| Part I Epidemiological characteristics of eight respiratory pathogens in hospitalized children in Changshu from 2016 to 2018Objective:To understand the distribution of eight pathogens infections:respiratory syncytial virus(RSV),adenovirus(ADV),influenza virus A(IFA),and influenza virus B(IFB),parainfluenza virus 1(PIV1),parainfluenza virus 2(PIV2),parainfluenza virus 3(PIV3)and mycoplasma Pneumoniae(MP).Analyze epidemiological characteristics of above respiratory pathogens infections in hospitalized children in Changshu areaMethods:The clinical characteristics and laboratory data of 5994 children with acute respiratory infection who were admitted to the First People's Hospital of Changshu,Suzhou University from January 2016 to December 2018 were retrospectively analyzed.Clinical epidemiology characteristics of eight common pathogens of respiratory infections:RSV,IFA,IFB,PIVi,PIV2,PIV3,ADV and MP were investigated by chi-square test.Results:(1)Pathogen detection:Of the 5994 hospitalized children,2448 had positive results,and the total positive rate was 40.84%(2448/5994 cases).The positive rate of each pathogen was MP18.18%,RSV13.55%,IFA5.56%,ADV2.77%,IFB2.54%,PIV10.48%,PIV2 0.17%,and PIV3 0.08%.There were 2299cases detected with one pathogen infection and 149 cases with mixed infections,both of which were mixed infections with two pathogens.There was no significant difference in the infection of each pathogen between boys and girls(?2=1.997,P>0.05).The pathogen detection rates in 2016,2017,and 2018 were 36.73%,44.23%,and 46.22%,of which the pathogen detection rates in 2016 were lower than in 2017 and 2018.The difference was statistically significant(?2=36.478,p<0.001).The detection rate of IFA in 2018 was significantly higher than in other years,The difference was statistically significant(?2=23.385,P<0.001).The detection rate of MP in 2016 was lower than that in 2017 and 2018,and the detection rate of pathogens in three years was different(?2=24.422,P<0.001).(2)Age distribution:The highest total detection rate of pathogens in all age groups was 66.52%in infants.the detection rate of pathogens decreased with age(?2=238.669,p<0.01).The detection rate of RSV was the highest in the infant group(38.99%),and decreased with age(?2=615.241,p<0.05).IFA has the highest detection rate in infant group(6.74%)(?2=8.516,P<0.05).IFB was detected in the school-age group with the highest rate of 3.69%(?2=8.936,P<0.05).The detection rate of ADV in preschool group and school-age group was higher than that in infant group(?2=14.619,P<0.05).The differences among the above groups were statistically significant.MP,PIV1,PIV2,and PIV3 were not statistically different in the age group(P>0.05).(3)Seasonal distribution:The pathogen detection rates in the four seasons are all different,with the highest in winter being 63.07%and the lowest in summer being 29.16%(?2=443.614,P<0.001).The highest detection rate of RSV in winter was 28.41%,higher than other seasons,in addition autumn is higher than spring and summer(?2=543.601,P<0.001);the detection of IFA increased significantly in winter,which was 15.35%,and detection rate in spring is higher than that in summer and autumn(?2=491.508,P<0.001);the detection of IFB in spring was higher than the rest Three seasons(?2=178.562,P<0.001);ADV was detected higher in spring and summer than in autumn and winter(?2=87.142,P<0.001);MP was detected higher in summer and autumn than in winter and spring(?2=62.567,P<0.05).The differences among the above groups were statistically significant.(4)Disease distribution:RSV was detected in the diagnosis group of bronchiolitis with the highest rate of 26.67%,which was higher than other diagnosis groups(?2=135.475,P<0.001).IFA has the highest detection rate of 15.91%in acute upper respiratory infection group,which is higher than that in other diagnosis groups,and the detection rate in bronchitis and pneumonia group is higher than that in bronchiolitis group(?2=231.335,P<0.001).The detection rate of IFB in acute upper respiratory tract infection group was higher than that in other diagnosis groups(?2=136.641,p<0.001).The detection rate of PIV1 in acute upper respiratory tract infection group and bronchitis group was higher than that in other groups(?2=36.609,p<0.001).The detection rate of MP in pneumonia diagnosis group was higher than that in other diagnosis groups,up to 22.06%(?2=59.324,p<0.001).The differences among the above groups were statistically significant.(5)Clinical characteristics:The detection rate of RSV in the feverless group was higher than that in the fever group(P<0.001),and the detection rate of IFA,IFB,and ADV in the fever group was higher than that in the feverless group(P<0.001).The detection rate of MP in the coughing group was higher than that in the non-coughing group(P<0.001).The detection rate of RSV and MP in the wheezing group was higher than that in the non-wheezing group(P<0.001).The differences among the above groups were statistically significant.