| 牛丹丹,张振,陈霓璇,刘婷婷,李莹莹,吕秋莹,程雁鹏,王洪琳,温莹,邹旋,逯建华,房师松,张新东,陈亿雄,徐仲尧,郭永超,石晓路,陈志高,冯铁建.深圳市冬春季社区儿童反复呼吸道感染病原谱特征及影响因素分析[J].中华流行病学杂志,2026,47(2):346-355 |
| 深圳市冬春季社区儿童反复呼吸道感染病原谱特征及影响因素分析 |
| Pathogen spectrum characteristics and influencing factors of recurrent respiratory infection in children in the Shenzhen community during winter and spring |
| 收稿日期:2025-06-04 出版日期:2026-02-13 |
| DOI：10.3760/cma.j.cn112338-20250604-00371 |
| 中文关键词: 儿童 社区 冬春季 反复呼吸道感染 病原谱 影响因素 |
| 英文关键词: Children Community Winter and spring Recurrent respiratory infections Pathogen spectrum Influencing factor |
| 基金项目:深圳市医学重点学科（公共卫生重点专科）-传染病防控（SZXK064）；深圳市科技计划基础研究重点项目（JCYJ20200109150715644）；深圳市医学研究专项资金（B2404002）；中国医学科学院医学与健康科技创新工程（2022-I2M-CoV19-006）；深圳市“医疗卫生三名工程”（SZSM202211023）；国家自然科学基金（82473754） |
| 作者 | 单位 | E-mail | | 牛丹丹 | 深圳市疾病预防控制中心传染病防控科, 深圳 518055
宝安区疾病预防控制中心流行病与传染病防制部, 深圳 518101 | | | 张振 | 深圳市疾病预防控制中心传染病防控科, 深圳 518055 | | | 陈霓璇 | 深圳市疾病预防控制中心传染病防控科, 深圳 518055 | | | 刘婷婷 | 深圳市疾病预防控制中心传染病防控科, 深圳 518055 | | | 李莹莹 | 深圳市疾病预防控制中心传染病防控科, 深圳 518055 | | | 吕秋莹 | 深圳市疾病预防控制中心传染病防控科, 深圳 518055 | | | 程雁鹏 | 深圳市疾病预防控制中心传染病防控科, 深圳 518055 | | | 王洪琳 | 深圳市疾病预防控制中心传染病防控科, 深圳 518055 | | | 温莹 | 深圳市疾病预防控制中心传染病防控科, 深圳 518055 | | | 邹旋 | 深圳市疾病预防控制中心办公室, 深圳 518055 | | | 逯建华 | 深圳市疾病预防控制中心办公室, 深圳 518055 | | | 房师松 | 深圳市疾病预防控制中心病原微生物检验所, 深圳 518055 | | | 张新东 | 宝安区疾病预防控制中心流行病与传染病防制部, 深圳 518101 | | | 陈亿雄 | 宝安区疾病预防控制中心流行病与传染病防制部, 深圳 518101 | | | 徐仲尧 | 深圳市联合医学科技有限公司, 深圳 518055 | | | 郭永超 | 深圳市联合医学科技有限公司, 深圳 518055 | | | 石晓路 | 深圳市疾病预防控制中心病原微生物检验所, 深圳 518055 | | | 陈志高 | 深圳市疾病预防控制中心传染病防控科, 深圳 518055 | 289210635@qq.com | | 冯铁建 | 深圳市疾病预防控制中心传染病防控科, 深圳 518055
中国医学科学院深圳传染性疾病防控研究中心, 深圳 518055 | |
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| 中文摘要: |
| 目的 了解深圳市冬春季社区儿童反复呼吸道感染的病原谱特征及其影响因素，为制定儿童呼吸道感染疾病相关精准防治策略提供科学依据。方法 2023年10月至2024年4月，采用三阶段分层整群随机抽样方法在深圳市4个区招募<14岁社区儿童开展队列随访，采用结构化问卷开展症状调查并采集咽拭子进行24种常见呼吸道病原体检测，并构建多水平随机截距混合效应模型探讨社区儿童反复呼吸道感染的影响因素。结果 共纳入219名社区儿童，年龄M（Q1，Q3）为9.0（6.0，11.0）岁。社区儿童总呼吸道症状发生率和任意1种呼吸道病原体检出阳性率分别为6.6%（96/1 463）和14.3%（217/1 517），反复呼吸道症状发生率和反复病原体检出阳性率分别为7.2%（15/208）和11.5%（25/218）。城中村儿童反复呼吸道症状发生率高于老旧小区和城市化小区（χ2=14.81，P=0.001）；家中儿童数≥2个或家人反复出现呼吸道症状时，社区儿童反复呼吸道症状发生率较高（χ2=13.03，P<0.001；χ2=16.27，P=0.001）。社区儿童常见检出病原体为鼻病毒（6.9%，105/1 517）、肺炎支原体（2.0%，31/1 517）和腺病毒（1.5%，22/1 517）；其中肺炎链球菌与呼吸道合胞病毒主要在<5岁儿童中检出，肺炎支原体主要在5~13岁儿童中检出；肺炎支原体在12月检出率较高（3.7%，8/219），腺病毒（5.9%，13/219）和肺炎链球菌（5.0%，11/219）在1月检出率较高。家庭-个体二水平模型显示，社区儿童反复呼吸道症状发生呈现较强的家庭聚集性（组内相关系数为0.999），且男孩发生反复呼吸道症状的风险高于女孩（Z=-1.74，P=0.081）。结论 深圳市冬春季社区儿童反复呼吸道感染病原体为鼻病毒和肺炎支原体，且主要受年龄、性别、季节、社区类型和家庭聚集性的影响，其他家庭相关环境因素值得进一步探索。 |
| 英文摘要: |
