2013—2018年江西省南昌市重症肺炎病例流行病学特征分析
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摘要
目的分析江西省南昌市重症肺炎病例的流行病学特征,为重症肺炎病例的临床防治提供依据。方法收集2013年4月至2018年3月南昌市重症肺炎病例的呼吸道样本和病例资料,进行病原学和流行病学分析。结果来自17家南昌市医疗机构的261例重症肺炎病例,检出流感病毒核酸阳性81例,阳性检出率为31.03%。其中包括新甲H1(43例)、季H3(13例)、人感染H7N9禽流感(18例)、人感染H10N8禽流感(3例)和乙型流感(4例)。重症肺炎病例主要集中在冬春季(12月至次年5月),男女性别比为1.69∶1。病例年龄最小为1月龄,最大为95岁。21例人感染H7N9/H10N8禽流感病例,病死率33.33%。90.48%(19/21)的病例通过不明原因肺炎监测发现,年龄中位数为69岁,大部分病例有基础性疾病和明确禽类接触史。结论南昌地区重症肺炎病例流感病毒以新甲H1流感病毒流行为主,应及时发现新型流感病毒,坚持监测工作常态化,做好传染病防控工作。
Objective To understand the epidemiological characteristics of severe pneumonia cases in Nanchang, Jiangxi province, and provide evidence for clinical prevention and treatment of severe pneumonia cases. Methods The respiratory samples and clinical data of severe pneumonia cases in Nanchang from April 2013 to March 2018 were collected for the etiological and epidemiological analyses. Results A total of 261 cases of severe pneumonia from 17 medical institutions in Nanchang were detected, in which 81 were detected to be positive for influenza virus nucleic acid(31.03%), including 43 cases of influenza A(H1 N1) pdm09 virus infection, 13 cases of influenza A(H3 N2) virus infection, 18 cases of human infection with avian influenza A(H7 N9) virus, 3 cases of human infection with avian influenza A(H10 N8) virus and 4 cases of influenza B virus infection. The cases mainly occurred in winter and spring(from December to May), and the male to female ratio of the cases was 1.69∶1. The youngest case was 1 month old and the oldest case was 95 years old. Twenty one cases of human infection with H7 N9/H10 N8 viruses were reported in Nanchang during the 5 years with the case fatality rate of 33.33%.Up to 90.48% of the cases(19/21) were detected through the surveillance for unexplained pneumonia. The median age of the cases was 69 years, most cases had underlying diseases and clear history of poultry contact. Conclusion The major influenza virus causing severe pneumonia was influenza A(H1 N1)pdm09 virus in Nanchang. It is necessary to conduct routine surveillance for the timely detection of novel influenza virus and better prevention and control of communicable diseases.
Objective To understand the epidemiological characteristics of severe pneumonia cases in Nanchang, Jiangxi province, and provide evidence for clinical prevention and treatment of severe pneumonia cases. Methods The respiratory samples and clinical data of severe pneumonia cases in Nanchang from April 2013 to March 2018 were collected for the etiological and epidemiological analyses. Results A total of 261 cases of severe pneumonia from 17 medical institutions in Nanchang were detected, in which 81 were detected to be positive for influenza virus nucleic acid(31.03%), including 43 cases of influenza A(H1 N1) pdm09 virus infection, 13 cases of influenza A(H3 N2) virus infection, 18 cases of human infection with avian influenza A(H7 N9) virus, 3 cases of human infection with avian influenza A(H10 N8) virus and 4 cases of influenza B virus infection. The cases mainly occurred in winter and spring(from December to May), and the male to female ratio of the cases was 1.69∶1. The youngest case was 1 month old and the oldest case was 95 years old. Twenty one cases of human infection with H7 N9/H10 N8 viruses were reported in Nanchang during the 5 years with the case fatality rate of 33.33%.Up to 90.48% of the cases(19/21) were detected through the surveillance for unexplained pneumonia. The median age of the cases was 69 years, most cases had underlying diseases and clear history of poultry contact. Conclusion The major influenza virus causing severe pneumonia was influenza A(H1 N1)pdm09 virus in Nanchang. It is necessary to conduct routine surveillance for the timely detection of novel influenza virus and better prevention and control of communicable diseases.