(6)Laboratory inspection:The detection rate of RSV and IFA in WBC?10×109 group is high(p<0.05),while that of MP in WBC>10×109 group is high(p<0.001).The detection rate of RSV and IFB in CRP<8mg/L group was high(p<0.001),while the detection rate of MP in CRP>8 mg/1 group was high(p<0.001).IFA has a higher detection rate in ALT<40U/L(P<0.05),while ADV and MP have a higher detection rate in ALT>40U/L(P<0.001).The detection rate of RSV in CK-MB>24u/l group was high(p<0.001),while the detection rate of IFA and IFB in CK-MB?24U/L group was high(p<0.001).The differences among the above groups were statistically significant.Conclusions:1.MP and RSV are the important pathogens causing ARI in hospitalized children in Changshu.2.RSV susceptible population is infants.Most occur in autumn and winter.Clinical manifestations such as wheezing are easy to occur after RSV infection,which is easy to cause bronchiolitis.3.IFA is popular in winter,IFB is popular in spring,both of which are prone to fever symptoms.4.ADV has a high incidence in spring and summer.Infection is prone to fever and wheezing,and serum ALT is prone to increase.5.Children with MP infection are prone to increase CRP and ALT indexes.Part 2 Study on correlation between respiratory pathogens,climatic factors and PM2.5 in children in ChangshuObjective:To explore the relationship between the detection rate of various pathogens and the meteorological factors such as monthly average temperature,monthly average humidity,monthly total rainfall,monthly average wind speed,and monthly Total sunshine time,as well as air pollution factor PM2.5.The result provide evidence for evidence-based medicine to prevent and treat respiratory infections in children in this area.Methods:Apply to Changshu Meteorological Bureau for relevant data of monthly average temperature,monthly average humidity,total monthly rainfall,monthly average wind speed,monthly sunshine duration and PM2.5 in Changshu area from 2016 to 2018.Pearson or Speraman nonparametric tests were used to analyze the interactions between meteorological factors.Results:The total virus detection rate correlates with the average monthly temperature,the total monthly rainfall,and the total monthly sunshine time(temperature>rainfall>sunlight),and is particularly well correlated with the monthly average temperature,which is negatively correlated(r=-0.843,P<0.001),Which is also negatively correlated with total monthly rainfall and monthly total sunshine duration,but the correlation is weak(r=-0.499,P=0.002;r=-0.381,P=0.022).The total virus detection rate was significantly positively correlated with the monthly average PM2.5(r=0.785,P<0.001).The detection rate of RSV is related to the monthly average temperature,total monthly rainfall,and monthly average sunshine duration,and all are negatively correlated(r=0.800,P<0.001;r=-0.568,P<0.001;r=-0.471,P=0.004),in which the temperature is highly correlated.The detection rate of IFA correlates well with the monthly average temperature,showing a significant negative correlation(r=-0.801,P<0.001),and negative correlation with rainfall and monthly sunshine time(r=-0.397,P=0.016;r=-0.374,P=0.025).The detection rate of IFB was negatively correlated with the monthly average temperature and monthly humidity(r=-0.432,P=0.009;r=-0.478,P=0.003).The detection rate of ADV was weak negatively correlated with wind speed(r=-0.293,P=0.018).The detection rates of PIV1,PIV2,and PIV3 were all negatively correlated with the monthly average temperature(r=-0.382,P=0.021;r=-0.410,P=0.013;r=-0.337,P=0.045).There was no correlation between MP detection rate and various meteorological factors(P>0.05).RSV,IFA,IFB have a good correlation with PM2.5,showing a positive correlation(r=0.697,P<0.001;r=0.662,P<0.001;r=0.432,P=0.09);ADV,PIV1,PIV2,PIV3,and MP There was no correlation between the detection rate and PM2.5(P>0.05).Conclusions:1.The total virus detection rate is related to the monthly average temperature,monthly rainfall,and total sunshine duration(temperature>rainfall>sunlight).2.The RSV detection rate was negatively correlated with the monthly average temperature,monthly total rainfall,and monthly Total sunshine time(temperature>rainfall>sunshine).3.The detection rate of IFA is negatively correlated with the monthly average temperature,the monthly total rainfall,and the monthly Total sunshine time(temperature>rainfall>sunshine).4.RSV,IFA,IFB are positively correlated with PM2.5. |
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