| ObjectiveAcute respiratory infection(ARI)is the most common respiratory disease in children and has attracted widespread attention from the World Health Organization(WHO).In this study,13 kinds of common viral agents causing acute respiratory infection(ARI)were detected by multiple real-time fluorescence polymerase chain reaction(PCR)assay,at the same time,we explored the epidemiological characteristics and development trends of ARI virology.To understand the relationship between the age,sex,season,and site of infection that caused acute respiratory infection(ARI)during the investigation,so that the corresponding department can make a correct diagnosis,establish a reasonable treatment plan and take effective preventive measures.MethodsFrom January 2016 to December 2016,the nasopharyngeal exfoliated cells and secretions collected with throat swabs in children under 14 years of age who were suffering from acute respiratory infection(ARI)and visited the pediatric outpatient department of the Third Affiliated Hospital of Zhengzhou University.Application of multiplex quantitative PCR to detect 13 common viral pathogens of acute respiratory infection(ARI),namely influenza A virus(IFVA),influenza B virus(IFVB),respiratory syncytial virus(RSV),Human parainfluenza virus?-?(HPIV1-4),Rhinovirus(RV),Adenovirus(ADV),human metapneumovirus(HMPV),Coronavirus(COV),human Bocavirus(HBOV)and Enterovirus(EV).At the same time,we reviewed the medical history of all subjects,collected clinical data,and performed statistical analysis.All statistical data were analyzed by SPSS 21.0software,with?=0.05 as the test level.The pairwise comparison between the two groups uses?=0.0167 as the test level.Results1.Detection of acute respiratory infection virusThe total positive detection rate of acute respiratory infection virus was 35.38%(340/961).The highest positive rate was IFV,and the positive rate was 6.45%,in which the detection rate of IFVB was higher than IFVA,and the positive rates were3.95%(38/961)and 2.50%(24/961)respectively.Followed by RV,RSV,and HPIV-3,the positive rates were 4.89%(47/961),4.79%(47/961),and 3.85%(37/961).2.Relationship between viral pathogens and seasons in acute respiratory tract infectionsThe virus detection rate in autumn and winter 2016 was higher than that in spring and summer.The positive rate of RV is highest between September and November.The positive rate of HPIV-3 was higher in January,April,and May.The positive rate of COV was higher in August and September,and RSV was seasonally dependent:the positive rate in autumn and winter increased significantly,and the positive rate in spring decreased gradually.The positive rate of IFVA was highest in late autumn and winter and was not detected in summer.The detection rate of IFVB was highest in January and February,and the positive rate decreased significantly afterwards.The positive rate of ADV in May,August,and September was high,and there was no obvious pattern detected in HMPV in each month.3.Relationship between viral pathogens and age of acute respiratory tract infectionMost viruses have an age-dependent distribution characteristics:The younger the children infected with RV,HPIV-3,COV,RSV and HMPV,the higher the positive rate of virus detection;the higher the age of IFVA and IFVB infection,the higher the positive rate.The positive rate of ADV in each age group did not change much.The positive rate of detection of the virus below 5 years old accounted for90.97%(252/277)of the total detection rate.The positive rate of virus in different age groups was different.The difference in age was statistically significant(?~2=14.344,P=0.001).The positive rate in the~1 year old group was 48.08%(125/260),and the positive rate was higher in the~5 year old group and the 5~year old group.The positive rates of RV,HPIV-3,RSV and HMPV in the~1 year old group were the highest,and the above four virus positive rates were statistically different in age(?~2=6.122,P=0.047;?~2=6.702,P=0.035;?~2=6.913,P=0.032;?~2=6.530,P=0.038).Comparing between age groups,the virus positive rate was higher in the~1 year old group than in the~5 year old group,and the difference was statistically significant(?~2=11.521,P=0.001),and the positive rate of virus in the~1 year old group was higher than the 5~year old group,there was a statistically significant difference between groups(?~2=8.357,P=0.004).The positive rate of RV in the~1 year old group was the highest(7.69%),and the positive rate in the~5year old group was the lowest(3.74%).According to statistics,the positive rate of RV in the~1 year old group was higher than the~5 year old group,and the difference between the groups was statistically significant(?~2=6.007,P=0.014).4.Relationship between viral pathogens and gender in acute respiratory infectionThere was no significant difference in the positive detection rate of male and female viruses.5.Relationship between the pathogens of acute respiratory infection virus and the site of respiratory infectionThe positive rates of HPIV-3,RSV and HMPV in acute lower respiratory infection(ALRI)were higher than in acute upper respiratory infection(AURI).The difference between the two was statistically significant(?~2=7.756,P=0.005;?~2=6.344,P=0.012;?~2=19.202,P=0.000).The positive rate of ADV in AURI was higher than that of ALRI,and the difference between the two was statistically significant.(?~2=3.958,P=0.047).6.Relationship between viral infection of acute respiratory tract infection and co-infectionThe positive rate of co-infection was 6.56%(63/961),and the positive rate of female children(8.65%)was higher than that of males(5.25%),The difference between the two is statistically significant(?~2=4.302,P=0.038).Children with acute respiratory tract infections were detected mainly in the age group below 5years old(90.48%,57/63),of which the positive rate in the~1 year old group(10.38%)was significantly higher than the other two groups(5.09%,5.36%),and the total positive rate was statistically significant(?~2=8.541,P=0.014).Comparisons were made between groups of different ages,The positive rate of co-infection in the~1 year old group was higher than that in the~5 year old group,and the difference between the two groups was statistically significant(?~2=8.063,P=0.005).The positive rate of ALRI with co-infection was higher than that of ALRI.There was no significant difference between the two groups.90.48%of co-infection was double infection,and RSV,ADV,HPIV-3 and RV were the main virus components in the co-infection pattern(78.79%).Conclusion1.The positive rate of acute respiratory infection(ARI)virus in children is related to age,season and respiratory tract infection site.During the investigation,the total positive rate of ARI virus was 35.38%,of which IFV,HPIV-3,RSV and RV were the major viral pathogens of childhood ARI.Children under 5 years of age are high-risk groups of acute respiratory infections.Autumn and winter are the most frequent seasons of acute respiratory infections.The positive rate of HPIV-3,RSV,HMPV in ALRI was higher than that of AURI,and the positive rate of ADV in AURI was higher than that of ALRI.2.The positive rate of co-infection was 6.56%.The positive rate of female children was higher than that of males.Children under 5 years of age were the most frequent age of co-infections.The co-infection pattern was mainly dual infection.RSV,ADV,HPIV-3 and RV were the main virus in the pattern constitutes in co-infections,and RSV is the most common co-infection virus. |
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