Objective: To explore the non-bacterial pathogen distribution, epidemiological characteristics, and clinical features of acute respiratory infections in children in Sichuan Province. Methods: Using a retrospective cohort study method, this study selected hospitalized children diagnosed with acute respiratory infections at West China Second Hospital of Sichuan University from February 2019 to January 2021, and tested 13 pathogens using polymerase chain reaction (PCR)-fragment analysis. The children were divided into infant group (<1 year old), toddler group (1 year old ≤ age <3 years old), preschool group (3 years old ≤ age <6 years old) and school-age group (6 years old ≤ age <18 years old). The distribution of pathogen positive rates, seasonal epidemic characteristics, clinical characteristics, and some laboratory test indicators were analyzed in children. Statistical analysis was performed on the results using SPSS 22.0 software, with count data expressed as percentages and inter group comparisons using SPSS 22.0 software χ2 Inspection. Results: A total of 2 922 pediatric patients were included in this study, with 1 748 (59.8%) positive for pathogens detected. Among them, 1 391 (79.6%) were detected as a single pathogen, and 357 (20.4%) were detected as a mixture of two or more pathogens. The most commonly detected pathogens were rhinovirus (HRV) (39.7%), syncytial virus (RSV) (22.8%), and parainfluenza virus (PIV) (12.5%). Pathogen positivity is more common in children under 6 years old (χ2=146.59, P<0.001), with a slightly higher positivity rate in male children (61.3%, 1 047/1 707) than in female children (57.7%, 701/1 215) (χ2=3.91, P=0.048), and compared with pathogen negative children, positive children are more prone to symptoms such as cough, wheezing, and shortness of breath (χ2=259.15, 366.06, 12.48, P<0.001). The distribution of different pathogens varies among children of different age groups, and HRV is more common in children aged 1-3 and 3-6 years old (χ2=9.74, P<0.001), while RSV is more common in children under 1 year old (χ2=178.63, P<0.001), while mycoplasma pneumoniae (MP) and influenza virus (InfA/B) are less common in children under 1 year old (χ2=92.54, 12.90,22.21, P<0.01). The prevalence of multiple pathogens showed seasonal changes. HRV showed a high prevalence trend in spring and autumn, while the prevalence of RSV infection was mainly seen in autumn and winter festivals. The positive rate of different pathogens after the outbreak of novel coronavirus pneumonia was significantly lower than that before the outbreak (χ2=252.68, P<0.001). Conclusion: The detection rate of non-bacterial respiratory pathogens in children in Sichuan Province from 2019 to 2021 is high, which is prone to symptoms such as cough, wheezing, and shortness of breath, with HRV and RSV being the main types. The positive rate of respiratory pathogens varies among different age groups, genders, and seasons.
目的： 探讨四川地区儿童急性呼吸道感染的非细菌性病原体分布、流行病学特点及临床特征。 方法： 采用回顾性队列研究方法，选取2019年2月至2021年1月期间在四川大学华西第二医院诊断为急性呼吸道感染，并通过聚合酶链反应（PCR）-片段分析法进行13种病原体检测的住院患儿为研究对象，按照年龄分为婴儿组（<1岁）、幼儿组（1岁≤年龄<3岁）、学龄前期儿童组（3岁≤年龄<6岁）和学龄期儿童组（6岁≤年龄<18岁），分析不同患儿的病原体阳性分布及季节流行特点、临床特征、部分实验室检测指标等。采用SPSS 22.0软件进行统计学分析，计数资料以百分比表示，组间比较采用χ2检验。 结果： 本研究共纳入2 922例患儿，检出病原体阳性1 748例（59.8%），其中1 391例（79.6%）为单一病原体检出，357例（20.4%）为2种及2种以上病原体混合检出，病原体检出率排名前三的依次为鼻病毒（HRV）（39.7%）、合胞病毒（RSV）（22.8%）及副流感病毒（PIV）（12.5%）。病原体阳性患儿以<6岁龄多见（1 563例，χ2=146.59，P<0.001），男性患儿阳性率（61.3%，1 047/1 707）略高于女性患儿（57.7%，701/1 215）（χ2=3.91，P=0.048），且与病原体阴性患儿相比，阳性患儿更易出现咳嗽、喘息和气促等症状（χ2=259.15，366.06，12.48，P<0.001）。不同病原体在各年龄组儿童中的分布存在差异，HRV多见于幼儿组和学龄前期儿童组（χ2=9.74，P<0.001），而RSV多见于婴儿组（χ2=178.63，P<0.001），而肺炎支原体（MP）和流感病毒（InfA/B）则少见于<1岁患儿（χ2=92.54，12.90，22.21，P<0.01）。多种病原体流行呈现季节性变化，HRV在春季和秋季呈现较高的流行趋势，而RSV感染流行性主要见于秋、冬季节，多种呼吸道病原体在新型冠状病毒肺炎疫情发生后的阳性率较疫情前明显降低（χ2=252.68，P<0.001）。 结论： 2019—2021年四川地区儿童呼吸道非细菌性病原体检出率高，易引起咳嗽、喘息、气促等症状，其中以HRV和RSV为主，且呼吸道病原体阳性率在不同年龄阶段、性别和季节间存在一定差异。.