引文
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[8]王镜泉,王瀚炜,羊晶晶.2013-2015年福州市不明原因肺炎监测结果分析[J].应用预防医学,2016,22(5):453-455.DOI:10.3969/j.issn.1673-758X.2016.05.025.Wang JQ,Wang HW,Yang JJ.Analysis of surveillance results of pneumonia in unknown causes in Fuzhou from 2013 to 2015[J].JAppl Prev Med,2016,22(5):453-455.DOI:10.3969/j.issn.1673-758X.2016.05.025.
[9]Lam TT,Pybus OG.Genomic surveillance of avian-origin influenza A viruses causing human disease[J].Genome Med,2018,10:50.DOI:10.1186/s13073-018-0560-3.
[10]Barnes SR,Wansaula Z,Herrick K,et al.Mortality estimates among adult patients with severe acute respiratory infections from two sentinel hospitals in southern Arizona,United States,2010-2014[J].BMC Infect Dis,2018,18:78.DOI:10.1186/s12879-018-2984-1.
[2]Liu SL,Sha JP,Yu Z,et al.Avian influenza virus in pregnancy[J].Rev Med Virol,2016,26(4):268-284.DOI:10.1002/rmv.1884.
[3]American Thoracic Society,Infectious Diseases Society of America.Guidelines for the management of adults with hospitalacquired,ventilator-associated,and healthcare-associated pneumonia[J].Am J Respir Crit Care Med,2005,171(4):388-416.DOI:10.1164/rccm.200405-644ST.
[4]Bui CM,Chughtai AA,Adam DC,et al.An overview of the epidemiology and emergence of influenza A infection in humans over time[J].Arch Public Health,2017,75:15.DOI:10.1186/s13690-017-0182-z.
[5]Chen HY,Yuan H,Gao R,et al.Clinical and epidemiological characteristics of a fatal case of avian influenza A H10N8 virus infection:A descriptive study[J].Lancet,2014,383(9918):714-721.DOI:10.1016/S0140-6736(14)60111-2.
[6]贺凤兰,夏文,周显凤,等.2011-2015年南昌市流感监测哨点医院病原学检测结果分析[J].中国卫生检验杂志,2016,26(18):2679-2681,2685.He FL,Xia W,Zhou XF,et al.Analysis of pathogenic surveillance results for influenza from sentinel hospitals in Nanchang during2011-2015[J].Chin J Health Lab Technol,2016,26(18):2679-2681,2685.
[7]周珺,熊英,李健雄,等.2009-2012年江西省流感病原学监测结果分析[J].中国卫生检验杂志,2014,24(12):1771-1775.Zhou J,Xiong Y,Li JX,et al.Influenza virus surveillance results in Jiangxi from 2009 to 2012[J].Chin J Health Lab Technol,2014,24(12):1771-1775.
[8]王镜泉,王瀚炜,羊晶晶.2013-2015年福州市不明原因肺炎监测结果分析[J].应用预防医学,2016,22(5):453-455.DOI:10.3969/j.issn.1673-758X.2016.05.025.Wang JQ,Wang HW,Yang JJ.Analysis of surveillance results of pneumonia in unknown causes in Fuzhou from 2013 to 2015[J].JAppl Prev Med,2016,22(5):453-455.DOI:10.3969/j.issn.1673-758X.2016.05.025.
[9]Lam TT,Pybus OG.Genomic surveillance of avian-origin influenza A viruses causing human disease[J].Genome Med,2018,10:50.DOI:10.1186/s13073-018-0560-3.
[10]Barnes SR,Wansaula Z,Herrick K,et al.Mortality estimates among adult patients with severe acute respiratory infections from two sentinel hospitals in southern Arizona,United States,2010-2014[J].BMC Infect Dis,2018,18:78.DOI:10.1186/s12879-018-2984-1.
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