目的 探讨苏州地区住院儿童呼吸道感染流感嗜血杆菌（Haemophilus influenzae，HI）的流行特征及其与气候因素和空气污染物的相关性。 方法 收集2016年1月—2019年12月苏州地区空气污染物和气候因子相关检测数据，并与同期7 940例急性呼吸道感染住院患儿呼吸道分泌物细菌培养HI检出情况进行比较，采用逐步回归法分析HI检出率与空气污染物（PM2.5、PM10、NO2、SO2、CO、O3）及气候因素（月平均气温、月平均湿度、月总雨量、月总日照、月平均风速）的相关性。 结果 2016—2019年苏州地区住院儿童HI总检出率为9.26%（735/7 940）。<1岁组和1~<3岁组HI检出率均明显高于≥3岁组，差异有统计学意义（均P<0.01）。春季HI检出率明显高于其他3季，秋季HI检出率明显低于其他3季，差异均有统计学意义（均P<0.001）。多元线性回归分析显示PM10和月平均风速为HI检出率的独立危险因素，其中PM10浓度每增加10 μg/m3，HI检出率增加0.86%；月平均风速每增加1 m/s，HI检出率增加5.64%。空气污染物和气候因素对HI检出率存在滞后效应。 结论 HI是苏州地区住院儿童急性呼吸道感染重要病原体，春季流行；PM10和月平均风速为HI检出率的独立危险因素。
Abstract
Objective To investigate the epidemiological characteristics of respiratory Haemophilus influenzae (HI) infection in children in Suzhou, China and its association with climatic factors and air pollutants. Methods The data on air pollutants and climatic factors in Suzhou from January 2016 to December 2019 were collected. Respiratory secretions were collected from 7 940 children with acute respiratory infection who were hospitalized during this period, and bacterial culture results were analyzed for the detection of HI. A stepwise regression analysis was used to investigate the association of HI detection rate with air pollutants (PM2.5, PM10, NO2, SO2, CO, and O3) and climatic factors (monthly mean temperature, monthly mean humidity, monthly total rainfall, monthly total sunshine duration, and monthly mean wind speed). Results In 2016-2019, the 4-year overall detection rate of HI was 9.26% (735/7 940) among the children in Suzhou. The children aged <1 year and 1-<3 years had a significantly higher HI detection rate than those aged ≥3 years (P<0.01). The detection rate of HI in spring was significantly higher than that in the other three seasons, and the detection rate of HI in autumn was significantly lower than that in the other three seasons (P<0.001). The multiple linear regression analysis showed that PM10 and monthly mean wind speed were independent risk factors for the detection rate of HI: the detection rate of HI was increased by 0.86% for every 10 μg/m3 increase in the concentration of PM10 and was increased by 5.64% for every 1 m/s increase in monthly mean wind speed. Air pollutants and climatic factors had a lag effect on the detection rate of HI. Conclusions HI is an important pathogen for acute respiratory infection in children in Suzhou and is prevalent in spring. PM10 and monthly mean wind speed are independent risk factors for the detection rate of HI.
关键词
呼吸道感染 /
流感嗜血杆菌 /
空气污染物 /
气候因素 /
PM10 /
儿童
Key words
Respiratory infection /
Haemophilus influenzae /
Air pollutant /
Climatic factor /
PM10 /
Child
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参考文献
1 Li ZJ, Zhang HY, Ren LL, et al. Etiological and epidemiological features of acute respiratory infections in China[J]. Nat Commun, 2021, 12(1): 5026. PMID: 34408158. PMCID: PMC8373954. DOI: 10.1038/s41467-021-25120-6.
2 汪倩钰, 李从荣, 郭静, 等. 2016~2018年儿童呼吸道感染病原菌谱与耐药监测[J]. 中国当代儿科杂志, 2019, 21(12): 1182-1187. PMID: 31874656. PMCID: PMC7389001. DOI: 10.7499/j.issn.1008-8830.2019.12.006.
3 王淑会, 季伟, 张新星, 等. 苏州地区14 994例儿童呼吸道感染细菌病原学特点[J]. 中国当代儿科杂志, 2016, 18(1): 44-50. PMID: 26781412. PMCID: PMC7390089. DOI: 10.7499/j.issn.1008-8830.2016.01.010.
4 代子瑞, 邵雪君, 陶云珍, 等. 苏州市区2010-2014年5岁以下儿童流感嗜血杆菌相关社区获得性肺炎的住院率估计[J]. 中华流行病学杂志, 2021, 42(7): 1246-1251. PMID: 34814539. DOI: 10.3760/cma.j.cn112338-20210111-00029.
