancheng District of Heyuan City,RSV was the major pathogen.Conclusions Autumn and winter were the seasons with high respiratory tract infection incidence in Yuancheng District of Heyuan City,and RSV was the main pathogen in these two seasons.RSV was also the main pathogen of infant group infection.But with the increase of children’s age,bacterial infection became the main reason of respiratory tract diseases.Mixed infection accounts for a high proportion in all age groups,which should be valued in clinical diagnosis and treatment.
论著

河源市某综合医院血源性病原体职业暴露调查研究

Occupational exposure survey of blood-borne pathogens in a general hospital in Heyuan City

:1259-1263
 
目的 深入了解河源市某综合医院职业暴露的真实情况,评估健康风险,从而提出有效的控制措施,并提升医院员工的职业防护意识,以保障他们的健康和安全。方法 采用回顾性调查,从暴露类型、环节、病原体种类、职业类别、工龄等方面,对河源市某综合医院在2022—2023年所发生的职业暴露事件进行统计分析。结果 在2022—2023年期间,该综合医院共计发生了93例血源性病原体职业暴露事件,以锐器伤为主,共80例,占86.02%;职业暴露最多的是护理人员,共发生61例,占65.59%;工作人员中工龄≤2年的职业暴露比例最多,共有71例,占76.34%;职业暴露的发生环节主要集中在处理丢弃锐器物以及进行检查、治疗、护理操作的过程中,均为30例,占32.26%;发生职业暴露的原因主要是缺少防护,出现34例,占36.56%;职业暴露主要发生在普通病房,为37例,占39.78%;其次为门急诊,均为15例,占16.13%;职业暴露发生的暴露源传染病病原体种类以不明病原体为主,为36例,占38.70%;其次是乙型肝炎病毒,为32例,占34.40%;所有发生职业暴露的员工均接受了全面的暴露风险评估、合理的预防性用药措施以及定期的健康监测。结论 医院管理部门需加强职业安全培训,特别是针对护理人员和低年资员工,严格执行标准操作规程,提供充足防护用品,改进医疗设备设计,建立完善的监测报告和保障体系,并强化监督和管理,以降低职业暴露风险,保障员工职业安全。
Objective To gain a deep understanding of the actual situation of occupational exposure in a general hospital in Heyuan City, assess health risks, propose effective control measures,and enhance the awareness of occupational protection among hospital staff to safeguard their health and safety. Methods A retrospective study was conducted to statistically analyze the occupational exposure events that occurred in a general hospital in Heyuan City from 2022 to 2023, in terms of exposure types, links, types of pathogens, occupational categories, and years of service. Results During the period from 2022 to 2023, a total of 93 cases of occupational exposure to blood-borne pathogens occurred in the general hospital, with sharp instrument injuries being the most common, accounting for 80 cases(86. 02%); nurses accounted for the majority of occupational exposures, with 61 cases(65. 59%); among the staff, those with a service time ≤ two years had the highest proportion of occupational exposures, with 71 cases(76. 34%); the main occurrence of occupational exposures was in the processes of disposing of discarded sharp instruments and conducting inspections, treatments, and nursing operations, both accounting for 30 cases(32. 26%); the main reason for occupational exposures was lack of protection, with 34 cases(36. 56%); occupational exposures occurred mainly in general wards, with 37 cases(39. 78%), followed by outpatient and emergency departments, both with 15 cases(16. 13%); the types of infectious pathogens exposed in occupational exposures were mainly unknown, with 36 cases(38. 70%), followed by hepatitis B, with 32 cases(34. 40%); all staff who experienced occupational exposures received comprehensive exposure risk assessments,reasonable preventive medication measures, and regular health monitoring. Conclusions Hospital management departments need to enhance occupational safety training, particularly for nursing staff and junior-level employees, strictly enforce standard operating procedures, provide adequate protective equipment, improve medical device design, establish a comprehensive monitoring and reporting system, strengthen supervision, and manage to reduce the risk of occupational exposure and ensure the occupational safety of employees.
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