| Objective To understand the pathogen spectrum characteristics of recurrent respiratory tract infection in children in the Shenzhen community during winter and spring, and to explore the influencing factors, to provide a scientific basis for accurate disease prevention and control strategies. Methods Children under 14 years old were recruited from four districts in Shenzhen for cohort follow-up by a three-stage stratified cluster random sampling method from October 2023 to April 2024. Structured questionnaires were used to conduct symptom surveys, and throat swabs were collected to detect 24 common respiratory pathogens. A multilevel random- intercept mixed-effects model was constructed to examine the factors influencing recurrent respiratory infections in children in the Shenzhen community. Results A total of 219 children in the Shenzhen community were included, with a M(Q1, Q3) age of 9.0 (6.0, 11.0) years. The incidence rate of total respiratory symptoms and the positive detection rate of any respiratory pathogen were 6.6% (96/1 463) and 14.3% (217/1 517), respectively. The incidence rate of recurrent respiratory symptoms and the positive detection rate of recurrent respiratory pathogens were 7.2% (15/208) and 11.5% (25/218), respectively. The incidence rate of recurrent respiratory symptoms in urban villages was higher than that in old and urban communities (χ2=14.81, P=0.001). When the number of children in the family was more than 2, or the family had recurrent respiratory symptoms, the incidence rate of recurrent respiratory symptoms in children was higher (χ2=13.03, P<0.001; χ2=16.27, P=0.001). The common pathogens detected in children in the Shenzhen community were rhinovirus (6.9%, 105/1 517), Mycoplasma pneumoniae (2.0%, 31/1 517), and adenovirus (1.5%, 22/1 517). Streptococcus pneumoniae and respiratory syncytial virus were mainly detected in children under 5 years old, and Mycoplasma pneumoniae was mainly detected in children aged 5-13 years. The detection rate of Mycoplasma pneumoniae was higher in December (3.7%, 8/219), and those of adenovirus (5.9%, 13/219) and Streptococcus pneumoniae (5.0%, 11/219) were higher in January. The family-individual two-level model showed strong family aggregation of recurrent respiratory symptoms in children (intraclass correlation coefficient=0.999), and boys had a higher likelihood of recurrent respiratory symptoms than girls (Z=-1.74, P=0.081). Conclusions Rhinovirus and Mycoplasma pneumoniae were the main pathogens of recurrent respiratory infections in children in the Shenzhen community during winter and spring, and were influenced by age, gender, season, community type, and family aggregation. Other family-related environmental factors deserve further exploration. |
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