| Upper respiratory tract infection(URTI)refers to the inflammatory reaction caused by various pathogens invading the upper respiratory tract,which is also a common disease in childhood.As a special group of children whose immune system is not fully developed,URTI is more common than Lower respiratory tract infection(LRTI).Despite the high incidence of URTI and the possibility of progression,However,current data on diagnosis and treatment guidelines and expert consensus of simple URTI are updated slowly.Most studies mainly focus on Respiratory tract infection(RTI)or LRTI.Since the outbreak of novel coronavirus,the flow of children has decreased relatively.The infection rate of children with upper respiratory tract infection was also reduced,and the characteristics of pathogen prevalence and its characteristics were changed to more accurately describe the pathogen spectrum in the urban area.Objective:To study the prevalence and characteristics of pathogens in children infected with upper respiratory tract infection in Chengde urban area during the epidemic period,analyze the characteristics of different diseases infected by various pathogens in the upper respiratory tract,summarize and summarize the characteristics of various pathogens,so as to provide reference for clinical work.Methods:Children hospitalized in Chengde Central Hospital from July 2021 to June 2022 who were diagnosed with upper respiratory tract infection were selected as the research objects.A total of 243 cases of children who met the inclusion criteria were collected,of which 234 qualified samples were selected for viral pathogen detection,and 145 qualified samples were selected for bacterial and atypical pathogen detection.Quantitative PCR(q PCR)was used to detect six common viruses in throat swab specimens of all the enrolled children,which were Respiratory syncytial virus A/B(RSV A/B),Human metapneumovirus(h MPV),Adenovirus(AdV),Human bocavirus(HBo V),Influenza A/B virus(Flu A/B),and Human rhinovirus(HRV);Eight kinds of bacteria were detected in 145 qualified specimens collected.Haemophilus influenzae(H.influenzae),Streptococcus pyogenes(S.pyogenes),Klebsiellar pneumonia(K.pneumonia),Escherichiacoli(E.coli),Streptococcus pneumoniae(SP),Staphylococcus aureus(S.aureus),Moraxella catarrhalis(MC),Pseudomonas aeruginosa(P.aeruginosa);And three atypical pathogens detection,respectively Chlamydia pneumoniae(CP),Legionella pneumophila(LP),Mycoplasma pneumoniae(MP).According to the test results,the time of first diagnosis and the age of the children,the types of pathogens and mixed infection of each child were counted,and the clinical manifestations of children with different pathogens were analyzed and summarized.Results:1、A total of 234 samples were selected for viral pathogen detection.The total positive rate of viral pathogens was 47.86%(112/234).The total detection rate of viral pathogens was the highest in April,with a detection rate of 75%(18/24),followed by February,with a detection rate of 66.67%(7/9).The lowest detection rate was 17.39%(4/23)in November,followed by 30.00%(3/10)in October.AdV had the highest detection rate of 33.33%(78/234),and Flu A had the lowest detection rate of 0.43%(1/234).AdV detection rate was the highest in both male and female children.The total positive rate of AdV was 63.20%(79/125)among the 125 specimens from12 months to 36 months of age.The positive samples of viral pathogens were mainly single infection,accounting for 30.77%(72/234).Double infection was most common in h MPV and AdV co-infection,and the infection rate was 36.26%(12/33).AdV combined with HBo V and RSV-A were the most common triple infections,and the detection rate was 42.86%(3/7).2、A total of 145 samples were selected to detect bacterial pathogens,and the overall positive rate was 82.07%(119/145).Bacterial pathogens were detected in all samples in September and October,and the total detection rate was 100.00%.The detection rate of S.aureus was the highest,which was 38.62%(56/145).Klebsiella pneumoniae was detected in only one positive specimen,and its detection rate was the lowest,which was0.69%(1/145).The positive rates of H.influenzae(χ~2=8.640,P<0.05)and P.aeruginosa(χ~2=8.452,P<0.05)showed seasonal differences between groups.The total positive rate was 84.72%(61/72)in 72 samples from 12 months to36 months old,MC was statistically significant in age groups(χ~2=0.000,P<0.05).There was a significant gender difference in the detection rate of H.influenzae(χ~2=3.956,P<0.05),and P.aeruginosa(χ~2=4.816,P=0.028),with statistically significant difference(P<0.05).Bacterial pathogens were mainly single infection,accounting for 37.93%(55/145).The