5 Cleland G, Leung C, Wan Sai Cheong J, et al. Paediatric invasive Haemophilus influenzae in Queensland, Australia, 2002-2011: young indigenous children remain at highest risk[J]. J Paediatr Child Health, 2018, 54(1): 36-41. PMID: 28871608. DOI: 10.1111/jpc.13662.
6 龚松迪, 华春珍, 李建平, 等. 浙江大学医学院附属儿童医院2007-2014年546株流感嗜血杆菌耐药模式及流行特点研究[J]. 中国实用儿科杂志, 2016, 31(12): 915-919. DOI: 10.7504/ek2016120610.
7 胡俊, 王晓蕾, 许峰, 等. 流感嗜血杆菌阳性住院患儿回顾性流行病学调查[J]. 中国当代儿科杂志, 2015, 17(6): 596-601. PMID: 26108322. DOI: 10.7499/j.issn.1008-8830.2015.06.014.
8 张新星, 顾文婧, 陈正荣, 等. 苏州地区儿童呼吸道感染肺炎链球菌流行特点及与空气污染物的相关性[J]. 中华实用儿科临床杂志, 2018, 33(22): 1707-1710. DOI: 10.3760/cma.j.issn.2095-428X.2018.22.007.
9 Zhang S, Chen X, Wang J, et al. Particulate air pollution and respiratory Haemophilus influenzae infection in Mianyang, southwest China[J]. Environ Sci Pollut Res Int, 2021, 28(25): 33158-33164. PMID: 33638077 DOI: 10.1007/s11356-021-13103-5.
10 Adam M, Schikowski T, Carsin AE, et al. Adult lung function and long-term air pollution exposure. ESCAPE: a multicentre cohort study and meta-analysis[J]. Eur Respir J, 2015, 45(1): 38-50. PMID: 25193994. PMCID: PMC4318659. DOI: 10.1183/09031936.00130014.
11 王俊, 徐文帅, 吴秀秀, 等. 空气中粒径小于等于10微米颗粒物对成人哮喘患者肺功能的影响[J]. 中华临床免疫和变态反应杂志, 2017, 11(1): 26-31. DOI: 10.3969/j.issn.1673-8705.2017.01.005.
12 Liang Z, Meng Q, Yang Q, et al. Size-specific particulate matter associated with acute lower respiratory infection outpatient visits in children: a counterfactual analysis in Guangzhou, China[J]. Front Public Health, 2021, 9: 789542. PMID: 34926398. PMCID: PMC8674437. DOI: 10.3389/fpubh.2021.789542.
13 Betancourt A, Zapatero A, Pola-Bibian B, et al. Impact of short-term exposure to below recommended PM10 pollution levels on asthma exacerbations[J]. J Investig Allergol Clin Immunol, 2021, 31(5): 439-440. PMID: 33439122. DOI: 10.18176/jiaci.0663.
14 Yitshak-Sade M, Yudovitch D, Novack V, et al. Air pollution and hospitalization for bronchiolitis among young children[J]. Ann Am Thorac Soc, 2017, 14(12): 1796-1802. PMID: 28787174. DOI: 10.1513/AnnalsATS.201703-191OC.
15 Prunicki M, Stell L, Dinakarpandian D, et al. Exposure to NO2, CO, and PM2.5 is linked to regional DNA methylation differences in asthma[J]. Clin Epigenetics, 2018, 10: 2. PMID: 29317916. PMCID: PMC5756438. DOI: 10.1186/s13148-017-0433-4.
16 Kurai J, Watanabe M, Sano H, et al. The effect of seasonal variations in airborne particulate matter on asthma-related airway inflammation in mice[J]. Int J Environ Res Public Health, 2016, 13(6): 579. PMID: 27294946. PMCID: PMC4924036. DOI: 10.3390/ijerph13060579.
17 肖纯凌. 大气PM2.5暴露致呼吸道微生态失衡对呼吸系统损伤相关研究进展[J]. 沈阳医学院学报, 2019, 21(2): 97-101. DOI: 10.16753/j.cnki.1008-2344.2019.02.001.
18 Wang L, Cheng H, Wang D, et al. Airway microbiome is associated with respiratory functions and responses to ambient particulate matter exposure[J]. Ecotoxicol Environ Saf, 2019, 167: 269-277. PMID: 30342360. PMCID: PMC6257984. DOI: 10.1016/j.ecoenv.2018.09.079.
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