most common co-infection was S.aureus and SP,and the detection rate was 22.73%(10/44).S.aureus combined with SP and MC were more common in triple infection,and the detection rate was 52.94%(9/17).3、Atypical pathogens were consistent with bacterial pathogen specimens.Three atypical pathogens were detected by PCR.The most positive samples were detected in August,with a detection rate of 91.67%(11/12),and the lowest detection rate was in October,with a detection rate of28.57%(2/7).A total of 68 atypical pathogen MP positive specimens were detected,and the detection rate was 46.90%(68/145).The positive rate of CP was 15.17%(22/145).LP was detected in 16 cases,and the detection rate was 11.03%(16/145).The detection rate of MP was the highest in all age groups,and there was a significant difference between the age groups(χ2=0.000,P<0.05).Among them,69 specimens were positive for single infection,including 7 cases of LP infection,with a detection rate of 10.14%(7/69).The detection rate of CP single infection was 15.94%(11/69).There were 51 cases of MP single infection,and the detection rate was 73.91%(51/69).There were 9 cases of CP combined with MP in double infection,and the detection rate was 52.94%(9/17),which was the most common combination.4、Acute upper respiratory tract infection(44.02%,103/234)was the most common pathogen in 234 samples detected by viral pathogens.The clinical manifestations of different disease types were significantly different in white blood cell count(Ζ=21.985,P=0.000),neutrophil percentage(Ζ=24.848,P=0.000),and neutrophil percentage(Ζ=24.848,P=0.000),percentage of lymphocytes(Ζ=29.531,P=0.000),and CRP(Ζ=41.124,P=0.001)were significantly different between the two groups(P<0.05).Only HBo V(χ~2=46.840,P=0.000)and AdV(χ~2=15.570,P=0.004)were statistically significant in different types of clinical diagnosis(P<0.05).Among 145 samples tested for bacterial pathogens and atypical pathogens,acute suppurative tonsillitis and acute upper respiratory tract infection were the most common,accounting for 39.31%(57/145).The clinical manifestations were sore throat(χ2=11.410,P=0.044),tonsil enlargement(χ~2=49.115,P=0.044),and acute upper respiratory tract infection(χ~2=11.410,P=0.044).P=0.000),runny nose(χ~2=14.718,P=0.002)and CRP(χ~2=24.214,P=0.000)were significantly different among different types of diseases(P<0.05).Escherichia coli(χ~2=18.360,P=0.000),H.influenzae(χ~2=16.777,P=0.000),S.aureus(χ~2=28.405,P=0.000),SP(χ~2=6.096,P=0.047),MC(χ~2=19.405,P=0.047),The positive rate of atypical pathogens was only CP(χ~2=9.124,P=0.010),which showed a significant difference between the groups(P<0.05).There were significant differences in the detection rates of5 different viral pathogens in the presence or absence of clinical manifestations of cough(χ~2=3.686,P<0.05),and 6 bacterial pathogens in the presence or absence of clinical manifestations of cough(χ~2=22.430,p<0.05)、enlarged tonsils(χ~2=26.303,P=0.000)and sore throat(χ~2=11.410,P<0.05).Conclusions:1.AdV is the most common viral infection in hospitalized children with upper respiratory tract infection in Chengde city from 2021 to 2022,and most of them occur in summer.Most of the viral infections were single infection,and human metapneumovirus and adenovirus were the most common in mixed infection.2.From 2021 to 2022,the highest detection rate of bacterial infection in hospitalized children with upper respiratory tract infection in Chengde city is S.aureus,followed by H.influenzae and SP.There are seasonal differences between S.aureus and H.influenzae.H.influenzae and P.aeruginosa showed gender differences.Single infection was the most common bacterial infection,and double infection was the most common mixed infection.3.MP has the highest detection rate of atypical pathogen infection in hospitalized children with upper respiratory tract infection in Chengde City from 2021 to 2022.LP has age differences,and MP combined with CP is the most common mixed infection.4.According to the classification of different diseases of URTI,only HBo V and AdV had statistical significance in the clinical diagnosis of different types of URTI.E.coil,H.influenzae,S.aureus,SP and MC had significant differences in the clinical diagnostic categories of URTI.5.According to the classification of pathogens,the detection rates of 5viral pathogens were different between the two groups in the presence or absence of clinical manifestations of cough,and the detection rates of 6bacterial pathogens were different between the two groups in the presence or absence of clinical manifestations of cough、enlarged tonsils and sore throat... |
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